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Wayne County Health Department
Executive Director: Eric Coulter
Located West of the Courthouse at 201 East Main
Vital Records and Environmental Health:
E-Mail:

Phone: (765) 973-9245
Clinic and Nursing Division:
Phone: (765) 973-9294

Although the Wayne County Health Department provides many services to the citizens of Wayne County, Indiana our most common inquiry from Internet users is for birth and death certificates for people who are doing genealogical research. To aid these researchers, we have provided scans of the forms used to request certificates through the mail below. Choose the appropriate form, fill it out, and then print the page from your browser. Instructions are on the forms. Note: You must have Adobe Acrobat Reader which you can get for free from Adobe's website

Address:
Wayne County Health Department
201 East Main
Richmond, IN 47375

 

Food Service Establishment Online Applications

Application for Food Service Establishment and/or Mobile Food Unit Permits
Application For Not-For-Profit Food Srvice Establishment
Application for Temporary Food Service Permit

 

Fee Schedule

Fee Schedule, The following fee schedule as established by the Board of Health and hereby approved by the Board of Commissioners of Wayne County, Indiana, pursuant to Indiana Code Section 16-20-1-27, shall be collected by the Health Department when providing those services described therein, or when furnishing to a person copies of vital records as set out therein:

FOOD SERVICES
AMOUNT
Food Service Establishment Permit and Retail Food Store Permit Up to 3,000 square feet, $200.00
Food Service Establishment Permit and Retail Food Store Permit From 3,001 square feet to 8,000 square feet $300.00
Food Service Establishment Permit and Retail Food Store Permit 8,001 square feet and over $450.00
Mobile Food Unit Permit (12 months) $150.00
Temporary Food Service Establishment Permit $15.00 per day
Retail Food Establishment-Bed & Breakfast Permit $100.00
Reinstatement of any Retail Food Establishment Permit or Mobile Retail Establishment Permit $200.00
Retail Food Establishment Plan Review (Application filed prior to commencement of any construction) $200.00
Retail Food Establishment Plan Review (Application filed after commencement of any construction) $300.00
Retail Food Establishment Plan Review (Application for remodel on existing construction) $150.00
Retail Food Establishment Plan Review (Application filed after remodel) $250.00
Retail Food Establishment Permits-issued after July 1st of any calendar year
One half the applicable annual fee

Note: All Retail Food Establishment fees are to be paid annually based on a calendar year.
No fees will be prorated during any calendar year except as noted herein.

RESIDENTIAL SEWAGE DISPOSAL SERVICES
AMOUNT
Residential Sewage Disposal - Written Permit (New Construction) $300.00
Residential Sewage Disposal - Written Permit (Replacement) $200.00
Residential Sewage Disposal - Written Permit (Repair) $100.00
Registration Fee for Residential Sewage Disposal System (Contractors) $150.00
Registration Fee for Residential Sewage Disposal System (Employee of Contractor) $50.00
Contractors indemnity bond (minimum amount of bond) $5,000.00

 

PUBLIC & SEMI POOL SERVICES
AMOUNT
Public and Semi-Public Pool License (12 months)
$150.00
Public and Semi-Public Pool License (Seasonal-6 months or less)
$100.00
Wading Pool, Spa, and Diving Pool (12 months)
$75.00
Wading Pool, Spa, and Diving Pool (6 months)
$50.00

 

VITAL RECORDS SERVICES
AMOUNT
Birth Certificate- first copy (Paper Copy)
$9.00
Each additional paper copy of birth certificate when issued at the same time on the same record
$3.00
Death Certificate (includes $1.75 for Coroner's training fund)
$12.00
Each additional copy of death certificate when issued at the same time on the same record
$6.00
Correction to Birth Certificate
$35.00
Paternity Affidavit Upon Marriage
$35.00
Paternity Affidavit
$35.00

 

 
Revised 01/02/2014 11:32 Copyright Wayne County Government