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

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

Online Application for Septic System (Mound, Presby or Infiltrator ATL)

**Septic Installer Information for Mound, Presby or Infiltrator ATL Systems**

*
 - 
*
 - 
*

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:

Force Main:

**All pump electrical connections must be inside a NEMA 4x junction box**

Presby or Infiltrator ATL System

Presby/Infiltrator ATL Drainage:

Sand Mound

Dimensions:

Sand Mound Drainage: