Bolthole Index county-legal census · checked 2026-08-08
Septic permitting in North Dakota is mixed: 4 counties use county health departments, 8 go through a state agency, and 41 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 North Dakota profile →
53 counties · mixed — varies by county · permit status scouted for 5
Southwestern District Health Unit
Southwestern District Health Unit - Environmental Health ↗North Dakota Department of Environmental Quality (ND DEQ)
North Dakota DEQ - Septic Systems ↗Lake Region District Health Unit
Lake Region District Health Unit ↗Southwestern District Health Unit
Billings County Zoning & Building Applications ↗First District Health Unit
First District Health Unit - Septic (Onsite Wastewater) Systems ↗Southwestern District Health Unit (Environmental Health)
Southwestern District Health Unit - Environmental Health ↗First District Health Unit (Environmental Health Division)
First District Health Unit - Septic (Onsite Wastewater) Systems ↗Burleigh County Building/Planning/Zoning Department
Burleigh County Building/Planning/Zoning FAQ ↗Fargo Cass Public Health, Environmental Health Division
Fargo Cass Public Health - On-site Sewage Treatment Systems ↗Lake Region District Health Unit (LRDHU)
Lake Region District Health Unit – Environmental Health ↗Central Valley Health District (Environmental Health)
Central Valley Health District - Environmental Health / Onsite Septic Systems ↗Upper Missouri District Health Unit (UMDHU) - Environmental Health
Upper Missouri District Health Unit - Environmental Health ↗North Dakota Department of Environmental Quality (ND DEQ); permits administered through the local public health unit
North Dakota DEQ — Septic Systems ↗North Dakota Department of Environmental Quality (with local public health unit permit)
North Dakota DEQ - Septic Systems ↗North Dakota Department of Environmental Quality (ND DEQ); permits administered through the local public health unit
North Dakota DEQ — Septic Systems ↗Central Valley Health District
Central Valley Health District Environmental Health ↗Southwestern District Health Unit
Golden Valley County Sewage & Water Application (Southwestern District Health Unit) ↗Grand Forks Public Health, Environmental Health Division
Grand Forks Public Health - On-Site Sewage Treatment Systems ↗Western Plains Public Health
Western Plains Public Health - Onsite Septic System Program ↗Nelson-Griggs District Health Unit
North Dakota DEQ Septic Systems Program ↗Southwestern District Health Unit (SWDHU)
Southwestern District Health Unit Environmental Health ↗Kidder County District Health Unit (services contracted through Western Plains Public Health)
Western Plains Public Health - Onsite Septic System Program ↗Central Valley Health District
LaMoure County - Environmental Health ↗North Dakota Department of Environmental Quality (Onsite Wastewater/Septic Program)
ND DEQ - Septic Systems Program ↗First District Health Unit (FDHU), Environmental Health Division
First District Health Unit - Septic (Onsite Wastewater) Systems ↗McIntosh District Health Unit
North Dakota DEQ - On-Site Wastewater Treatment Systems ↗Local public health unit (per ND DEQ)
North Dakota DEQ Septic Systems ↗First District Health Unit (local public health district), under ND DEQ
First District Health Unit - Septic (Onsite Wastewater) Systems ↗Western Plains Public Health
Western Plains Public Health - Onsite Septic System Program ↗Western Plains Public Health
Western Plains Public Health Onsite Septic System Program ↗Upper Missouri District Health Unit
Mountrail County Planning & Zoning ↗Nelson/Griggs District Health Unit (with ND DEQ oversight)
Nelson County, ND - Public Health ↗Western Plains Public Health (formerly Custer Health)
Western Plains Public Health - Onsite Septic System Program ↗North Dakota Department of Environmental Quality (with Pembina County Public Health regional environmental inspector)
North Dakota DEQ - Septic Systems ↗Lake Region District Health Unit
Lake Region District Health Unit — Environmental Health ↗Lake Region District Health Unit (LRDHU)
Lake Region District Health Unit — Environmental Health ↗Fargo Cass Public Health, Division of Environmental Health
Ransom County Public Health — Environmental Health ↗First District Health Unit
First District Health Unit — Septic (Onsite Wastewater) Systems ↗Richland County Health Department / Fargo Cass Public Health (Environmental Health)
Richland County Health Department - Environmental Health ↗Rolette County Public Health District (Environmental Health)
Rolette County Public Health District - Environmental Health ↗North Dakota Department of Environmental Quality (Division of Water Quality)
North Dakota DEQ - Septic Systems ↗First District Health Unit (Environmental Health Division)
First District Health Unit - Septic (Onsite Wastewater) Systems ↗Sioux County local public health unit (permit issuance) under ND DEQ Septic Systems Program, NDCC 23.1-07.1
North Dakota DEQ - Septic Systems Program ↗North Dakota Department of Environmental Quality (with local public health unit permit)
North Dakota DEQ - Septic Systems ↗Southwestern District Health Unit
Southwestern District Health Unit - County Contact Info ↗Steele County Public Health
Steele County Public Health ↗Central Valley Health District
Stutsman County Health Department / Central Valley Health District ↗Lake Region District Health Unit
Lake Region District Health Unit Environmental Health ↗Traill District Health Unit
Traill County ND - Environmental Health ↗Walsh County Health District
Walsh County Health District - Application for Permit (Septic) ↗First District Health Unit (Environmental Health Division)
First District Health Unit Septic (Onsite Wastewater) Systems ↗Wells County Public Health District (Environmental Health)
Wells County Public Health District – Environmental Health ↗Upper Missouri District Health Unit (Environmental Health)
Upper Missouri District Health Unit Environmental Health ↗Every county here has a full profile — its index score, water, land prices, and the rest of its building rules. See the North Dakota 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.
