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 Massage 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
Mailing Address (invoice/correspondence)
Applicant's Phone Number
Applicant's Address
Applicant Is
Individual
Partnership
If partnership, list name and address of each partner:
If you have additional documents to send, please email them to eh@tooeleco.gov.

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. Permit is valid for one year from date issued.
Signature of Applicant
Date

Massage Establishment Permit:   $25.00   Item Subtotal:  
$25.00
Total:
$25.00

'Please Select Method of Payment to Continue'

Payment Information:
Method of Payment:
  Credit/Debit Card
  eCheck
 Update Name from Above
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
Mailing Address (invoice/correspondence) is required
Applicant's Phone Number is required
Applicant's Address is required
Signature of Applicant is required
Date is required
You must enter a payment method.