Septic Permit Application

Septic Permit Application

All fields are required. If not applicable, please mark with N/A.
Owner Name*
Legal Description *
Project Location Physical Address *

Project Street Address

Owner Mailing Address

CityState

Zip Code
Owner Mailing Address *

Street Address or PO Box

Street Address Line 2

CityState / Province

Postal / Zip Code
Owner Phone Number*
Please enter a valid phone number.
Owner Email*
example@example.com
Location Type*

OwnRent
Upload a signed affidavit of permission from the property owner to apply for building permits for this location *

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Select permit classification.*

Single-Family ResidentialMultiple-Family ResidentialCommercial
Select system type*

ConventionalEngineered
Please upload a copy of ADEC approval to operate documentation*

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Select permit type.*

NewAlterationRepair
Please write a description of work*
Total project valuation*
Percolation test results
Septic tank size (gallons)*
Number of bedrooms*
Soil type or rating
Ground cover over septic tank / surface water table
Please upload a copy of septic plans, including site plan*

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Who will be performing work under this permit?*

ADEC approved homeowner installer.Certified InstallerEngineer OversightOther
Upload a copy of your ADEC approved homeowner installer documentation*

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Certified Installer Name
Certified Installer Phone Number
Please enter a valid phone number.
Certified Installer Email
example@example.com
Certified Installer License Number
Please upload a copy of your current State of Alaska contractor's license

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Engineer Name
Engineer Phone Number
Please enter a valid phone number.
Engineer License Number
Additional Information

If you prefer a fillable PDF or paper form, please visit https://www.valdezak.gov/DocumentCenter/View/192 or email planningdept@valdezak.gov

Questions?

Call the City of Valdez Planning Department at 907-834-3401 or email planningdept@valdezak.gov
Signature*

Clear
Printed Name of Person Signing Above.
Name of Signee and therefor primary contact for this project.
Internal Fields Only
PIDN:
Permit Number:
Permit Fee:
Zoning District:
Confirmed Legal Description:
Confirmed Project Location Physical Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Permit Issue Date:

MonthDayYear
Date
Should be Empty: