Monroe County, MI · Monroe County
Environmental Health Inspection Request
Child care center applicants and licensees use this form to request an environmental health inspection from their local health authority.
At a glance
- Issued by
- City of Monroe County · Monroe County, Monroe County, Michigan
- Notarization
- Not required: file this form without a notary.
- Official source
- co.monroe.mi.us
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This request asks the local health authority to inspect a facility for licensing, renewal, reinspection, plan review, or another listed reason. The applicant or licensee completes sections 13–25 with facility and contact details, directions, comments, and a signature. The instructions say to contact the local health department about its inspection fee; incomplete sections may result in the form being returned.
Who needs it
Child care center applicants or licensees who need an environmental health inspection for a listed licensing, renewal, reinspection, or plan review reason use this form.
How to submit it
Use the local health department map to identify the health inspection agency for the county where the center is located. Mail the completed form to that agency and enclose its required fee; contact the agency to verify the fee.
About notarization
This document is signed and dated without a notary; the signer just signs and dates the request.
How to submit this form
- 1
Download the Request
Download the Environmental Health Inspection Request form.
- 2
Complete the Applicant Sections
Complete sections 13–25 with facility details, directions, comments, and the applicant or licensee signature and date.
- 3
Identify the Health Agency
Use the local health department map to find the inspection agency for the county where the center is located.
- 4
Submit the Request
Mail the completed form to the local health department with its required fee; contact the agency to verify the fee.
Frequently asked questions
- Who uses the Environmental Health Inspection Request?
- Child care center applicants or licensees use it to request an environmental health inspection from the local health authority for a listed reason, such as a new application, renewal, reinspection, or plan review.
- How do I submit the inspection request?
- Use the local health department map to identify the health inspection agency for the county where the center is located. Mail the completed form to that agency and enclose its required fee; contact the agency to verify the fee.
- Do I need a notary for the Environmental Health Inspection Request?
- No. The form asks the applicant or licensee to sign and date the request; it does not require notarization.