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Tooele County Health Department
151 N. Main Street, Suite 140 - Tooele, UT 84074
Phone (435) 277-2440 Fax (435)277-2444
www.tooelehealth.org
eh@tooelehealth.org
Application For Septic / Wastewater Permit
Please put N/A for any fields that are not applicable
Permit fee must be paid before permit will be issued.
Any changes to design must be approved in writing by TCHD.
Inspections must be completed by TCHD for system approval.
Will Serve letter is required if property will be connected to a public water system.
A percolation test, plat map, and septic design need to be emailed to eh@tooelehealth.org in order to obtain a permit.
If you have additional documents to send, please email them to eh@tooelehealth.org.
Owner Name
Phone Number
Mailing Address
Email Address
Site Address
Subdivision
Lot #
Parcel #
Installer's Name
Installer's Phone Number
Designer's Name
Designer's Phone Number
Unfinished Basement
Yes
No
# of Bedrooms
System
New
Replacement
Type of Water System that will serve this property
Public (*Will Serve letter from public system is required before permit will be issued*)
Non-Public
Applicant's E-Signature
Date
New Onsite Wastewater Permit:
$350.00
Select:
Item Subtotal:
$0.00
Replacement Septic Permit:
$100.00
Select:
Item Subtotal:
$0.00
Onsite Wastewater Holding Tank Permit(max of 2yrs):
$100.00
Select:
Item Subtotal:
$0.00
Septic Location Tracking:
$50.00
Select:
Item Subtotal:
$0.00
Septic System Recertification:
$50.00
Select:
Item Subtotal:
$0.00
Total:
$0.00
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Method of Payment:
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eCheck
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