Applications, Forms & Fees

Food Service

  1. 2018 Food Service Plan Review Application (PDF)
  2. 2018-19 Food Service License Application (PDF)
  3. Mobile Food Service Establishment Commissary Verification Form (PDF)
  4. Restaurant Change of Owner Application (PDF)
  1. Special Transitory Food Unit (STFU) and Mobile Food Establishment Plan Review Application (PDF)
  2. STFU Notice of Intent to Serve (PDF)
  3. Temporary Food Service License Application (PDF)

Pollution Prevention

  1. 2018 Pollution Prevention Status Sheets (PDF)
  1. 2018 P2 Cover Letter (PDF)

Well / Septic

  1. Application for Non-Residential Onsite Well and - or Sewage Project (PDF)
  2. Application for Residential Onsite Well and - or Sewage Project (DOC)
  3. Application for Residential Onsite Well and - or Sewage Project (PDF)
  4. Application for Subdivisions and Site Condominiums (PDF)
  5. Auxiliary Well Registration Form (PDF)
  6. Septic Tank Pumper Report (DOC)
  7. Septic Tank Pumper Report (PDF)
  8. Sewage System Operation and Maintenance Report (PDF)
  9. Time of Sale Escrow Agreement (PDF)
  10. Time of Sale Inspection Report (PDF)
  1. Time of Sale Inspector Application (PDF)
  2. 2018 Initial Application for Certification as a Sewage System Installation and Repair Contractor (PDF)
  3. 2018 Initial Application for Certified Operation and Maintenance Provider (COMP) (PDF)
  4. 2018 Renewal Application for Certification as a Sewage System Installation and Repair Contractor (PDF)
  5. 2018 Renewal Application for Certified Operation and Maintenance Provider (COMP) (PDF)
  6. Application for Environmental Health Addition or Change of Use Review (PDF)
  7. Application for Non-Potable Well Project (PDF)
  8. Application for Non-Residential Onsite Well and - or Sewage Project (DOC)
  9. Processing Procedures and Guidelines for Subdivisions and Site Condominiums

Forms

  1. Hearing Request Form (PDF)
  1. Credit Card Authorization Form (PDF)

Fees

  1. 2018 Environmental Health Fee Schedule (PDF)
  2. 2018 Temporary Food Service Licensing Fees (PDF)
  1. Water Testing Fees (PDF)

The Credit Card Authorization form (PDF) can be faxed (734-222-3930) or mailed it to our office. For security and privacy reasons, Washtenaw County does not accept credit card information via email.


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