Other Environmental Health Services Only EH Other Payments (New) Name* First Last Phone*Submitting payment for service type* Environmental Health Services Check box for pop-up menu and list of other EH services.For Environmental Health Services (EHS) Please select items below, enter Facility Name, Mailing Address and Attach Applications, supporting documents or images below.For Environmental Health Services (EHS) Please select items below, enter Facility Name, Mailing Address and Attach Applications, supporting documents or images below. Campground Inspection Food License New / Renewal Level 2 Assessment Pool Inspection Temporary Food Permit Type II Permit Other EHS Description for Other EHSDescription for Other EHSDescription for Other ServicesDescription for Other ServicesFacility NameMailing Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Submitting payment(s) for which County:CASSVAN BURENBOTHThis field is hidden when viewing the formDescriptionInvoice / License / Permit NumberPlease provide if possibleAttach applications, supporting documents or images (optional) Drop files here or Select files Max. file size: 50 MB. Payment Amount Please Note: We no longer will be processing payments by PayPal. All payments are processed by AllPaid. See updated payment fees schedule.EmailThis field is for validation purposes and should be left unchanged.
