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Permit Forms

A permit application is required to be submitted, with fees, to the Local Health District prior to the construction, alteration, or sealing of any private water system.  Please contact the Local Health District in which the property is located to obtain information about the permitting process and the required fees.

Local Health District Search

The following form may be completed online and printed or printed and filled out by hand.  All permit applications must be complete and include a site plan.

Application/Permit and Site Plan Form

 (electronic fill-in)

Required Prior to Constructing, Altering, or Sealing Private Water Systems.

If you are supplying water to a building, a small business, or multiple dwellings, you must also supply additional plans as required in Ohio Administrative Code rules 3701-28-03 (E) and (F).  Additional plans are also required for the construction of a pond, spring, or cistern to supply water as a private water system.

Additional Plans Forms

 (print-only forms)

  • Required under Ohio Administrative Code rule 3701-28-03 (E) and (F);

  • If you are a small business that supplies water to more than 25 people, more than 60 days out of the year, please contact the Ohio Environmental Protection Agency (OEPA) District Office Drinking and Ground Waters prior to obtaining a permit from the local health district.  The OEPA will determine if you meet the requirements as a public water system.  If not, contact your Local Health District to obtain a permit to construct, alter, or seal a private water system.  

A private water systems permit is not currently required for non-potable wells (such as: agricultural, irrigation, geothermal, and monitoring wells), ponds, springs, cisterns, and hauled water storage tanks that were not constructed as a private water system as defined in Ohio Administrative Code rule 3701-28-01  (PPP).  Non-potable wells must be reviewed by the Local Health District prior to obtaining a permit to be converted to a private water system.


Updated 05/22/2018