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Septic Permit PDF Print E-mail

Gibson County Health Department
800 S. Prince Street
Princeton, IN 47670
Office: 812-385-3831 Fax: 812-386-8027


Application for Septic Permit
Septic Permit Fees
New - $30.00 
Repairs - $15.00
Dye tests -$75.00



PERMIT NUMBER: _______________________________________________

DATE OF APPLICATION: _________________________________________

NAME: _________________________________________________________

ADDRESS: ______________________________________________________
_______________________________________________________________

Phone: _________________________________________________________

Location & Directions: ______________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

All sand soil: YES or NO

Lot Size: ____________________
Water Source: Public__________ Private Well____________
Proposed Well__________________________
Number of Bedrooms: ______________________________________________
Repair or New: ___________________________________________________ 

OFFICE USE ONLY

Receipt Number:____________________Amount Paid:____________________

Person Requesting Permit :___________________________________________

Staff: ___________________________________________________________