Type Full Name :
Sign With Hand
Organization Name
Property Manager
State
City
Certification
Required Attachments
Who is the primary contact person for this project. e.g. the property owner, a project supervisor or site foreman
Address
Name
State
Business Owner Information
Email
Phone #
Name
Name
Name
Licensed Pool Operator Information
Address 2
ZIP
Phone #
Phone #
Signature
ZIP
Specify Address where the pool is located.
Email
ZIP
The undersigned do hereby apply for an inspection to operate a Public Pool in South Orange Village. I/We agree to abide by the regulations and ordinances of the Village and the State of NJ.
City
Email
Email
{[PNAME]}
Phone #
Application Fee
Same as Owner?
In order to obtain a {[PNAME]} permit, you must provide a Trained Pool Operator's Training Certificate.
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Address
Same as Owner?
Address
Facility Information
Amount Due
City
State
Emergency Contact Information