Forms & Applications

Forms & Applications

Food Service Applications, Forms, & Regulations
Name: Description:
Food Permit Application Application for a Virginia Department of Health Foodservice Establishment Permit
Plan Review Application

*Submit the Plan Review Application and the Food Permit Application to:

Piedmont Health District

 111 South St, Ground Floor

Farmville, VA 23901

Application for Virginia Department of Health Plan Review
VA Food Regulations Virginia Department of Health Food Regulations
Mobile Unit Fire Inspection Checklist

Mobile Unit Fire Inspection Contract

Mobile Unit Plan Review

Virginia Department of Health required Mobile Unit forms
Temporary Food Event Vendor Application

*To apply for a Temporary Food Establishment Permit, submit a completed application and fee of $40 to the local health department in which the TFE will be located.

Application for a Temporary Food Establishment which must be submitted 10 business days prior to an event
TFE Checklist Checklist of requirements for a Temporary Food Establishment
Temporary Food Event Coordinator Application  Event coordinators should submit the application at least 30 calendar days before the event in order to assist in the review of the individual temporary food establishment applications.

 

Fees effective as of July 1, 2011
Program Plan Review Fee Annual Permit Fee
Hotels/Motels $40 $40
Restaurants $40 $40
Summer Camps $40 $40
Campgrounds $40 $40
Temporary Food Permit n/a $40 Annual Permit Fee

 

Hotel, Summer Camp, Campground, & Migrant Labor Camp Applications, Forms, & Regulations
Name: Description:
Hotel/Tourist Establishment Permit Application Application for a Hotel or Tourist Establishment permit
Hotel Plan Review Application Application for a Hotel Plan Review
Sanitary Regulations for Hotels Virginia Department of Health Sanitary Regulations for Hotels
Chapter 460. Regulations Governing Tourist Establishment Swimming Pools and Other Public Pools Virginia Department of Health Regulations for Tourist Establishment Swimming Pools
Chapter 462. Swimming Pool Regulations Governing the Posting of Water Quality Test Results Virginia Department of Health Regulations for Posting Water Quality Test Results
Campground Application

Application for a Campground Plan Review

Applications for a Virginia Department of Health Campground Permit & Plan Review
Summer Camp Application Application for a Department of Health Summer Camp Permit
Migrant Labor Camp Permit Application Application for a Migrant Labor Camp Permit
Chapter 501. Rules & Regulations Governing the Construction & Maintenance of Migrant Labor Camps Virginia’s Legislative Informative System, Chapter 501. Rules & Regulations Governing the Construction & Maintenance of Migrant Labor

 

Onsite Sewage (Septic) & Well Water Program
Name: Description:
Commonwealth of VA Septic & Well Application Application for Sewage System & Water Supply
SAP Application Safe, Adequate, & Proper (SAP) Application
Survey Plot Waiver Request for a Waiver to the Survey Requirement
Verification of System Location Documentation Verifying Sewage System Location
Temporary Pump & Haul Application for Pump & Haul
Sewage Handler Application for Sewage Handling Permit
Find an Operator, OSE VDH Septic System & Private Well Service Providers
VDH Water Services VDH Description of On-Site Water & Wastewater Services
Regulations & Current Regulatory Activity VDH Regulations & Current Regulatory Activity

 

APPLICATION TYPE FEE (effective June 27, 2025)
Certification letter with OSE/PE documentation, < = 1,000 gpd $320
Certification letter with OSE/PE documentation, > = 1,000 gpd  $1,400
Construction permit for only onsite sewage system with OSE/PE documentation, < = 1,000 gpd $225
Construction permit for only onsite sewage system with OSE/PE documentation, > = 1,000 gpd $1,400
Private well only, with or without OSE/PE documentation $300
Repair permit for a treatment works, < 1,000 gpd with OSE/PE documentation $225
Repair permit for a treatment works, > 1,000 gpd with OSE/PE documentation $1,400
Voluntary Upgrade for a treatment works, < 1,000 gpd with OSE/PE documentation $225
Voluntary Upgrade for a treatment works, > 1,000 gpd with OSE/PE documentation $1,400
Safe, adequate, and proper evaluation with OSE/PE/Installer/Operator Documentation $100