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PLC:7710
Agency:Tulare County Environmental Health Department
For:FEES
Phone:559-624-7400

Address:5957 S Mooney Blvd
Visalia, California 93277

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*Required Fields
*Business Owner's Name First:
Business Owner's Name Middle:
*Business Owner's Name Last:
*Facility Name:
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Street 2:
*City:
*State:
*Zip:
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if different from business owner.

*Invoice Date: (mm/dd/yyyy)
*Invoice ID #:
*Amount Due:
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