Bolthole Index county-legal census · checked 2026-08-08
Septic permitting in North Carolina is handled at the county level — county health departments approve systems in 82 of 100 counties.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 → North Carolina water rights & wells → Full North Carolina profile →
100 counties · county health departments · permit status scouted for 25
Alamance County Environmental Health
Alamance County Environmental Health — Applying for a Septic System Permit ↗Alexander County Health Department - Environmental Health Division
Alexander County Environmental Health ↗Appalachian District Health Department (AppHealthCare) - Environmental Health / Water Protection Program
AppHealthCare - Environmental Health ↗Anson County Environmental Health Division (under NC DHHS Division of Public Health)
Anson County - Environmental Health ↗AppHealthCare (Appalachian District Health Department) Environmental Health
AppHealthCare Septic System Program ↗Toe River Health District (Avery, Mitchell, Yancey counties)
Toe River Health District - Environmental Health ↗Beaufort County Environmental Health Department (Beaufort County Health Department)
Beaufort County NC - Apply For (Septic or Well Permit) ↗Bertie County Environmental Health (Planning & Inspections)
Bertie County Planning & Inspections / Environmental Health ↗Bladen County Environmental Health Division (under NC DHHS Division of Public Health)
Bladen County - Environmental Health ↗Brunswick County Environmental Health Services
Brunswick County On-Site Wastewater Permitting Options ↗Buncombe County Environmental Health (REHS authorized by NC Division of Environmental Health / DHHS)
Buncombe County - Environmental Health ↗Burke County Environmental Health
Burke County, NC - Septic ↗Cabarrus Health Alliance - Environmental Health (Onsite Wastewater)
Cabarrus Health Alliance - Onsite Wastewater ↗Caldwell County Health Department - Environmental Health (agent of NC DHHS)
Caldwell County - Septic & Wells ↗Albemarle Regional Health Services (Environmental Health)
Albemarle Regional Health Services ↗Carteret County Health Department, Environmental Health (Onsite Water Protection)
Carteret County NC - Septic System Permits ↗Caswell County Environmental Health (under NC DHHS On-Site Wastewater Program)
Caswell County Health Department - Environmental Health ↗Catawba County Environmental Health, On-Site Wastewater Program
Catawba County Environmental Health - Septic Systems ↗Chatham County Environmental Health Division
Chatham County - Septic System Permits (On-Site Wastewater) ↗Cherokee County Health Department - Environmental Health
Cherokee County Environmental Health - Septic ↗Albemarle Regional Health Services
Albemarle Regional Health Services - Environmental Health ↗Clay County Environmental Health Department
Clay County Health Dept - Septic & Wells ↗Cleveland County Health Department - Environmental Health
Cleveland County (NC) Health Department - Environmental Health ↗Columbus County Health Department - Environmental Health
Columbus County Environmental Health ↗Craven County Environmental Health Department
Craven County Permitting Process ↗Cumberland County Environmental Health, On-Site Wastewater (OSSW) Section
Cumberland County Environmental Health - Water and Sewage ↗Albemarle Regional Health Services, Environmental Health Division
Albemarle Regional Health Services - Environmental Health ↗Dare County Environmental Health Services (Health & Human Services)
Dare County - Environmental Health Services ↗Davidson County Environmental Health Division
Davidson County Environmental Health Permits ↗Davie County Environmental Health
Davie County Environmental Health ↗Duplin County Health Department, Environmental Health Division
Duplin County - Water and Sewage Services ↗Durham County Environmental Health, On-Site Water Protection
Durham County - On Site Water Protection ↗Edgecombe County Health Department, Environmental Health Division
Edgecombe County Environmental Health ↗Forsyth County Environmental Health (Land Use Section)
Forsyth County Environmental Health - Septic ↗Franklin County Environmental Health
Franklin County - Permits ↗Gaston County Environmental Health (Gaston County Health Department)
Gaston County On-Site Wastewater and Wells ↗Albemarle Regional Health Services — Environmental Health Division
Albemarle Regional Health Services Environmental Health ↗Graham County Health Department, Environmental Health Services
Graham County Health Dept - Septic Systems ↗Granville Vance Public Health - Environmental Health
Granville County NC - Water Testing & Septic Permits ↗Greene County Environmental Health
Greene County Environmental Health ↗Guilford County Environmental Health, On-Site Wastewater Program
Guilford County - On-site Wastewater (Environmental Health) ↗Halifax County Environmental Health
Halifax County, NC - Environmental Health ↗Harnett County Health Department - Environmental Health, On-Site Wastewater Section
Harnett County On-Site Wastewater Section ↗Haywood County Environmental Health (under NC DHHS)
Haywood County Septic & Wastewater ↗Henderson County Environmental Health
Henderson County Zoning Permits ↗Albemarle Regional Health Services (Environmental Health Division)
Albemarle Regional Health Services - Environmental Health ↗Hoke County Health Department - Environmental Health
Hoke County Environmental Health ↗Hyde County Health Department - Environmental Health (under NC DHHS)
Hyde County Health Department On-Site Wastewater Systems ↗Iredell County Environmental Health - Onsite Water Protection Program
Iredell County Onsite Water Protection ↗Jackson County Department of Public Health - Environmental Health
Jackson County - On-Site Waste Water Protection ↗Johnston County Environmental Health Department
Johnston County Environmental Health - On-Site Wastewater ↗Jones County Environmental Health (Health Department) under NC DHHS
Jones County, NC - Environmental Health ↗Lee County Environmental Health Department
Lee County (NC) Public Health - Environmental Health, Septic & Wells ↗Lenoir County Health Department - Environmental Health
Lenoir County Environmental Health ↗Lincoln County Environmental Health
Lincoln County - Onsite Water ↗Macon County Public Health - Environmental Health Services
Macon County Public Health - Onsite Wastewater Septic Systems ↗Madison County Health Department - Environmental Health (On-Site Wastewater/Septic Program)
Madison County Health Department - Environmental Health ↗Martin-Tyrrell-Washington District Health Department (Environmental Health)
Martin-Tyrrell-Washington District Health - Environmental Health ↗Foothills Health District - Environmental Health
Foothills Health District Environmental Health ↗Mecklenburg County Public Health, Environmental Health
Mecklenburg County Environmental Health — Groundwater & Wastewater ↗Toe River Health District (Environmental Health)
Toe River Health District - Environmental Health ↗Montgomery County Health Department - Environmental Health
Montgomery County NC - Environmental Health ↗Moore County Health Department, Environmental Health Section
Moore County Septic / Wells ↗Nash County Environmental Health
Nash County Environmental Health ↗New Hanover County Environmental Health - On-Site Water Protection (under NC DHHS wastewater rules)
New Hanover County, NC - On-Site Well Water Protection (Environmental Health) ↗Northampton County Health Department — Environmental Health (under NC DHHS On-Site Wastewater Program)
Northampton County Health Department — Environmental Health ↗Onslow County Health Department - Environmental Health Division
Onslow County - Septic Systems ↗Orange County Environmental Health Division
Orange County Septic Systems (Environmental Health) ↗Pamlico County Health Department, Environmental Health Division
Pamlico County Environmental Health ↗Albemarle Regional Health Services
Albemarle Regional Health Services - Environmental Health ↗Pender County Health Department, Environmental Health
Pender County Application for Environmental Health Permits ↗Albemarle Regional Health Services (Environmental Health)
Albemarle Regional Health Services - Environmental Health ↗Person County Environmental Health, Onsite Wastewater Program (under NC DHHS Division of Public Health)
Person County - Onsite Wastewater Program ↗Pitt County Environmental Health (under NC DHHS on-site wastewater rules)
Pitt County - On-Site Wastewater & Septic Systems ↗Polk County Environmental Health
Polk County Environmental Health / Community Development ↗Randolph County Environmental Health - On-Site Water Protection Program
Randolph County - On-Site Water Protection Program ↗Richmond County Health Department - Environmental Health Section (under NC DHHS)
Richmond County, NC On-Site Wastewater Systems ↗Robeson County Health Department (Environmental Health)
Robeson County Health Department - Onsite Waste Water ↗Rockingham County Environmental Health - On-Site Wastewater Program (under NC DHHS)
Rockingham County, NC - On-Site Wastewater Program ↗Rowan County Environmental Health (On-Site Waste Water Program)
Rowan County NC Septic System Permitting Process ↗Rutherford County Health Department / Foothills Health District - Environmental Health (under NC DHHS)
Foothills Health District - Environmental Health ↗Sampson County Environmental Health (Sampson County Health Department)
Sampson County Environmental Health - On-Site Septic Systems ↗Scotland County Environmental Health Division
Scotland County NC Septic System Permits ↗Stanly County Environmental Health Department
Stanly County Environmental Health ↗Stokes County Environmental Health Division
Stokes County Environmental Health ↗Surry County Environmental Health - On-Site Water Protection
Surry County Environmental Health - Septic New and Existing ↗Swain County Health Department, Environmental Health
Swain County Environmental Health ↗Transylvania Public Health - Environmental Health
Transylvania Public Health - Environmental Health ↗Martin-Tyrrell-Washington District Health Department, Environmental Health Division
Martin-Tyrrell-Washington District Health - Environmental Health ↗Union County Environmental Health, On-Site Water Protection Program
Union County Environmental Health - On-Site Wastewater (Septic) ↗Granville Vance Public Health
Granville Vance Public Health - Environmental Health ↗Wake County Onsite Water Protection Division (under NC DHHS)
Wake County Onsite Water Protection ↗Warren County Health Department - Environmental Health
Warren County NC Health Department - Environmental Health ↗Martin-Tyrrell-Washington District Health Department (Environmental Health)
Martin-Tyrrell-Washington District Health - Environmental Health ↗AppHealthCare (Appalachian District Health Department)
AppHealthCare - Septic System Program ↗Wayne County Environmental Health / Wayne County Health Department
Wayne County Health Department - Sewage Treatment Systems ↗Wilkes County Environmental Health / Wilkes County Health Department
Wilkes County, NC - Permit Information ↗Wilson County Health Department, Environmental Health (On-Site/Well Program)
Wilson County, NC - On-Site Wastewater ↗Yadkin County Environmental Health, On-Site Wastewater Program (under NC DHHS Division of Public Health)
Yadkin County - On-Site Wastewater Program (Septic Systems) ↗Yancey County Health Department - Environmental Health
Yancey County Building Inspections ↗Every county here has a full profile — its index score, water, land prices, and the rest of its building rules. See the North Carolina 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.
