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Please complete this form after you have submitted your renewal application through DocuSign.
The following fee schedule as established by the St. Joseph County Board of Healthand hereby approved by the Board of Commissioners of St. Joseph County Ordinance No. 149-22
Government and Schools are exempt from late fees.
You must list all the business addresses for all the permits you are paying for at this time. For example, if you have 3 locations, you can fill out 3 applications through DocuSign, and then use this one payment form to pay for all three applications. Just list all three business location addresses.
Online payments are processed by Forte. A fee of 2.55% or $1.55 (whichever is greater) will be assessed for all credit card payments. Electronic Checks are also accepted, and will be assessed a flat $2.00 for any payment under $50,000. The appropriate fee will be added to the total cost of your payment.
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