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 Temporary Massage Establishment Permit
** Application and Permit Fee Schedule**
$15.00 per day, per booth, per location

If you have additional documents to send, please email them to eh@tooeleco.gov.

Please put N/A for any fields that are not applicable

Event Name
Location
Event Coordinator
Phone Number
Booth Name
Booth Owner
Organization Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:

Booth Contact Person
Phone
Requested Permit Dates:
First Day
Last Day
Time of Operation:
From AM/PM
To AM/PM
What sanitation procedures will you be using at the event?
Will there be a hand sink at the temporary location?


Applicant agrees that maintenance of a health permit is predicated on compliance with the
Tooele County Health Department Regulations for Massage Establishments.
This permit is revocable for non-compliance.

Booth Fee Per Day Per Booth:   $15.00   Quantity:   Item Subtotal:  
$0.00
*If you have multiple booths, you will need to complete an application for each booth.
Total:
$0.00

I Agree
Applicant agrees that maintenance of a health permit is predicated on compliance with the Tooele County Health Department for Body Are Establishments. This permit is revocable for non-compliance.
Applicant's Signature
Date
 
Event Name is required
Location is required
Event Coordinator is required
Phone Number is required
Booth Name is required
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
Booth Contact Person is required
Phone is required
First Day is required
Last Day is required
From AM/PM is required
To AM/PM is required
What sanitation procedures will you be using at the event? is required
Will there be a hand sink at the temporary location? is required
'I Agree' must be checked to submit
Applicant's Signature is required
Date is required