Private Well Permit Application

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Terms & Conditions

This application cannot be processed unless all of the required information is provided. Please complete all of the following fields to apply for a private well permit.

This application must be accompanied by a plat or site plan of the property that includes the existing and proposed property lines with dimensions, the specific location of the facility and any existing or future appurtenances, the location of any existing septic
system, sewer lines, water lines, any existing water supplies and any surface waters. The applicant is responsible for identifying and marking the property lines and corners. The applicant is responsible for making the site accessible.

By submitting this application, the applicant signifies that they understand the terms and conditions and that they give permission for Davie County Environmental Health representatives to perform necessary field evaluations and procedures deemed necessary to determine the best location for a well.

Applicant Information

Property Information

Development Information

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