Recreational Camp Permit Application

Recreational Camp Permit Application
Please ensure the following are submitted with this application:
- Proof of connection to an approved water source
- Proof of connection to public sewer or an onsite wastewater system operating permit.
- Swimming pool and spa operating permits from TriCounty Health (if applicable).
- Food Service operating permit from TriCounty Health (if applicable).
- Company information for solid waste disposal.
*Additional applications and fees may be required based on services provided by your facility. Ex) swimming pools and food service applications must be submitted seperately.

The facility must have a pre-opening inspection performed by TriCounty Health prior to use.

Parcel Number*
Facility Name*
Facility Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is the Mailing Address Different From the Facility Address?*

YesNo
Mailing Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Purpose of Camp*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.

Owner Name*

First NameLast Name
Owner's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Name of Secondary Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.

Please Submit Any Permits or Other Required Documents*

Cancelof

Inspection & Permit Fee

$100.00 Quantity

Total

$0.00

Credit Card

Signature*

Clear
Should be Empty: