Septic As-Built / Inspection Form

Important: This As‑Built form is intended to be completed by the installer and/or other qualified licensed professional. It documents the system as constructed and includes required certification and site drawing details.

As‑Built / Inspection Form (Web Form)

A. Property & Parties

Owner Name Owner Phone Site Address Parcel / PIN # Installer / Company Installer MPCA License #

B. System Installed

System Type (trench/bed/mound/at‑grade/other) Bedrooms / Design Flow (GPD) Soil / Site Notes Limiting Layer Depth (ft/in)

C. Tanks

Septic Tank Manufacturer/Model Septic Tank Capacity (gal) Dosing/ Pump Tank Model Dosing/ Pump Tank Capacity (gal)

D. Pump / Controls (if applicable)

Pump Make/Model Pump HP / Voltage Float Settings / Notes Alarm / Control Panel Notes

E. Soil Treatment Area

Distribution Media # Trenches / Bed Size Rock depth under pipe (in.) Cover depth (in.)

F. Site Drawing / Sketch

The official As‑Built requires a site drawing showing the system location and key setbacks. You may attach a sketch when emailing, or upload it through the online permit portal.

Sketch filename / notes Additional Notes

G. Certification (print and sign)

By signing, the licensed professional certifies the system was installed per MN Rules 7080–7083 and local ordinance (as applicable).

Upload documents to an existing permit