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Floyd County, IA - Septic Permit Application

  1. The permit must be printed and signed and delivered with the $200 permit fee.

  2. Office Use

  3. who is filling out the form*

  4. Status of Building

  5. (Feet by Feet)

  6. Type of Property

  7. Garbage Disposal*

  8. Water Softener *

  9. Dishwasher*

  10. Please discribe the poposed location of the septic system

  11. Please print and sign this form and include the $200 fee to:
    Floyd County Board of Health
    101 S. Main St.
    Charles City, IA 50616

  12. Leave This Blank:

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