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Swimming Pool Renewal Application Business Owner Information: Date Tax ID # Name _____________________________________ Business Phone ____________________________________________ Name of Business _______________________ Business Owner Name__________________________________ Business Address Suite Zip Code Mailing Information: Name Phone Mailing Address City State Zip Code Property Owner Information: Name Phone Address City State Zip Code General Information: Gate Code (if applicable) ___________________________ Emergency Contact Phone Name of person holding Certified Pool Operator Certification_____________________________________________________Expiration Date _______________________ Health Permit Information: Permit # New Pool Application Fee: $250.00 #4418 Swimming Pool (number of pools) @$160.00 per pool Consumer Health Renewal Swimming Pool Application PHONE 940-349-8360 FAX 940-349-7208 Consumer Health Division * 401 N. Elm St. Denton, Texas 76201 * 940.349.8360 * 940.349.7208 Fax