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Bureau of Environmental Health

Application For Site Evaluation & Permit For Sewage Disposal System And/Or Well
A permit must be obtained before any construction is started. A permit would become void if soil conditions are altered by scraping, filling or driving on the surface causing compaction of soil. Any decision by the Bureau of Environmental Health may be appealed. See Provisions of the Ingham County Sanitary Code, latest edition.
 
Authorization:

I hereby grant and authorize representatives of the Ingham County Health Department a right of entry onto the property described below, and to hold them harmless against any and all claims of trespass. Their right of entry shall include the right to make borings or backhoe excavations for evaluating geological and soil conditions for an on-site sewage disposal system and/or well. The buyer or owner will have to provide a backhoe for Vacant Land evaluations.

Selecting 'I Accept' will also serve as your official signature for this application. Selecting 'I Decline' will terminate the application process.

                 
Please fill out the form below. All fields marked  *  are required.

Application Type * (Select all that apply)            Fee

 - must be completed before a sewage permit can be requested for a parcel that does not have an existing sewage disposal system.
 


N/C
Township *  
Section  (2 digits) 
Property #   Lookup property #
(ex. 33-00-00-00-000-000)
Property Type
Subdivision
Lot #
Parcel Size  ft.  X   ft.
# of Acres
Road Location/or Address *    
Present Owner
Buyer
Nearest Cross Street
Side of Road
   
If known, Please provide:   
# of Bedrooms
Has land been previously evaluated?  

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