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2. Northeast Tri County Health District (NETCHD) maintains files of permits for completed on-site sewage systems. To obtain information on a permitted septic system, please complete this form. Searches are done on a first come – first serve basis. We will make every attempt to provide the requester with information within five days of receipt of the application. However, we reserve the right to allow for up to two weeks to respond. Because historical records may have brief legal descriptions and lack parcel numbers, please complete all fields below to assist in locating the correct record. Property information that may help you complete the form can be located at the specific county assessor’s website.

4. Requester Information
6. Type of Information Requested (Check all that apply):

   1. Permit & As-Built

   1. Other
7. If other, please specify:
9. Name
11. Mailing Address
13. City
14. State
15. Zip Code
17. Phone Number
18. Email Address
20. Select Preference to Receive Information

    1. Email
    2. Mail
    3. Pick Up In Office
22. Property Information
    (Please provide as much information as possible)
24. Current Property Owner
26. Property Owner(s) at Time of Install
28. Property Address
29. City
31. County
32. Parcel Number
34. Legal Description
36. Section
37. Township
38. Range
40. Sewage Permit Number
41. Date Installed
    Date Installed
43. Has property been segregated?

    1. Yes
    2. No
44. If yes, segregation date:
    If yes, segregation date:
46. Plat Name and/or Plat Number
48. Submit this application to the Northeast Tri County Health Office where the property is located.
57. NETCHD Contact
    View contact information for the District Offices.
Leave This Blank:


59. 1. Receive an email copy of this form.
60. Email address

    This field is not part of the form submission.

61. Submit

* indicates a required field