Form Center

Information concerning this application and NETCHD findings will be mailed or provided to the primary contact, and septic designer or engineer as appropriate. It will be the responsibility of the primary contact to provide the information to others involved with the project.

In accordance with Chapter 246-272A WAC, this application shall be signed by the property owner, the contract purchaser of the property, or the property owner’s authorized agent. This application is made for the permit to authorize the activities described herein. I certify that I am familiar with the information contained in the application and that to the best of my knowledge, such information is true, complete, and accurate. I certify that I have received and read the permit application instructions and information. I grant permission to allow representatives of the Health Office to enter this property for the purpose of the application evaluation and any subsequent inspections. I understand that requests to be present for inspections must be made at least 72 hours in advance and appointments are scheduled as a multi-hour time slot based on the inspector’s availability. All fees and required paperwork must be received prior to a permit being granted. Fees are non-refundable.

A copy of the most recent tax statement, printout from the county assessor office, or a recorded document (real estate contract, quit claim deed, etc.) verifying property legal description and ownership must be submitted with the permit application. If ownership and legal description verification documents are not submitted, the application will not be processed.

(Rural Description or Lot, Block and Subdivision)

An accurate and detailed site plan must be submitted with the on-site sewage permit application for review. The site plan must show all existing and proposed elements for this project. See site plan instructions and sample site plan for more information.

Provide accurate and detailed directions to the site on a separate document. If there is a driveway or access to the property, it is helpful if this is flagged or marked to help identify the access. Mark or flag the test hole locations if they are not visible from the access to the property.

A site analysis must be completed and paid for prior to test hole review. Please contact your local county Planning Office for more information. Pend Oreille county requires approved site analysis to be submitted with on-site sewage application.