Wastewater System Permit Application

Pawnee Nation Waste Water Regulation Application for Permit

General Permit Individual Permit
Permit Type

Construct new On-Site Treatment System Modify an Existing On-Site Treatment System
Type:

Municipal Treatment Works Non-Industrial Wastewater Treatment System Sanitary Sewer System Other Sewage Treatment Works
System Owner
Address
Phone
System Installer
Address
Phone
Location of Existing or New System:
Latitude
Longitude
Legal:
Section
Township
Range
Type of System

Lagoon Aerobic
*If installing an alternative system, check the Individual Permit box above and submit all engineering documents with the application.

By signing below, I certify that I will comply with the terms and conditions of this permit and all laws and regulations of the Pawnee Nation of Oklahoma, including providing reports and submit to
File Upload

Cancel of
Signature

Clear
Date

Month Day Year
Date
Should be Empty: