|
Environmental Health Applications
and Forms
These forms are in Adobe PDF format, which means you will need
Adobe Acrobat Reader in order to view them. For best results, Adobe Acrobat
Reader 6.0 or higher should be used. Adobe Acrobat Reader is free
software and can be downloaded from the following link:
Adobe Reader Download
These forms implement interactive textfields and
checkboxes. Note that if you plan on taking advantage of these, all
data must be entered into the form during the same session. Also, if
you are on a dial-up or other slow connection, these forms may take some
time to load.
The links below provide the applications and forms
that can be downloaded and/or printed.
| * EH Fees are subject to change. |
| Type of Application / Form |
Description |
Price |
|
Environmental Health Services Application |
|
Raw Land Evaluation
|
$156.00
|
|
Water System Evaluation
|
$156.00
|
|
On-Site Sewage Treatment
Disposal System Evaluation
|
$156.00
|
Water System and OSTDS Evaluation
|
$208.00
|
|
Water Sample Collection (lab fees additional)
|
$52.00
|
|
| On-Site
Sewage Treatment/Disposal System & Well Construction Permit Application |
|
On-Site Sewage
Treatment/Disposal System - (new systems with prior approval)
|
$219.00
|
|
Repair or Replacement of
OSTDS
|
$219.00
|
|
Earthen Privy
|
$156.00
|
|
Vaulted Privy
|
$115.00
|
|
Septic Tank Replacement
|
$115.00
|
|
Residential Well
(new or replacement)
|
$208.00
|
|
Type II Well
(new or replacement)
|
$364.00
|
|
Type III Well
(new or replacement)
|
$312.00
|
|
|
Write-Off Of Existing Sewage System Application
|
|
Request to utilize existing
sewage system (with Soil Test)
|
$156.00 |
|
| Parcels |
Onsite Sewage & Water Supply for Parcels Less than 1 Acre |
N/A |
|
| Authorization Form |
Property owners
authorization for a representative to sign permits |
N/A |
|
| Temporary Food Service Application |
A temporary food service license for food
service establishments operating on a temporary basis. [Less than two
weeks]. (Price is if
applied for seven or more days prior to event). |
$56.00 |
|
Food Service Plan Review |
|
| Variance Request Form |
Request for deviation/variance.
|
$59.00
|
| FOIA Request Form |
Request for information pursuant to the Freedom of Information
Act.
|
Varies
|
|