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Septic Permit Application

  1. County of Dubuque
    Department of Health
    Environmental Health Division
    13047 City View Drive
    Dubuque, IA 52003
    Phone: 563-557-7396

  2. Class of Work

  3. Occupancy

  4. Building / Structure

  5. Type of Water Supply

  6. Facility Used

  7. Gravity Dosing

  8. Pressure Dosing

  9. Drop Boxes

  10. Special Approvals

  11. Water Softener - Zoning

  12. Garbage Disposal - Engineer

  13. Jacuzzi / Whirlpool Tub - IDNR

  14. N.O.I. - IDOT

  15. Perc Test

  16. Soil Boring

  17. I hereby certify that the above information is correct and that all proposed work will be completed in accordance with the Dubuque County Rules and Regulations regarding Private Sewage Disposal. I also agree to construct the system in accordance to the condition listed herein.

  18. Leave This Blank:

  19. This field is not part of the form submission.