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Onsite Wastewater Systems Program Permit Application Submittal Form

2. Submittal of incomplete or incorrect information may cause delays in the plan review time.

4. Owner Name*

6. Project Address/Cross Streets*

8. City

9. MCESD Permit/Application Number

   If applicable.

11. Contact Name*

12. Phone Number*

14. Email Address*

15. Fax Number

17. Type of Application*

    1. Phase I: Site & Soils Evaluation
    2. Phase II: System Design (NOID)

    1. Abandonment/Closure
    2. Alteration

    1. Minor Plan Review
    2. Domestic Well

19. Upload completed application forms and supporting documents.

    Please be aware that the file must be in PDF format. Total file size is limited to 250 MB. Upload any additional files below.

31. Online site plan submittals must be legible and to scale. If site plans do not meet the above criteria, new plans will be required.

33. For questions, assistance, or feedback, please contact us at (602) 506-6666 and ask for the Onsite Wastewater Program or email us at the link below.
    Onsite Wastewater Program.

35. Comments/Special Instructions

Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field