180 S. Main St., Ste. 252, Martinsville, IN 46151

765-342-6621, Fax: 765-342-1062 morgancohd@morgancountyhealth.com

Online Application for Septic Permit (Conventional Systems)

Septic Installer Information for Trench Systems

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By checking the box below, I hereby certify that I am the installer named above and that I am authorized to request a permit for the above property, in accordance with Indiana Code 410 IAC 6-8-3.

Sewer Pipe:

Septic Tank:

Dose Tank:

Effluent Pump:

*All pump electrical connections make be completed inside a NEMA 4x junction box.*

Force Main:

Distribution Box:

Absorption Field:

*If Chamber or Other, please indicate Manufacturer and Model below:

Drainage:

Drainage: