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FOSTER-ADOPTION APPLICATIONMarshal’s Office Environmental Health 1400 Schertz Parkway Schertz, TX 78154 210-619-1650 Schertz.com Environmental Health FOSTER/ADOPTION LICENSE APPLICATION PLEASE FILL OUT ALL INFORMATION: RESIDENT NAME: ________________________________________________________________________________________________________ STREET ADDRESS: _______________________________________________________________________________________________________ CITY, STATE, ZIP CODE: __________________________________________________________________________________________________ DRIVERS LICENSE# (ATTACH CURRENT COPY): ______________________________________________________________________ PHONE: __________________________________ EMAIL: ________________________________________________________________________ FOSTER AGENCY INFORMATION: ______________________________________________________________________________________ CITY, STATE, ZIP CODE: __________________________________________________________________________________________________ PHONE: ____________________________________________________EMAIL: _______________________________________________________ AGENCY CONTACT PERSON: ____________________________________________________________________________________________ FIRE INSPECTION $50.00 HEALTH INSPECTION $50.00 _________________________________________________________________________________________ All of the information contained in this application is true and correct to the best of the applicant’s knowledge and belief. Applicant acknowledges that the permit applied for shall be subject to all provisions of the orders and ordinances of the City of Schertz. Applicant Signature: _____________________________________________________________Date: ____________________ Office use only-Permit#: ____________________________ Date Pd.: ______________________________________ Ck/CC Inspection Date: ________________________________________ Time: _______________________________________________