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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, you must 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 5 days of receipt of the application. However, we reserve the right to allow for up to two weeks to respond. Property information that may help you complete the form can be located at the specific county assessor’s website.
4. Requester Information
6. Name
8. Address
10. City
11. State
12. Zip Code
14. Phone Number
15. Email Address
17. Select Preference to Receive Information

    1. Email
    2. Mail
    3. Pick Up In Office
19. Property Information
    (Please provide as much information as possible)
21. Current Property Owner
23. Previous Property Owner(s)
25. Property Address
26. City
28. County
29. Parcel Number
31. Legal Description
33. Section
34. Township
35. Range
37. Sewage Permit Number
38. Date Installed
    Date Installed
40. Has property been segregated?

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


56. 1. Receive an email copy of this form.
57. Email address

    This field is not part of the form submission.

58. Submit

* indicates a required field