NOTICE OF INTENT - EXEMPTION
  The Department will evaluate your site for all options relating to on-site wastewater treatment and disposal.
  You will receive a recommendation for disposal systems appropriate for your site. The Department WILL NOT inspect
   your system during installation. It will be you responsibility to ensure that no wastewater leaving the property or impacts  
  any watercourse on the United States or Mississippi as defined by section 51-3-3 (h) of the Mississippi Code of 1972.
    * Required fields 
 
Site Information
Site Address / Street Name * 
Zip *   
County * 
City * 
State * 
Acreage *    (>2 acres)  
       
Contact Information
Name * 
Mailing Address * 
Zip * 
City * 
State *   
Email Address *    Re-Enter Email Address
Phone #1 * 
Phone #2 * 
Number Of Bedrooms  *      Number Of Occupants  * 
Are there pets on the premises *    Yes     No
Is there a locked gate to the property *    Yes     No
Will this be Public or Private water  * 
Notes/Directions   
 
  An Invoice of $100 + a processing fee will be emailed within one(1) business day.