Polk County

Polk County

Environmental Health Records Request Form
General searches must be requested in writing at least two weeks prior to the requested search date. Please Be Advised That Septic Records Prior To 1970 Are Often Non-Existent.
Date of Request*

MonthDayYear
Date
1. Original Owner Name*
Original Builder Name: (This information can be found via a deed search on the Polk County, NC Register of Deeds website at: https://cotthosting.com/ncpolkexternal/LandRecords/protected/v4/SrchName.aspx or in person at the Registrar of Deeds office)
1a. Original Builder Name*
2. List All Other Possible Names Information Could Be Filed Under: (i.e. Previous or Current Owner, etc.)*
3. Tax Parcel I.D.# (PIN)*
4. Road Name*
5. Year Home Built*
6. Year Septic/Well Installed*
7. Subdivision & Lot #*
All information On 1 thru 7 MUST Be Completed In Order To Perform A Records Search (Incomplete Requests Will Be Returned)
Requestors Information
Name*
Email
example@example.com
Phone*
Fax
Should be Empty: