Tooele Health Department
             
Tooele County Health Department
151 N. Main Street, Suite 140 - Tooele, UT 84074
Phone (435) 277-2440 Fax (435) 277-2444

Application for Body Art Establishment Permit
Please put N/A for any fields that are not applicable
Establishment Name
Organization Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:

Name of Business Owner
Phone Number
Street Address
Mailing Address (invoice/correspondence)
Applicant is
If partnership, list name and address of each partner
If you have additional documents to send, please email them to eh@tooeleco.gov

 
Is this for a Mobile Body Art Establishment?
Yes
No
If yes, please email EH@TooeleCo.Gov with dates and locations of each event. Pictures of the space used for the events must also be emailed.


Applicant agrees that maintenance of a health permit is predicated on compliance with the
Tooele County Health Regulations for Body Art Facilities.
This permit is revocable for non-compliance.
Permit is valid for one year from date of issue.

Applicant's Signature

BODY ART ESTABLISHMENT PERMIT (Annual):   $100.00   Select:   Item Subtotal:  
$0.00
MOBILE BODY ART ESTABLISHMENT PERMIT(Annual):   $100.00   Select:   Item Subtotal:  
$0.00
Temporary Event Permit (per day/per event):   $15.00   Quantity:   Item Subtotal:  
$0.00
Late Fee If Applicable:   $   Item Subtotal:  
$0.00
Total:
$0.00
'Please Select Method of Payment to Continue'
Organization Name: is required
Address: is required
City: is required
State/Province: is required
ZIP/Postal Code: is required
Phone: is required
Email: is required
Name of Business Owner is required
Phone Number is required
Street Address is required
Mailing Address (invoice/correspondence) is required
Applicant is is required
If partnership, list name and address of each partner is required
Applicant's Signature is required