Well, Septic, and Short-Term Rental Forms

How to Apply and Pay

Submitting your Well and/or Septic project or inspection form and payment can be done in a few easy steps. 

Step 1
Review New Fee Schedule

Review the updated 2026 fee schedule to determine the fee related to the inspection you need. 
Step 2
Complete the Form Below

Use the form below to submit the information about your project. 

This form needs a stable internet connection. If it stalls or doesn’t submit, please call (269) 621-3143 for help.
Step 3
Submit Payment

Options to submit payment:

  • Online via the payment link below
  • Over the phone
  • In person
Step 1

Review 2026 Fee Schedule

Find the fee related to the inspection you need. 

2026 Fee Schedule 1-14-26
Step 2

Fill Out The Form

This form needs a stable internet connection. If it stalls or doesn’t submit, please call (269) 621-3143 at ext.1311 for help.

Instructions: Fill in all details about your inspection request. When you click Submit, your information will be sent to the correct office and a PDF copy will be created for your records.
Required: Your site drawing must show how far the well is from the nearest contamination source.

Application for WELL and/or SEPTIC Project or Inspection

Choose your PROJECT OR INSPECTION TYPE(S) and take note of the ASSOCIATED FEES. Look for the * as some services will require a Scale Site Drawing, including dimensions and all possible sources of contamination be provided.

Next Step: Click the Submit button above and a printable version of your application will be emailed. If you are having difficulties submitting your application, contact EH at (269) 621-3143 at ext. 1311.

Step 3

Submit Payment

We offer several ways to pay. 

Pay Online

You can pay your permit fee easily through our secure online payment portal.

Click to Pay Online

Mail or In-Person Payment

You can send your payment to the Van Buren/Cass District Health Department at either of these locations:

Cass County Office:
302 S. Front Street, Dowagiac, MI 49047

Van Buren County Office:
260 South Street, Lawrence, MI 49064

You can also print your application and bring your payment to one of the offices listed above.