Application Forms
Non-Discharge Branch
Use the tabs below to view the application forms and miscellaneous documents
Electronic Applications are now being accepted!
Notice: The 15A NCAC 02T and 02U Rules have changed. The application forms may reference the old rule citation. For questions regarding the application forms, please contact Nathaniel Thornburg.
Application Forms
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Permit Type |
New / Modification3 Application |
Renewal Application |
Ownership / Name Change |
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Single-Family Residence System |
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Wastewater Irrigation System |
NDSR 01-20 | ||
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High-Rate Infiltration System |
NDSR 01-20 | ||
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Closed-Loop Recycle System |
NDSR 01-20 | ||
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Other Wastewater System |
NDSR 01-20 | ||
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Reclaimed Water Bulk Distribution |
NDSR 01-20 | ||
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Reclaimed Water Conjunctive Utilization |
NDSR 01-20 | ||
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Reclaimed Water Generation |
NDSR 01-20 | ||
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Reclaimed Water Dedicated (Non-Conjunctive) Utilization |
NDSR 01-20 | ||
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Reclaimed Water Distribution Lines |
NDSR 01-20 | ||
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Reclaimed Water Local Program Approval |
NDSR 01-20 | ||
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Reclaimed Water Wetlands Augmentation |
NDSR 01-20 | ||
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Residuals Class A Distribution 1, 2 |
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Residuals Land Application Program 1, 2 |
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Residuals Surface Disposal 1, 2 |
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.
3 - For questions about which portions of the application form(s) are required for modifications, please contact Nathaniel Thornburg.
Miscellaneous Documents
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Documents |
Form |
Download |
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Coastal Area Map - 15A NCAC 02H .0403 |
N/A |
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Developer Operational Agreement |
DEV 01-20 |
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Homeowner's Association Operational Agreement |
HOA 01-20 |
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Signature Delegation Authority Letter |
NDSDAL 01-20 |
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Setback Waiver Form - Wastewater & Reclaimed Water |
NDWSW 02-19 |
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Setback Waiver Form - Class B Residuals |
NDRMPW-LAS 11-18 |
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Setback Waiver Form - Residual Treatment/Storage/Disposal |
NDRMPW-ST 11-18 |
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Watershed Classification Attachment |
WSCA 08-13 |
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Operator Designation Form |
WPCSOCC |
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General Permit to Discharge Reclaimed Water from Conjunctive Use Reclaimed Water Systems |
NCG580000 |
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Checklist for Boat Washing Operations with Closed-Loop Recycle System |
N/A | ||
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