180 S. Main St., Ste. 252, Martinsville, IN 46151

765-342-6621, Fax: 765-342-1062 morgancohd@morgancountyhealth.com

Online Swimming Pool Permit Application

The fee for the Swimming Pool Permit is $150 for full-time, and a seasonal permit is $75.

Credit or debit card via the GovPay website:

GovPay Button

***Please note: When paying online, you MUST include a copy of the receipt from GovPay with your application forms. Please fill out one form for each establishment. You may combine payments for your establishments, but you must upload the GovPay receipt to each form.

Online Application for Public or Semi-Public Pool/Spa Permit

Type of facility:*

Pool & Spa Facility Information

Facility Name:*
Facility Address:*
Facility Phone:*
-
Facility Fax:
-
Facility E-mail:

Email addresses are solely used as contact information and will not be shared with 3rd parties.

Owner Information

Owner Name:*
Owner Address:*
Owner Phone:*
-
Owner E-mail:*

Operator Information (if different from the above)

Operator Name:
Operator Address:
Operator Phone:
-
Operator E-mail:
Dates & Hours of Operation:*
Check all amenities available at this facility:*

A weekly water sample must be submitted at least one week prior to opening date and the results must be satisfactory.

Has the pool/spa been remodeled or have operations of the pool changed?*
If yes, please describe:
Contact Information in Case of Emergency:*
Go paperless! Please indicate below if you would prefer electronic notification regarding your permit(s):

Payment Information

Total Amount Paid to GovPay:*
GovPay Transaction Number:*
Upload a Copy of GovPay Receipt (jpg, jpeg, png, gif, doc, docx, xls, xlsx):*
Word Verification: