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Application Forms

Electronic applications are now being accepted

NOTICE: The 02T and 02U Rules have changed. The application forms are in the process of being re-done. Until then, please note that all applications submitted after September 1, 2018 must meet the newly revised rules. Links to the rules: 15A NCAC 02T & 15A NCAC 02U.

Application Forms

Permit Type New / Major Modification Application Renewal Application Ownership / Name Change
Single-Family Residence System SFRWWIS-R 09-18 NDPONC 06-16
Wastewater Irrigation System WWIS 06-16 NDSR 09-19 NDPONC 06-16
High-Rate Infiltration System HRIS 06-16 NDSR 09-19 NDPONC 06-16
Closed-Loop Recycle System CLRS 06-16 NDSR 09-19 NDPONC 06-16
Other Wastewater System ONDWWS 06-16 NDSR 09-19 NDPONC 06-16
Reclaimed Water Bulk Distribution NDSR 09-19 NDPONC 06-16
Reclaimed Water Conjunctive Utilization NDSR 09-19 NDPONC 06-16
Reclaimed Water Generation NDSR 09-19 NDPONC 06-16
Reclaimed Water Dedicated (Non-Conjunctive) Utilization NDSR 09-19 NDPONC 06-16
Reclaimed Water Distribution Lines NDSR 09-19 NDPONC 06-16
Reclaimed Water Local Program Approval NDSR 09-19 NDPONC 06-16
Reclaimed Water Wetlands Augmentation NDSR 09-19 NDPONC 06-16
Residuals Class A Distribution 1, 2 DCAR 06-16 DCAR 06-16  
Residuals Land Application Program 1, 2  
Residuals Surface Disposal 1, 2 SDR 06-16 SDR 06-16  

1 - The County Manager Notification (Form: CMN) has been updated in accordance with  Session Law 2013-340, which is intended to provide the county board an opportunity to comment on proposed residuals land application sites within their county. Accordingly, the form title has been changed to County Board Notification (Form: CBN). The updated form is required prior to the permitting of proposed new fields, and can be found as part of the Form: RLAP (under section V. Land Application Site Certification). Please note that this notification is not required for fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100.

2 - The web location of our Critical Watershed Map has been changed to a permanent location at: Water Supply Watersheds


Miscellaneous Documents

Documents Form Download
Coastal Area Map - 15A NCAC 02H .0403 N/A JPG
Developer Operational Agreement DEV 11-17 PDF
Homeowner's Association Operational Agreement HOA 11-17 PDF
Signature Delegation Authority Letter NDSDAL 11-17 DOC
Setback Waiver Form - Wastewater & Reclaimed Water
Setback Waiver Form - Class B Residuals NDRMPW-LAS 11-18 PDF
Setback Waiver Form - Residual Treatment/Storage/Disposal NDRMPW-ST 11-18 PDF
Watershed Classification Attachment WSCA 08-13 PDF
Operator Designation Form WPCSOCC PDF
General Permit to Discharge Reclaimed Water from Conjunctive Use Reclaimed Water Systems NCG580000 PDF