Bolthole Index county-legal census · checked 2026-08-08
Septic permitting in Missouri is mixed: 82 counties use county health departments, 33 go through a state agency, and 0 through regional districts.Every entry below names the approving authority for that county, cited to the authority’s own page.
Septic rules change and some cities run their own programs — treat this as a verified starting point, not legal advice. All states → Full Missouri profile →
115 counties · mixed — varies by county · permit status scouted for 53
Missouri Department of Health and Senior Services (DHSS)
Adair County Health Department - Onsite Sewage ↗Andrew County Health Department
Andrew County Health Department - Sewage ↗Missouri Department of Health and Senior Services (DHSS) Onsite Wastewater Treatment Program
Missouri DHSS — OWTS Construction Permit Required ↗Audrain County Health Department - Environmental Public Health Services
Audrain County Health Department - Environmental Public Health Services ↗Barry County Health Department, Environmental Services
Barry County Health Department - Environmental Services ↗Barton County Health Department (Environmental Health)
Barton County Health Department ↗Bates County Health Center - Environmental Health (under Missouri DHSS)
Bates County Health Center - Environmental Health ↗Benton County Health Department (enforcing the 1991 Benton County Wastewater Treatment Systems Ordinance)
Benton County Health Department - Wastewater and Septic ↗Bollinger County Health Center - Environmental Services
Bollinger County Health Center - Environmental Services ↗Boone County Resource Management (On-Site Wastewater)
Boone County Resource Management - FAQs ↗Buchanan County Planning & Zoning (onsite wastewater under Missouri DHSS standards)
Buchanan County MO - Planning & Zoning ↗Butler County Health Department (On-Site Sewer Program, under Missouri DHSS)
Butler County Health Department - On-Site Sewer Program ↗Missouri Department of Health and Senior Services (DHSS)
Caldwell County Health Services ↗Callaway County Health Department (onsite wastewater under MO DHSS, 19 CSR 20-3)
Missouri DHSS — Onsite Wastewater Treatment ↗Camden County Wastewater Department
Camden County Wastewater Department ↗Cape Girardeau County Public Health Center
Cape Girardeau County Public Health Center - On-Site Sewage ↗Carroll County Health Department (under Missouri DHSS Onsite Wastewater program)
Missouri DHSS — OWTS Construction Permit Required ↗Carter County Health Center, Environmental Public Health
Carter County Health Center - Environmental Public Health ↗Cass County Environmental Health Department
Cass County Building Codes, Zoning & Environmental Health ↗Cedar County Health Department (Environmental)
Cedar County, Missouri - Health Department ↗Chariton County Health Center (local onsite wastewater authority under DHSS)
Missouri DHSS - Onsite Wastewater Treatment ↗Christian County Health Department
Christian County Health Department - Wastewater ↗Clark County Health Department
Clark County Health Department ↗Clay County Public Health Center - Environmental Health (Onsite Sewage program)
Clay County Public Health Center - Onsite Sewage ↗Clinton County Health Department (on-site wastewater; applications routed via Planning & Zoning)
Clinton County Planning & Zoning ↗Cole County Health Department
Cole County - Onsite Wastewater Permit (Sewage) ↗Cooper County Public Health Center (Missouri DHSS Onsite Wastewater program)
Cooper County Public Health - Wastewater Information ↗Crawford County Health Department
Crawford County Health Department - Private Sewage ↗Dade County Health Department (Environmental Public Health)
Dade County Health Department - Sewage Laws ↗Dallas County Health Department (Environmental Health)
Dallas County Health Department - Environmental Health ↗Daviess County Health Department (under Missouri DHSS Onsite Wastewater Program)
Missouri DHSS — OWTS Construction Permit Required ↗Missouri Department of Health and Senior Services (DHSS) Onsite Wastewater Treatment Program
Missouri DHSS - Onsite Wastewater Treatment ↗Missouri Department of Health and Senior Services (DHSS), Onsite Wastewater Treatment Program
Missouri DHSS — OWTS Construction Permit Required ↗Missouri Department of Health and Senior Services (DHSS) - Onsite Wastewater Treatment Program
Missouri DHSS — OWTS Construction Permit Required ↗Dunklin County Health Department (onsite wastewater, under Missouri DHSS standards)
Dunklin County Health Department - Sewage ↗Franklin County (On-Site Sewer / Building Permits Department)
Franklin County - Permits ↗Missouri Department of Health and Senior Services (DHSS) - Onsite Sewage Program
Gasconade County Health Department - Waste Water ↗Missouri Department of Health and Senior Services, Onsite Wastewater Treatment Program
Missouri DHSS — OWTS Construction Permit Required ↗Greene County Resource Management Environmental Division (installers also certified with Missouri DHSS)
Greene County Resource Management - Environmental ↗Missouri DHSS Onsite Wastewater Treatment Program – Northeast Regional Office (Macon)
Missouri DHSS — Onsite Wastewater Resources ↗Harrison County Health Department
Harrison County Health Department - Sewage ↗Henry County Health Center
Henry County Health Center - Regulations (Wastewater) ↗Hickory County Health Department
Hickory County, Missouri - FAQ ↗Holt County Health Department
Missouri DHSS — Onsite Wastewater Complaints ↗Missouri Department of Health & Senior Services (DHSS) — Onsite Wastewater Treatment Program
Missouri DHSS — Onsite Wastewater Treatment ↗Howell County Health Department (Environmental Public Health)
Howell County Health Department ↗Missouri Department of Health and Senior Services (DHSS) Onsite Wastewater Treatment Program
Missouri DHSS - OWTS Construction Permit Application Process ↗Jackson County Public Works On-Site Wastewater program
Jackson County Public Works ↗Jasper County Health Department (Environmental Services)
Jasper County Environmental Services ↗Jefferson County Health Department (MO), Environmental Services
Jefferson County Health Department (Hillsboro, MO) ↗Johnson County Community Health Services - Environmental Health
Johnson County Community Health - Onsite Wastewater Treatment Systems ↗Missouri Department of Health and Senior Services (Onsite Wastewater Treatment)
Knox County Health Department - Environmental Services ↗Laclede County Health Department, Environmental Services
Laclede County Health Department - Waste Water Treatment ↗Lafayette County Planning & Economic Development (unincorporated parcels 25 acres or less); Lafayette County Health Department (other cases)
Lafayette County Health Department - Sewage System ↗Lawrence County Health Department
Lawrence County Health Department - Septic ↗Missouri DHSS Onsite Wastewater Treatment Program
Missouri DHSS — OWTS Construction Permit Required ↗Lincoln County Health Department (Onsite Ordinance; MO DHSS oversight)
Lincoln County Health Department - Wastewater Treatment Systems ↗Missouri Department of Health and Senior Services (DHSS) Onsite Wastewater Treatment Program
Missouri DHSS - OWTS Construction Permit Application Process ↗Livingston County Health Center, Environmental Health
Livingston County Health Center - Services ↗Missouri Department of Health & Senior Services (DHSS) Onsite Wastewater Treatment Program (local administrative authority typically the county health department)
Missouri DHSS — Onsite Wastewater Treatment ↗Missouri Department of Health and Senior Services
Madison County Health Department - On Site Sewage Services ↗Missouri Department of Health and Senior Services (DHSS) - Onsite Wastewater Treatment Program
Phelps/Maries County Health Department - Safe Environment (OWTS permit notice) ↗Marion County Health Department (Environmental Health)
Marion County MO - County Coordinator ↗McDonald County Health Department
McDonald County Health Department - Environmental ↗Missouri Department of Health and Senior Services, Onsite Wastewater Treatment Program
Missouri DHSS — OWTS Construction Permit Required ↗Miller County Health Center (Environmental), under Missouri DHSS
Miller County Health Center - Onsite Wastewater Treatment System Requirements ↗Mississippi County Health Department
Mississippi County Health Department — On-Site Sewage ↗Missouri DHSS Onsite Sewage Program (locally supported by Moniteau County Health Center)
Moniteau County Health Center - Waste Water ↗Monroe County Health Department
Monroe County Health Department - Environmental Health ↗Montgomery County Health Department (County Sanitarian)
Montgomery County MO Planning and Zoning ↗Morgan County Health Center (Environmental Health)
Morgan County Health Center - Waste Water ↗New Madrid County Health Department (under Missouri DHSS Onsite Wastewater program)
Missouri DHSS - New Madrid County Health Department ↗Newton County Health Department - Environmental Health
Newton County (MO) Health Department - Waste Water Permits ↗Nodaway County Health Center, Environmental Health
Nodaway County Health Center - Environmental Health ↗Oregon County Health Department (under MO DHSS Onsite Wastewater Program)
Missouri DHSS — OWTS Construction Permit Required ↗Missouri Department of Health & Senior Services (DHSS), Onsite Wastewater Treatment Program
Osage County Health Department - Environmental Health ↗Missouri Department of Health and Senior Services, Onsite Wastewater Treatment Program
Missouri Department of Health and Senior Services - Onsite Wastewater Treatment ↗Missouri Department of Health and Senior Services - Onsite Wastewater Treatment Program
Missouri DHSS — OWTS Construction Permit Required ↗Missouri Department of Health and Senior Services (DHSS)
Perry County Health Department ↗Pettis County Health Center (Environmental Public Health)
Pettis County Health Center — Environmental Health ↗Missouri Department of Health and Senior Services (DHSS) - Onsite Wastewater Treatment Program
Phelps-Maries County Health Department - Safe Environment ↗Pike County Health Department
Pike County Health Department - Sewage & Septic System Information ↗Platte County Health Department, Environmental Health (Sewage Program)
Platte County Health Department - Sewage Program ↗Polk County Health Center
Polk County Health Center - Septic Permits and Inspections ↗Pulaski County Health Center (On-Site Wastewater Treatment Systems program under the 2007 county OWTS ordinance / MO DHSS framework)
Pulaski County Health Center - On-Site Wastewater Treatment Systems ↗Putnam County Health Department
Putnam County Health Department - Inspections & On-Site Sewage ↗Ralls County Health Department - Environmental (Onsite Wastewater)
Ralls County Health Department - Environmental ↗Randolph County Health Department
Randolph County MO — Ordinances ↗Ray County Health Department Environmental Health / Ray County Septic Inspector
Ray County MO - County Planning & Zoning ↗Reynolds County Health Center (Environmental Health)
Reynolds County Health Center - Environmental Health ↗Ripley County Health Department
Ripley County Health Department, Water & Sewer ↗Saline County Health Department, Environmental Health
Saline County Health Department - Environmental Health ↗Missouri Department of Health and Senior Services (DHSS) Onsite Wastewater Treatment Program
Missouri DHSS — OWTS Construction Permit Required ↗Missouri DHSS Onsite Wastewater Treatment Program – Northeast Regional Office (Macon)
Missouri DHSS — Onsite Wastewater Resources ↗Scott County Health Department
Scott County Health Department - Environmental ↗Missouri Department of Health and Senior Services - Onsite Wastewater Treatment Program
Missouri Dept. of Health and Senior Services - Onsite Wastewater Treatment ↗Missouri Department of Health and Senior Services (Onsite Wastewater Treatment Program)
Shelby County Health Department, On-Site Sewage Management ↗St. Charles County Division of Building and Code Enforcement
St. Charles County Onsite Wastewater Treatment Systems (OWTS) ↗St. Clair County Health Center (Environmental/Sanitation)
St. Clair County Health Center - Sanitation ↗St. Francois County Health Center, Environmental Health Department
St. Francois County Health Center - Wastewater Treatment ↗St. Louis County Department of Public Health
St. Louis County - Septic Application ↗Missouri Department of Health and Senior Services
Missouri Department of Health and Senior Services, Onsite Sewage ↗Ste. Genevieve County Health Department (Environmental / Onsite Sewage)
Ste. Genevieve County Health Dept — Onsite Sewage ↗Missouri Department of Health and Senior Services, Onsite Wastewater Treatment Program
Missouri DHSS Onsite Wastewater Treatment Program ↗Stone County Health Department
Stone County Health Department - Septic System Information ↗Missouri Department of Health and Senior Services (Onsite Wastewater Program); Sullivan County Health Department assists
Sullivan County Health Department – Sewage Information ↗Taney County Environmental Services Department (OWTS program)
Taney County Environmental Services ↗Texas County Health Department (under Missouri DHSS onsite sewage rules)
Texas County Health Department - Sewage Disposal ↗Vernon County Health Department (Environmental Health)
Vernon County Health Department ↗Warren County Sanitarian
Warren County Planning and Zoning - Structure Packet ↗Washington County Health Department
Washington County Health Department - OWTS/Septic Information ↗Missouri Department of Health and Senior Services (Onsite Wastewater Treatment)
Missouri DHSS - Onsite Wastewater Treatment ↗Webster County Health Unit
Webster County Health Unit - Onsite Wastewater ↗Missouri Department of Health and Senior Services, Onsite Wastewater Treatment Program
Missouri DHSS — OWTS Construction Permit Required ↗Wright County Health Department (Environmental Public Health)
Wright County Health Department - Environmental Public Health ↗Every county here has a full profile — its index score, water, land prices, and the rest of its building rules. See the Missouri state page for all counties ranked, or the national septic guide.
General guidance, not legal advice. Off-grid, building, and land-use rules are often set at the county level and change often. Verify with your county and state before acting. Data reviewed 2026-06-26.
