Soil Evaluation Application – Van Buren Cass District Health Department

Land appraisal of soil, water table, and sewage system validation.

Filing Fee $200.00
Owner's Name:*
First Last
Owner's Address:*
Street Address Address Line 2 City State ZIP Code
Phone #*
Phone #
Email
Fax #
Mail Evaluation To (Name):
First Last
Mail Evaluation To (Address):
Street Address Address Line 2 City State ZIP Code
Property Address*
Parcel Id #
Lot Size
County*
Township
Section
Sudivison
Lot #
Directions
Soil Evaluation Fee
***SCALED DRAWING of Proposed Soil Boring Location
Max. file size: 50 MB.
(Drawing shall include dimensions to permanent landmarks and any known sources of contamination. Required for permit approval.)
Applicant's Signature*

By typing your own name above you are voluntarily signing this document electronicly, acknowledging and agreeing to its terms.
Phone
This field is for validation purposes and should be left unchanged.