Septic Permit Application

What is the anticipated depth of the lowest floor below natural grade:

Will the proposed construction have (mark all that apply):

If the proposed construction is a single family dwelling, how many bedrooms will the dwelling have (add one bedroom for an unfinished basement and two bedrooms for an accessory dwelling unit):

If the proposed construction will have short term rentals, what is the maximum number of guests allowed:

If the proposed construction is non-residential, what is the anticipated maximum daily wastewater flow (gallons per day):

If a public water system will supply potable water, has a connection been approved for the proposed construction:

If a private well/spring will supply potable water, what is the water right number or date right was applied for:

Please provide any additional explanation that will help us better understand your proposed project:

Please attach a PDF building site plan that is drawn to scale. The site plan file must be able to clearly show the required information details when opened. The following information is required to be on the site plan:

1. Complete address, Parcel identification number, Owner, and Date plans were drawn

2. North Arrow

3. Property line boundaries

4. Access to property from point of connection with publicly maintained road(s)

5. Ground surface contours (topographical) or slope direction/percent arrows

6. Location and explanation of type of dwelling or structure to be served by the septic system

7. Location of utility lines or service points of connection (water, electrical, gas, propane tanks)

8. Location of all intermittent or year-round streams, ditches, watercourses, ponds, subsurface
   drains, etc.

9. Location of all existing and proposed water supply sources. Also include the location of existing
   and proposed water supply sources on neighboring properties within 200 feet of the proposed
   septic system area

10. A general location of the proposed/preferred septic system area and 100% replacement area

11. If public drinking water source protection zone two area(s) are located on the parcel, show the
    area(s)

12. If the property is located within a sewer service boundary, show the location and distance to
    nearest sewer

13. Show any existing easements

14. Show existing structures

Max File Size: 2MB

Or for larger files provide a public link to DropBox, or GoogleDrive, so that we can download your files:

Application Signature

I certify that the information given is true and correct to the best of my knowledge