North Dakota Code § 23-30-11

Territory to be annexed
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1. Any territory which is adjacent to the boundary of an existing hospital district may be 
annexed to such district in the manner hereinafter provided.
2. The proceedings for the annexation, referred to in subsection 1, may be initiated by 
the presentation to the county auditor of a petition signed by thirty percent or more of 
the qualified electors who are owners of any interest in real property assessed for 
taxation in the territory to be annexed and who are residing within the boundaries of 
such territory stating the desires and purposes of such petitioners. The petition must 
contain a description of the boundaries of the territory proposed to be annexed. It must 
be accompanied by a map or plat and a deposit for publication costs.
3. The county auditor shall consult the tax schedules in the county auditor's office and 
determine and certify whether or not such petition complies with the requirements of 
subsection 2 and that the qualified electors signing the same appear to reside within 
the boundaries described by such petition. Thereafter, the county auditor shall forward 
such petition, map or plat, and certificate to the board of directors of the district 
concerned.
4. Within thirty days after receiving the petition, map or plat, and certificate of the county 
auditor, in accordance with subsection 3, from the county auditor, such board of 
directors shall transmit the same to the proper county board, accompanied by a report 
in writing approving or disapproving the proposal contained in the petition, or 
approving such proposal in part and disapproving it in part.
5. If the report of the board of directors, referred to in subsection 4, disapproves the 
proposal, the petition must be rejected. If the report is favorable to such proposal, 
either in whole or in part, the board of county commissioners shall give notice of 
election in the manner prescribed by section 23 -30-03 and submit the question to the 
qualified electors at the next regularly scheduled primary or general election as to 
whether or not the qualified electors of the proposed area desire to be annexed and 
whether they approve of the mill levy authorized by section 23-30-07 for the purpose of 
supporting such hospital district. If at least sixty percent of the qualified electors voting 
in the election within the territory proposed to be annexed approve, the territory 
becomes a part of the existing hospital district.

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