Plan Review Forms

Plan Review mailing address:

Public Water Supply Section
1634 Mail Service Center
Raleigh, NC 27699-1634

Flowchart Detailing the Plan Review Process

Partial Final Approvals

Suggested Template Engineer’s Report for Water Main Extensions

Digital Submittal of Projects

Forms Submitted Before Construction

• Application for Plan Approval: [pdf] [Word]
  • Fees are now required. See Plan Review Fees or page 4 of the application for more info.
  • New well projects must go through the PWSS regional office.
• Water System Management Plan
  • To complete the plan review process, systems must have an approved Water System Management Plan.
  • See Water System Management Plan Forms for more information.

Certifications Submitted Before Placing Project in Service

• Upon completion of the construction or modification of a public water system, an applicant must submit an Applicant Certification in accordance with 15A NCAC .0303(c). An applicant must also submit a certification statement signed and sealed by a registered professional engineer stating that construction was completed in accordance with approved plans and specifications in accordance with 15A NCAC .0303(a).  No construction, alteration or expansion of a community or non-transient, non-community public water system shall be placed into final service or made available for human consumption until the applicant has submitted both the engineer certification and applicant certification and has received Final Approval from the Department. Revisions may only be made in accordance with the provisions of 15A NCAC 18C .0306.
• Applicant Certification: [pdf] [Word]
• Applicant Certification for Water Main Extensions not Owned by the Supplier of Water
• Engineer's Certification
  • Certifications must be signed and sealed, and must identify the project name and DEH serial number.
    Suggested template: [Word] [pdf]
  • Certifications must satisfy requirements of the N.C. Board of Examiners for Engineers and Land Surveyors.
• Mail certifications to
  • Public Water Supply Section, Technical Services Branch
    1634 Mail Service Center
    Raleigh, NC 27699-1634
• Forms missing required information will be returned.