Do you have a septic system already on the property?

Yes

No

Do you believe this existing system is usable?.

Yes

No

Please select your County and Water source.

County:  Adams Alcorn Amite Attala Benton Bolivar Calhoun Carroll Chickasaw Choctaw Claiborne Clarke Clay Coahoma Copiah Covington DeSoto Forrest Franklin George Greene Grenada Hancock Harrison Hinds Holmes Humphreys Issaquena Itawamba Jackson Jasper Jefferson Jefferson Davis Jones Kemper Lafayette Lamar Lauderdale Lawrence Leake Lee Leflore Lincoln Lowndes Madison Marion Marshall Monroe Montgomery Neshoba Newton Noxubee Oktibbeha Panola Pearl River Perry Pike Pontotoc Prentiss Quitman Rankin Scott Sharkey Simpson Smith Stone Sunflower Tallahatchie Tate Tippah Tishomingo Tunica Union Walthall Warren Washington Wayne Webster Wilkinson Winston Yalobusha Yazoo        Water Provider:

Enter Water Provider if not listed:         Contact #:

Do you have less than two(2) acres for a single dwelling?

Yes

No

Do you wish for the Department to inspect the installation of your on-site wastewater disposal system.

Yes	No
NOTE: If home financing is involved, we advise you to select Yes. We will not approve the system after installation if the      mortgage company, utilities, local municipalities, or other entities require it.

Please be aware that applying to use the existing system does not guarantee MSDH can accept its usage. You may be required to replace the system and be changed a Final Approval Fee.
I understand