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HomeMy WebLinkAboutFY24-25 Fee ScheduleNew Hanover County Fee Schedule FY24-25 Department Service Fee Amount COUNTY-WIDE Copy Fee $0.10 per page County-wide unless Department has an established copy fee for specialized documents. Known exceptions to this fee are Elections, Library, Building Safety, Register of Deeds and Tax. 911 COMUNICATIONS CD $5 Copies $0.10 per page BUILDING SAFETY Refer to Exhibit 1 of this document for the Inspection Fee structures. NHC Training and Education Classes:Not to exceed $25 per contact hour per participant Classes are periodically offered to the public. Classes may include inspector continuing education, Journeymen classes, and Contractor continuing education. Fees for these classes vary, based on class duration (contact hours), complexity of the material, number of handouts, other included services (such as exam scoring and processing to State examining authorities), completion certificates, and qualification cards. COMMUNICATIONS NHCTV Service Fees for each event: & OUTREACH Studio & Control Room Equipment Fee $50/hr. (4 hour minimum) Meeting set-up/breakdown, any location, using 2 technicians $35/hr./tech. (2 hour minimum) Production Services: Live Broadcast from NHC Government Center or Historic Courthouse Assembly Room and Rebroadcast. Minimum 2 NHCTV technicians at 3 hours each $35/hr./tech. (6 hour minimum) Live Broadcast from Off-site locations with appropriate internet access and rebroadcast. Minimum 3 NHCTV technicians at 3 hours each. $35/hr./tech. (9 hour minimum) Minimum 2 IT staff support at 2 hours each. $50/hr./IT staff (4 hour minimum) Recording from NHC Government Center & Rebroadcast. Minimum 1 NHCTV technician at 3 hours. $35/hr./tech. (3 hour minimum) Recording from NHC Historic Courthouse Assembly and Rebroadcast. Minimum 2 NHCTV technicians at 3 hours each. $35/hr./tech. (6 hour minimum) Recording from Off-site locations and Rebroadcast. Minimum 3 NHCTV technicians at 3 hours each. $35/hr./tech. (9 hour minimum) Post-processing: Minimum of 1 NHCTV technician @ 3 hours $35/hr./tech. (3 hour minimum) Travel from NHC Government Center to Broadcast Site: Minimum 1 hour per NHCTV technician $35/hr./tech. (1 hour minimum) Minimum 1 hour per IT staff support $50/hr./staff (1hour minimum) Related fees that may apply for NHC Government locations: Facility and Overhead Fees As determined by County Manager Housekeeping Service As determined by Property Mgt. Security Fees As determined by Sheriff's Office COUNTY ATTORNEY Preparation/recordation of notice of noncompliance $28 Preparation/recordation of promissory note/deed of trust (These fees are collected by Finance.)$40 LEGAL DIVISION Public document request under G.S. 132-6-2, where the compilation and quantity does not constitute extensive use of resources. $0.10 per page ELECTIONS CD $25 e-mail no charge Campaign finance reports and related elections $0.20 per page Copies: Color Copies 8x11 $1.00 Copies: Color Copies 11x17 $1.00 District Maps:Color 8.5x11 $1.00 District Maps:Color 11x17 $1.00 District Maps:Color 22x34 $10.00 EMERGENCY MANAGEMENT Hazardous Material Reporting (Tier II) by weight: Underground storage containers $50 0-999,999 lbs. per facility $150 1,000,000 lbs. and above per facility $300 ENGINEERING Sedimentation & Erosion Control Fees: Residential Subdivision: Review Fee (paid at time of application; includes initial and 2nd review)$200 Land Disturbance Fee (paid at time of plat recordation)$300 per acre All lots must be in the limits of disturbance and have erosion control measures Fee Schedule FY24-25 (Revised 7-01-24)Page 1 New Hanover County Fee Schedule FY24-25 Department Service Fee Amount ENGINEERING (continued) Subsequent Reviews (for each review after 2nd review)$200 each Modifications $200 Name/Address Change $200 Transfer of Ownership $200 Commercial Development: Review Fee (paid at time of application; includes initial and 2nd review)$200 Land Disturbance Fee (paid at time of Certificate of Completion or Occupancy)$300 per acre Subsequent Reviews (for each review after 2nd review)$200 each Modifications $200 Name/Address Change $200 Transfer of Ownership $200 Stormwater Authorization to Construct (ATC): Application Fee: Review Fees: 10,000 Square Feet up to 1 Acre: Includes initial and 2nd review $100 (includes both the initial and 2nd review) For each review after 2nd review $100 (per review) 1 Acre up to 10 Acres: Includes initial and 2nd review $250 (includes both the initial and 2nd review) For each review after 2nd review $250 (per review) 10 Acres up to 50 Acres: Includes initial and 2nd review $500 (includes both the initial and 2nd review) For each review after 2nd review $500 (per review) 50 Acres and more: Includes initial and 2nd review $10 per Acre (includes both the initial and 2nd review) For each review after 2nd review $10 per Acre (per review) Transfer of Ownership of a stormwater facility operating in accordance with an Authorization to Construct (ATC) $100 ENVIRONMENTAL Category: MANAGEMENT Minimum Fee $5.00 Municipal Solid Waste $52 per ton Atypical/Non-Standard/Unconventional Acceptable Solid Waste: Requiring additional site preparation $62 per ton Likely create a nuisance condition $62 per ton Provides a beneficial use $52 per ton less materials' value if purchased from commercially available sources for its intended use Banned Material $104 per ton Construction/Demolition $52 per ton Concrete/Brick/Dirt (Contaminated)$52 per ton Concrete/Brick/Dirt (100% Clean - Recycled)*$30 per ton Sheetrock, Clean $35 per ton Shingles/Built-Up Roofing (Mixed)$52 per ton Asphalt Shingles (100% Clean - Recycled)*$30 per ton Cardboard (100% Clean - Recycled)*no charge Mixed Glass (Recycled)no charge Color Sorted Glass (Recycled)no charge Sludge (accepted with Special Approval only)$80 per ton Tires (Generated during the "Normal Course of Business")no charge Tires (Not generated during the "Normal Course of Business")$100 per ton Pender Commerce Special Waste $54 per ton Palm Trees $25 each Yard Waste-Commercial $25 per ton Yard Waste-Residential Less than 10,000 cumulataive tons per fiscal year $30 per ton Yard Waste-Residential More than 10,000 cumulataive tons per fiscal year $20 per ton Mattresses and Box Springs - per piece $52 per ton plus $10 per piece for each mattress and box spring Clean Lumber and Clean Concrete $10/ton Pallets Disposed in the Landfill $5/pallet Jump Starts $20 Safety Vest $5 Oyster Shells (Recycled)no charge Household or Lead Acid Batteries (Recycled)no charge Waste Oil/Antifreeze - Recycled no charge Appliances (Recycled)no charge Electronics Recycling (Homeowners only, Recycled) no charge Used Oil Filters (Homeowners only, Recycled)no charge *Must be verified by landfill attendant. FACILITIES MANAGEMENT Labor for non-county vehicle maintenance $53 per hour Fee Schedule FY24-25 (Revised 7-01-24)Page 2 New Hanover County Fee Schedule FY24-25 Department Service Fee Amount FINANCE Parking Deck Fees: Market & 2nd Street Decks Up to 2 hours $2 Up to 3 hours $3 Up to 4 hours $4 Up to 5 hours $5 Up to 12 hours $8 12 to 24 hours (max)$10 Monday thru Friday after 6:30pm $5 flat evening rate Saturday and Sunday (9pm-2am)$5 flat evening rate Monthly Unreserved Rate $75/month Special Events $10 flat rate fee FIRE RESCUE Refer to Exhibit 2 of this document for the Fire Fee structures. HEALTH Refer to Exhibit 3 of this document for the Health Fee structures. HUMAN RESOURCES Replacement badges for lost badges $7 per badge LIBRARY Lost & Damaged items: Lost items and items beyond repair List price + $5 Damaged items Case by case not to exceed list price Replacement disk (audio/visual)$10 Library card $1 Processing for books & audio/visual materials $5gpp magazines $2 Copies: Copies/Printing black/white $0.10 unit charge Copies/Printing black/white (cash)$0.15 unit charge Copies/Printing color (cash)$0.50 unit charge Copies/Printing color $0.30 unit charge FAX $1 unit charge Meeting Rooms (nonprofit use only): Administrative Fee-Nonrefundable $5 Miscellaneous: Non-Resident Library Card (annual)$30 Non-Resident Library Card (six months)$15 Flashdrive $5 Earbuds $1 MUSEUM Admission Fees: Adults $8 ($1 discount with AAA) Youth (6-17)$5 College Students $7 Seniors (65 and over)$7 Military with ID $7 Children, under 6 $0 First Sunday, NHC residents $0 Members $0 Museums for All $0 Room Use Fees - (during hours of operation): Non-Profit & government organizations $0 For-profit, private companies or groups $50 plus $10/hour Room Use Fees - (After hours of operation): Non-Profit & government organizations $20 plus $10/hour For-profit, private companies or groups $120 plus $20/hour School Programs: Museum Field Trips/Outreach (on-site): In-County Schools - guided: Student $4 Adult Free Teacher Free Bus Driver Free In-County Schools - self-guided: Student Free Adult Free Teacher Free Bus Driver Free Non-County Schools - guided: Student $7 Adult Free Teacher Free Bus Driver Free Non-County Schools - self-guided: Student $5 Adult Free Teacher Free Bus Driver Free Fee Schedule FY24-25 (Revised 7-01-24)Page 3 New Hanover County Fee Schedule FY24-25 Department Service Fee Amount MUSEUM (continued)Museum Outreach (off site): In-County Schools: Student $6 Non-County Schools: Student $7 Travel Subject to add'l mileage fee Virtual: Student $0 Museum Kits (check-out): In-County Schools Free Non-County Schools $15/week Family $5 School Events: In-County Schools - Student $5 Non-County Schools - Student $5 Public Programs: Scouts: Workshop $10 Summer Camps: Member Camper $70 Nonmember Camper $90 Summer Shorts (on-site or off-site): Participant $7 Family Programs (included with general Programs and Workshops Varies Family Events: Member Free Nonmember $5 Preschool Family Event: Children 6 and under $5 Accompanying Adultls Free Museum members Free Adult Programs: Lectures & Workshops Vary Collections Services: (Research, Consultation, Reproduction) 1st hour of staff time no charge Additional Staff Hours: Museum members $15/hour New Hanover County Residents $25/hour Non-New Hanover County Residents $50/hour Commercial Projects $100/hour Conservation Materials:Current Manufacturer Price; Price subject to change Encapsulation Materials: Polyester film $.004 per square inch Double-sided tape $.007 per inch Clothing and Textile Storage Products available through Cape Fear Museum Store Document and Photograph Storage Products available through Cape Fear Museum Store Reproduction Costs: Up to 12 low-resolution digital images by email Free High-resolution digital images Negotiated on a case by case basis. Use fees - one-time-use only: Commercial Projects: Book or Magazine: B&W/Color image $100/image Front Cover image $500/image Back Cover image $250/image Video or Film: Image provided by Cape Fear Museum $100/image On-site filming $200/object CD/DVD: B&W/Color image $100/image Decoration/Exhibit: B&W/Color image $100/image Website -renewable annually: B&W/Color image $100/image/annually Nonprofit Profits (501(c)(3) status)10% of commercial rate NCSU EXTENSION Master Gardener Training Program $275 - 10 week program-2 times a week Various classes $5 to $30 to cover materials only Soil, Nematode and irrigation water samples: varying fees charged by NCDA and go to the NCDA $0-$20 Soil Samples Free Fee Schedule FY24-25 (Revised 7-01-24)Page 4 New Hanover County Fee Schedule FY24-25 Department Service Fee Amount NCSU EXTENSION (continued)4-H Camps Various fees depending on camp Rain Garden Certification:Certificate $125 per person Friend of the Arboretum Membership: Student $15 Individual $30 Family $40 Contributor $100 Benefactor $250 Partner $500 Patron $1,000 Private Events-Weddings: Azalea Package Wedding1 hour up to 30 people, Monday - Friday $400 Camellia Package Wedding 2 hours up to 250 people, Tuesday - Thursday $1,000 Camellia Package Wedding 2 hours up to 250 people, Friday - Saturday $1,400 Rose Package Wedding & Reception 4 hours up to 250 people, Tuesday -Thursday $2,000 Rose Package Wedding & Reception 4 hours up to 250 people, Friday - Sunday $2,800 Additional hours above 4 hours $250 per hour Use of kitchen for cooking $200 per hour Auditorium use above 1 hours prior $50 per hour Refundable Security Deposit: Ceremony only $100 Ceremony and/or reception $500 Public Programs: Art in the Arboretum/Other Public Programs $0-$15/person PARKS & GARDENS PARKS DIVISION Fitness and Education based family programs Fee varies based on program Athletic Fields - Per Hour: Youth - Non-profit* (No Lights)None Youth - Non-profit* (Lights)None *Must show proff of Non-profit status Youth - Private/for profit (No Lights)$10 per hour Youth - Private/for profit (Lights)$30 per hour Adult - No Lights $10 per hour Adult - With Lights $30 per hour Tennis/Pickle Ball Courts-nonprofits (league reservations)$2.50 per hour Athletic Field Tournament Fees: Includes full weekend (2 days) Day Rental $125 per field Tournament Lights $20 per hr. per field Out of town team fee $30 per team Portable concessions $35 per day Electrical Box use $35 per day per box Picnic Shelters (4 hour rental): Small - County $25 Medium - County $35 Large - County $45 Small - Non-County $50 Medium - Non-County $70 Large - Non-County $90 Event Areas: Long Leaf Park Gazebo and Garden Area $300 for 4 hour rental Long Leaf Park Major Event (1,000 plus people)$1,000 per day Long Leaf Park Special Event (100-999 people)$500 per day Ogden Park Major Event (1,000 plus people)$1,000 per day Veteran's Park Major Event (1,000 plus people)$1,000 per day Walking Trail use for fitness events $150 per day Airlie Admission: Adults (non-member) County Resident $5 (includes tax) Adults (non-member) Non-Resident $10 (includes tax) Adults (non-member) Active Military $5 (includes tax) Children (ages 4-12)$3 (includes tax) Children under 4 years Free County free day; first Sunday of each month New Hanover County residents no charge Fee Schedule FY24-25 (Revised 7-01-24)Page 5 New Hanover County Fee Schedule FY24-25 Department Service Fee Amount PARKS & GARDENS (continued)Airlie Membership: Individual $40 (includes tax) Family Package (2 adults; children under 18 free)$75 (includes tax) Magnolia Package $525 (includes tax) Azalea Package $1000 (includes tax) Airlie Concert Series: Adults (non-member)$10 (includes tax) Children (ages 4-12)$3 (includes tax) Echo Farms Pool: Children $2 Adults $4 Season Pass - Family $175/swim season Season Pass - Individual $100/swim season Echo Farms Tennis: Court Reservation (1.5 hour block)$8 Skills Clinic (1 hour)$10 Round Robin $3 Enchanted Airlie: Member no charge Carload Pass $35 (includes tax) Environmental Education (EE) Programs: NHC schools $3 per child (includes tax) Private NHC County Schools $4 per child (includes tax) Private Out of County Schools $5 per child (includes tax) Guided tours:no extra charge with admission Bird Hikes: Non-member-NHC resident or military $5 (includes tax) Non-member and Out of County resident $10 (includes tax) Oyster Roast $150 (includes tax)/ticket After-hour/Private Events: Two hour event or wedding only Tuesday - Thursday $500/Friday $1,000 (Fee incudes Bridal portrait opportunity) Three hour event or wedding only $3,000 (Fee incudes Bridal portrait opportunity) 4 hour event or reception/rehearsal dinner only $4,000 (Fee includes Bridal portrait opportunity) 5 hour event or reception/rehearsal dinner only $5,000 (Fee includes Bridal portrait opportunity) Damage Deposit $1,000 refundable Security Fee $300 non-refundable Easter Sunday Sunrise Service $500 per hour Bridal Portraits only: Site fee $200 Request for staff member & golf cart $100 TV & movie films (paid to Airlie Foundation): Production $1,750 per day Pre or post-production $250 per day PLANNING & LAND USE Flood Determination Letter $25 Rezoning - General $500 less than 5 acres - $600 more than 5 acres Rezoning - Conditioned Zoning $600 less than 5 acres - $700 more than 5 acres Continuances: After Advertisement $300 Planning Board and County Commissioners Special Use Permit $250 Single Resident - $500 all other Text Amendments $400 per application - $600 Land Use Plan Board of Adjustment $400 per application Zoning Letter of Verification $25 TRC Review: Preliminary Plan $300 Final Plat $20 per lot Commercial Site Plan Review $75 Street/Easement Closure $1,000 Street Naming $250 + cost of sign Mobile Home Park $250 per preliminary - $20 per final space Zoning Enforcement Fees: Final - Flood: Residential $25 Commercial $45 Tree Inspection $45 Tree Mitigation $200 per caliper inch Zoning Only Permit: Residential $25 Commercial $45 Fee Schedule FY24-25 (Revised 7-01-24)Page 6 New Hanover County Fee Schedule FY24-25 Department Service Fee Amount PLANNING & LAND USE (continued)Commercial Final $45 Home Occupation $10 Postage & Handling $5 Publications: 2016 Comprehensive Plan $40 Unified Development Ordinance (b/w)$48 Copies: Letter black/white $0.10 Letter color $1 Legal black/white $0.25 Legal color $1.50 Tabloid black/white $1 Tabloid color $2 Black/white large plotter maps $10 Zoning Maps $10 REGISTER OF DEEDS REAL ESTATE FILING FEES: Deeds and Other Instruments: (except plats, deeds of trust, and mortgages) Up to 15 pages $26 Each additional page $4 Additional fee for each multiple instrument $10 Deed of Trust and Mortgages: Up to 35 pages $64 Each additional page $4 Additional fee for each multiple instrument $10 Satisfaction No Fee Add'l Subsequent Instrument Index Ref.$25 each UCC (Fixture Filing): 1 to 2 pages $38 3 to 10 pages $45 Each additional page over 10 pages $2 Non-Standard Document Fee G.S. 161-14B $25 additional recording fee Condo & Subdivision Plats: First Page $21 Each additional page $21 Highway Right-Of-Way Plats: First Page $21 Each additional page $5 REAL ESTATE COPY FEES: Instruments In General: Uncertified $0.25 each page Certified: First Page $5 Each additional page $2 Maps Uncertified: 8-1/2 x 11 $0.25 each page 11 x 17 $1 each page 17 x 22 $2 each page 18 x 24 $3 each page 24 x 36 $5 each page Maps Certified: 8-1/2 x 11 First page $5 8-1/2 x 11 Each additional page $2 11 x 17 First page $6 11 x 17 Each additional page $3 17 x 22 First page $7 17 x 22 Each additional page $4 18 x 24 First page $8 18 x 24 Each additional page $5 24 x 36 First page $10 24 x 36 Each additional page $7 NOTARY: Oath $10 Notorial Acts $5 EXCISE TAX VALUATION: 1991 to current $2 per $1,000 1968 - 1991 $1 per $1,000 Prior - 1967 $1.10 per $1,000 Fee Schedule FY24-25 (Revised 7-01-24)Page 7 New Hanover County Fee Schedule FY24-25 Department Service Fee Amount REGISTER OF DEEDS (continued)VITAL RECORDS FEES: Marriage License $60 Certified copies Birth, Death & Marriages $10 Uncertified copies Birth, Death & Marriages/Mail $1.25 Birth and Death Amendments $10 VRAS Search (state)$14 at time of search Postage & Handling Expediate Mail $15.00 PASSPORTS: First-time Adult Passport Book $165.00 First-time Adult Passport Card $65.00 First-time Adult Passport Book and Card $165.00 Adult Passport Card $30.00 Minor Passport Book $135.00 Minor Passport Card $50.00 Minor Passport Book and Card $150.00 Expediate Passport Fee $26.00 SENIOR RESOURCE CENTER Multipurpose Room Use Fee - (After hours of operation Mon. - Thu)$20.00 Multipurpose Room Use Fee - (After hours of operation Fri. & Sat.)$50.00 Special lectures, workshops, classes, & trips. Covers instructor, materials, & admission Varies Instructors charge $3 - $8/class Varies $3 to $8 per class (paid directly to instructor) 90785:Interactive Complexity/Add-on $5.00 90791:Psychiatric Diagnostic Evaluation $180.00 90832:Psychotherapy, 16-37 minutes $75.00 90834:Psychotherapy, 38-52 minutes $115.00 90837:Psychotherapy, 53+ minutes $175.00 90839:Psychotherapy for Crisis, 30-74 minutes $180.00 90840:Psychotherapy for Crisis, each additional 30 minutes, maximum of two add-ons per 90839 $90.00 90846:Family Psytx w/o patient $115.00 90847:Family Psytx w/patient $140.00 90853:Group Psychotherapy $40.00 96130:Psychological test administration; first hour $150.00 96131:Psychological test administration; each additional hour $120.00 96136:Psychological test administration and scoring; first 30 minutes $60.00 96137:Psychological test administration and scoring; each additional 30 minutes $60.00 98966:Non-Face-to Face Nonphysician Telephone Services 5-10 minutes (Behavioral Health)$15.00 98967:Non-Face-to Face Nonphysician Telephone Services 11-20 minutes (Behavioral Health)$30.00 98968:Non-Face-to Face Nonphysician Telephone Services 21-30 minutes (Behavioral Health)$40.00 SHERIFF Concealed Weapons Fees: First Application $80 Renewal $75 Qualified Retired LEO Application $45 Retired LEO Application Renewal $40 Duplicate $15 Citations - Civil Penalty: Most offenses $100 Second offenses $300 Third Offenses $500 These penalties may vary depending on type. Fingerprint Fee $10 Parking Citations: Overtime Parking $25 No parking area $25 Rrestricted Parking $25 Loading Zone $25 Fire Lane $50 Handicapped zone Administrative Penalty/Late Payment Penalty for Non- Payment after 20 Days Service fees - Civil Papers: In-state fee per paper served Out-of-state fee per paper served Sheriff Fees - Miscellaneous Found Property sales Sheriff Fees - Execution Fees Sheriff Fee - Deputy Contract Pay (Set by Sheriff)* Sheriff Fee - Vehicle Contract Pay* *To avoid a fee, contract must be cancelled 12 hours in advance. Sheriff Fees - Precious Metals Dealer Permit Firing Range User Fee $250 $25 $30 $50 $15 fingerprinting not associated with pistol permits Proceeds go to NHC School Board 5% of first $500/2-1/2% of remainder $46/hr with a minimum of 4 hours $25/for up to 4 hours; $50 for 4 plus hours $180 filing fee; $180 Renewal fee for 12 months $1,000 annually Fee Schedule FY24-25 (Revised 7-01-24)Page 8 New Hanover County Fee Schedule FY24-25 Department Service Fee Amount SHERIFF (continued)Detention Center Health Fees: Doctor Visit $20 Pharmacy $5 Animal Services Unit Fees are several pages. Refer to Exhibit 4 of this document for the Animal Services Unit Fees. SOCIAL SERVICES Adoption Services Application fee for Preplacement Assessments $100 Preplacement Assessment ($100 application fee & cost of Preplacement Assessment)$1,000 Preplacement Assessment Update $300 Preparation of report to Court on stepparent or relative adoptions where child not in legal custody of County. $200 Services to adult adoptees (for researching adoptee's biological family)$50/hour Child Support Enforcement (as follows) Non-Public Assistance applicant requests CSE services $25 ($10 if applicant is "indigent") Former CSE client reapplies for services after case closed $25 ($10 if applicant is "indigent") Recipient of Health Choice medical insurance requests CSE services $25 ($10 if applicant is "indigent") Noncustodial parent applies for CSE services $25 ($10 if applicant is "indigent") Health Coverage for Workers with Disability Health Choice/Medicaid $50 per client SOIL AND WATER Rain Barrel Sale $85 STORMWATER Developed Single Familty Residential Property No County Stormwater permit, located in the unicorporated area of New Hanover County $6.14 per ERU per month With County Stormwater permit, located in the unicorporated area of New Hanover County $6.14 per ERU per month less a 31% discount Developed Non-residential property No County Stormwater permit, located in the unicorporated area of New Hanover County Amount of impervious area in square feet divided by 4,000 then multiplied by 1 ERU multiplied by $6.14 per month per ERU With a County Stormwater permit, located in the unicorporated area of New Hanover County Amount of impervious area in square feet divided by 4,000 then multiplied by 1 ERU multiplied by $6.14 per month per ERU less a 31% discount TAX Property Record Card $0 8 1/2" x 11" ortho color map $2 8 1/2" x 11" B&W line map no charge 8 1/2"x 14" B&W line map no charge 8 1/2"x 14"ortho color map $4 11"x17" ortho color map $5 11"x17" B&W line map no charge 17"x22" ortho color map $10 17"x22" B&W line map $4 24"x36" ortho color map $10 24"x36" B&W line map $5 36"x48" ortho color map $15 36"x48" B&W line map $10 Custom Map (Definition - Any effort used to perform $25 plus standard map cost Case by case basis CD's / Tapes etc.$5 Mailing Labels $5 per 1,000 Business License Categories and Rates: [NC G.S. 105] Beer - On premises $25 Beer - Off premises $5 Beer - On and Off premises $25 Beer and Wine - On premises $50 Beer and Wine - Off premises $30 Beer and Wine - On and Off premises $50 Beer on, Wine off premises $50 Wine - On premises $25 Wine - Off premises $25 Wine - On and Off premises $25 1.To reduce; or 2.To waive for specific events or identified persons or entities; or 3.To increase in an amount not to exceed one-hundred percent (100%) not to exceed $50; or 4.Add a new fee in an amount not to exceed twenty dollars ($20) 5.Prior payment for same service. The County Manager is authorized, delegated and empowered to enact and adopt the following changes to those existing fees, charges and expenses set-forth in any County schedule, without further Board of Commissioner approval, notification or authorization: Fee Schedule FY24-25 (Revised 7-01-24)Page 9 $.441 x sq.ft. Minor Alteration, Remodel, Renovation, Repair (defined as requiring one building inspection)$60 Major Alteration, Remodel, Renovation, Repair, $400 minimum fee (all trade permits included)$.221 x sq.ft. Accessory Buildings (greater than 12' in any direction)$60 Electrical Permit $60 Mechanical Permit $60 Plumbing Permit $60 Prior Cut On Electrical / Gas $60 Mobile Home Setup / Relocation (fee includes electrical, mechanical and plumbing permits)$300 Single Family Home Setup / Relocation (fee includes electrical, mechanical and plumbing permits)$375 Site Conference $50 $120 Excessive Inspections Service Fee $50 Failure to Obtain Final Inspection When Job Complete $100 Starting Work Without a Permit $100 Starting and substantially completing work without a permit (1st occurrence)$250 Starting and substantially completing work without a permit (2nd occurrence)$500 Occupying a Structure Prior to Receiving Certificate of Occupancy (first day)$100 Occupying a Structure Prior to Receiving Certificate of Occupancy (second day)$300 Occupying a Structure Prior to Receiving Certificate of Occupancy (each day after 2nd day)$500 Building permit fees shall be refunded minus a 25% service fee or $60 minimum, whichever is greater Building permits where work has commenced or expired are not eligible for refunds Residential Permits Residential Administration Residential Penalties Permit Cancellations / Refunds Costs are calculated based on square footage of structure, $400 minimum fee Residential Alteration / Remodel / Renovation / Repair After hours inspection rate; also used for verifying Safety & Hazards on Buildings etc., pursuant to complaints. Residential New Construction and Additions Includes all electric, mechanical and plumbing permits Development Services Center (DSC) Residential Fee Schedule Building Safety Fee Schedule: Residential Exhibit 1 Page 1 Exhibit 1 Page 2  BUILDING SAFETY DEPARTMENT’S PERMIT SERVICE FEE SCHEDULE  The Building Safety Department revised and clarified its schedule, effective July 1, 2022.  In general, the department’s intent is to make it easier for customers to understand  how to use the formulas and the schedule.  And more specifically, it assigns the same fee for all trade permits.  The revised fee schedule should also make it easy for developers,  architects, and builders to determine the permit and inspection costs before bidding a project, and there is no plan review fee.   COMMERCIAL  Minimum permit service fee is $75 unless otherwise noted, and the service fee amount, which is the cost of providing service, is non‐refundable.  New construction  and additions  (minimum $400)  ICC Value  per sq. ft. (A)  X Total sq. ft.  up to 15,000  (B)  X NHC cost  recovery  factor (C)  plus Sq. ft. over  15,000 (D)  X ICC Value*  per sq. ft. (E)  X Reduced cost  factor  (0.0012) (F)  EQUALS Permit Service Fee (G)  Shell buildings  (minimum $400)  ICC Value  per sq. ft. (A)  X Total sq. ft.  (B)  X NHC cost  recovery  factor (C)  X 80% Cost  Factor (D2) EQUALS Permit Service Fee (H2)  Upfit and major  remodel  (minimum $400)  ICC Value  per sq. ft. (A)  X Total sq. ft.  (B)  X NHC cost  recovery  factor (C)  X 50% Cost  Factor (D3) EQUALS Permit Service Fee (H3)  For Modular buildings, calculate them as new construction using the utility/miscellaneous row under the “Group” heading/column in the ICC table for cost per sq. ft.  A.ICC value – International Code Council (ICC) Building Valuation tables contains values for different types of buildings, found on Page 2 of this document.  B.The total area is that which is within surrounding exterior walls or under the horizontal projection of the roof. C.Cost recovery factor is inserted to recover a pre‐determined percentage of Building Safety Department’s costs.  D.D is used for buildings larger than 15,000 sq. ft., and the total of the multiplication of D X E X F is added to the total of A X B X C.  D2: Shell building permit service fees are 80% of the cost of new construction and have the cost represented by H2. Shell buildings – construction partially complete – never had a tenant.  D3: Up‐fit building permit service fees are half the cost of new construction and have the cost represented by H3. Up‐fit – construction complete – has been occupied.  E.The ICC Value per sq. ft. is found on Page 2 of this document. F.A reduced cost factor is used such that the square footage over 15,000 sq. ft. is reduced by this factor to ensure that fees for large buildings do not become too costly. G.Permit Service Fee for New Construction and Additions. Electrical, Mechanical, and Plumbing trades have already been included in the fees*.  H.Major remodel Permit Service Fee is obtained by multiplying 50% with G (the permit service fee for new construction/additions). The remodel fees* are half the fees of new construction. I.Included in the fees of G and H2 and H3 are the trades (electrical, mechanical, and plumbing work) associated with new construction, additions, and remodels. J.For Wrightsville, Carolina or Kure Beach calculate trade fees at 25% of new construction permit fee for each trade with which the work will be performed.  Cost Recovery factor is 0.004 up to 15,000 sq. ft.  Cost recovery factor is 0.0012 for portion over 15,000 sq. ft.*See next page for ICC values  August 2013 Table currently used ICC Table  can be found at http://www.iccsafe.org/cs/Pages/BVD.aspx Exhibit 1 Page 3  August 2013 Building Valuations from ICC https://www.iccsafe.org/wp-content/uploads/BVD-0813.pdf Construction Type Group (2012 International Building Code) IA IB IIA IIB IIIA IIIB IV VA VB A-1 Assembly, theaters, with stage 224.86 217.27 211.75 202.82 190.47 185.12 196.05 174.13 167.22 A-1 Assembly, theaters, without stage 205.84 198.25 192.73 183.80 171.46 166.11 177.03 155.12 148.21 A-2 Assembly, nightclubs 175.48 170.50 165.74 159.07 149.41 145.36 153.20 135.40 131.56 A-2 Assembly, restaurants, bars, banquet halls 174.48 169.50 163.74 158.07 147.41 144.36 152.20 133.40 130.56 A-3 Assembly, churches 207.90 200.31 194.78 185.86 173.66 168.32 179.09 157.32 150.42 A-3 Assembly, general, community halls, libraries, museums 173.93 166.34 159.82 151.89 138.66 134.32 145.12 122.32 116.42 A-4 Assembly, arenas 204.84 197.25 190.73 182.80 169.46 165.11 176.03 153.12 147.21 B Business 179.33 172.77 166.90 158.73 144.01 138.61 152.18 126.55 120.48 E Educational 190.23 183.68 178.30 170.23 158.53 150.15 164.36 138.54 134.04 F-1 Factory and industrial, moderate hazard 108.42 103.32 97.18 93.38 83.24 79.62 89.22 68.69 64.39 F-2 Factory and industrial, low hazard 107.42 102.32 97.18 92.38 83.24 78.62 88.22 68.69 63.39 H-1 High Hazard, explosives 101.53 96.44 91.29 86.49 77.57 72.95 82.34 63.02 N.P. H234 High Hazard 101.53 96.44 91.29 86.49 77.57 72.95 82.34 63.02 57.71 H-5 HPM 179.33 172.77 166.90 158.73 144.01 138.61 152.18 126.55 120.48 I-1 Institutional, supervised environment 177.76 171.50 166.52 159.45 146.31 142.45 159.13 131.29 126.72 I-2 Institutional, hospitals 304.49 297.93 292.06 283.89 268.07 N.P. 277.34 250.61 N.P. I-2 Institutional, nursing homes 210.47 203.90 198.04 189.87 175.09 N.P. 183.31 157.63 N.P. I-3 Institutional, restrained 204.27 197.71 191.84 183.67 170.47 164.08 177.12 153.01 144.94 I-4 Institutional, day care facilities 177.76 171.50 166.52 159.45 146.31 142.45 159.13 131.29 126.72 M Mercantile 130.79 125.81 120.05 114.38 104.47 101.42 108.50 90.46 87.62 R-1 Residential, hotels 179.14 172.89 167.90 160.83 147.95 144.10 160.52 132.93 128.36 R-2 Residential, multiple family 150.25 143.99 139.01 131.94 119.77 115.91 131.62 104.74 100.18 R-4 Residential, care/assisted living facilities 177.76 171.50 166.52 159.45 146.31 142.45 159.13 131.29 126.72 S-1 Storage, moderate hazard 100.53 95.44 89.29 85.49 75.57 71.95 81.34 61.02 56.71 S-2 Storage, low hazard 99.53 94.44 89.29 84.49 75.57 70.95 80.34 61.02 55.71 U Utility, miscellaneous 74.83 70.51 66.11 62.74 56.42 52.69 59.81 44.15 42.06 New Construction permit fee is ICC Value X Sq. Ft. of building up to 15,000 X .004 plus Sq. Ft. over 15,000 X ICC Value X 0.0012 Exhibit 1 Page 4  BUILDING SAFETY DEPARTMENT’S PERMIT SERVICE FEE SCHEDULE  The Building Safety Department revised and clarified its fee schedule, effective July 1, 2022.  In general, the department’s intent is to make it easier for customers to understand  how to use the formulas and the schedule.  And more specifically, it assigns the same fee for all trade permits.  The revised fee schedule should also make it easy for developers,  architects, and builders to determine the permit and inspection costs before bidding a project, and there is no plan review fee.   Commercial Charges/Fees (Differs for each)  All outstanding fees must be paid before a certificate of compliance or certificate of occupancy is issued  *Building Trades: E‐Electric, M‐Mechanical, P‐Plumbing COMMERCIAL CHARGES/FEES  Refund notice below and on Page 4  Accessory buildings each trade $75 Building relocation or change of use includes trades $375 Construction site office includes trades $200 Demolition $100 *E,M,P appliance/equipment changeout $75 *E,M,P permits for minor work $75 Facility licensing verification (inspection)$100 Mobile sales office includes trades $300 Pole and attached to buildings includes trades $125 Prior to final utility release*$75 Power release without CO (existing building)$200 Roof Repair $100 Signs with foundation includes trades $200 Window replacement Additional $10 per window after the 1st window  $100 Refunds for any of the above permits will not include the  minimum service fee of $75  Working without a permit ‐ Commercial  Based on double the permit fee  Starting work without a permit  Starting and substantially completing work  Starting and substantially completing work  $100  $250 for 1st occurrence [After the fact]  $500 for 2nd occurrence [After the fact]   In a 12‐month period  Exhibit 1 Page 5  BUILDING SAFETY DEPARTMENT’S PERMIT SERVICE FEE SCHEDULE  The Building Safety Department revised and clarified its fee schedule, effective July 1, 2022.  In general, the department’s intent is to make it easier for customers to understand  how to use the formulas and the schedule.  And more specifically, it assigns the same fee for all trade permits.  The revised fee schedule should also make it easy for developers,  architects, and builders to determine the permit and inspection costs before bidding a project, and there is no plan review fee.  Commercial Fees (Consistent amounts for each)  All outstanding fees must be paid before a certificate of compliance or certificate of occupancy is issued  After hours inspection rate; also used for  verifying Safety & Hazards on Buildings etc.,  pursuant to complaints.  $120 Failure to Obtain Final Inspection When Job Complete $100  Contractor Change  Commercial $45  Occupying a Structure Prior to CO  $100 First day known  $300 Second day, after the first known day  $500 Each day after the second day  Copy of Certificate of Occupancy $10 Service fee for excessive inspections $50 per inspection  Copies of Records  Document Research: Temporary Help  $0.10 per page Site conference $50  Refunds  Request for refunds must be made to DSC before work commences  25% or the minimum fee whichever is greater will be retained if a permit is canceled before  work begins  There is no refund for the minimum permit service fee  There is no refund once work has started on a building project  There is no refund for expired permits  For Fees from other Departments, please refer to their fee schedules.  Exhibit 1 Page 6  BUILDING SAFETY DEPARTMENT’S FEES FOR FIRE PREVENTION PERMIT SERVICES, VERIFICATIONS, AND APPROVALS  The Building Safety Department uses a modified fee structure for Fire Prevention permit services, on‐site field verifications, and approvals.  The department modified the fees to make it easier for  developers, architects, and builders to determine the permit and inspection costs and the fees for other fire‐safety services. The department removed the fees for plan reviews and those previously  charged for inspections on permit‐related work, except for the (Page 4) excessive inspections requested by contractors.  FIRE PREVENTION FEES – NEW CONSTRUCTION PERMITS  New Fire Alarm NHC ERRCS (Emergency Responder Radio Coverage  System) Install/Addition  $100 + $10 per 1000 SQFT  Fire Alarm Upfit NHC ERRCS (Emergency Responder Radio Coverage  System) Modify/Alter  $100  Compressed Gases Fire Code Plan Review $0  Fire Pump & Related Materials, Backflow Prevention Fast‐Track Fire Code Plan Review $0  Hazardous Materials Install, Repair, Abandon Minimum Permit Fee (in general, unless otherwise stated) $90  Industrial Ovens – Install Additions $0.06 per SQFT  Sprinkler‐ Auto Fire Extinguishing Systems Upfits $0.06 perSQFTX0.75  Sprinkler Upfit  $100+$10 per 1000 SQFT  $100  $75  $85  $120  $75  $100 + $10 per 1000 SQFT  $100 Mobile Buildings $0  Sprinkler (on‐site) Verifications (Alterations= no permit fee) $45 Accessory Structures $0  Above Ceiling Verifications $45 Commercial Inspection Fee $0  Spray Booth Rooms, Dip Operations $100 Demolition $0  Standpipe System Install/Modify $75 0 to 5,000 SQFT Permit Fee Formula •• (A) X $0.06 Fee per SQFT  Tanks, Pumps, Piping, New Construction $100 5,001 to 15,000 SQFT Permit Fee Formula •• (A) X $0.06 Fee per SQFT X 0.75 Underground Tank Abandoned $75 per Tank Over 15,000 SQFT Permit Fee Formula •• (A) X $0.06 Fee per SQFT X 0.75 Underground Tank At Installation/Removal $100 per Tank Commercial Shell Application ** (A) X $0.06 Fee per SQFT X 0.90  Underground Tank Testing $75 ••(A)"' Gross Building Floor Area in SQFT. Above‐ground Tank Installation/Removal $100 per Tank Fee Rate for After‐hours, Weekend and Holiday  commercial inspection  $120  FIRE PREVENTION FEES – PERMITS/VERIFICATIONS FOR OTHER THAN NEW CONSTRUCTION  Fire Alarm and Detection Systems/Equipment $100 + $10 per 1000 SQFT Fire Code Plan Reviews $0  Fire Pump $75 Hood‐Suppression Systems (Minimum $110) $100 + $10 per 1000 SQFT  FIRE PREVENTION FEES‐ ADMINISTRATIVE FEES  Occupying a Building without C/O or C/C •‐1st known date $100 Working without the required Fire Permit (Commercial  and Multi‐Family)  Double the permit fee  Occupying a Building without C/O or C/C • ‐ 2nd day after first $300 Failure to obtain a final Fire Inspection $100  Occupying a Building without C/0 or C/C • ‐ each day after 2nd $500 Verifying Fire Hazard or Safety of Vacant Occupancy  Buildings  $120  • C/0, C/C = Certificate of Occupancy, Certificate of Completion Inspection Fee (unless otherwise specified) $0  FIRE PREVENTION FEES – FOR REFUNDS, PERMIT REVOCATIONS, EXPIRED PERMITS, CANCELLATIONS  Refund "if work has commenced" No Refund Expired Permit   See Page 5 of Fee Schedule  Refund "if work has not commenced" See Page 5 of Fee Schedule Canceled Permits  See Page 5 of Fee Schedule  Fraudulent Permit revocation with no refund. Fee charged if Inspection not cancelled by 7 am of scheduled day? No Fee  Fire Services Fee Schedule Apparatus Pump Testing $150 per test Ground Ladder Testing $2 per foot x length of ladder Respirator Fit Testing $25 per test SCBA/Respirator Flow Testing $25 per test SCBA Respirator Maintenance $25 per hour + Parts (actual + 5%) Standpipe/Sprinkler Testing $75 per riser Fire Pump Testing $150 per test Hydrant Flow Test $200 per trip/test Tank Testing (Above or Below Ground)$75 per tank Apparatus QRV/Mini-Engine/Brush Truck/Squad $100 per hour Tender $150 per hour Engine $200 per hour Tower/Ladder/Rescue $250 per hour Rescue Boat $50 per hour Mobile Light/Air Unit $50 per hour Personnel Firefighter $35 per hour Fire Marshal/Deputy Fire Marshal $50 per hour Chief Officer/Battalion Chief $50 per hour Emergency Management Personnel $50 per hour Off Duty Call Back Personnel $50 per hour Consumables Used Actual cost + 5% Site/Incident Assessment Fee $50 per hour 1st Inspection No Fee 2nd Inspection (Notice of compliance issued)No Fee 3rd Inspection (Identified code violation(s) not corrected)$50 per inspection + $100 Civil Citation 4th Inspection (Identified code violation(s) not corrected)$100 per inspection + $300 Civil Citation 5th Inspection (Identified code violation(s) not corrected)$150 per inspection + $500 Civil Citation After Hours or Holiday Inspection (excluding tents) $120 ($60 for each hour after initial 2) Fire Lane Violation $50 per violation Civil Citations 1st Offense $100 each 2nd Offense $300 each 3rd Offense $500 each Locked or Blocked Exit(s)$500 each door, each occurrence False Alarm Response Residential (2 or more)$60 per incident Commercial (2 or more)$120 per incident Key holder Failure to Respond $100 per incident Copy of Fire Report (Incident or Investigation) $3 per copy (no charge to owner) TESTING/MAINTENANCE HAZMAT, STAND BY OR INCIDENT REPSONSE FEES INSPECTION FEES VIOLATIONS/FINES/CITATIONS MISCELLANEOUS Exhibit 2 Page 1 Bonding for Public Fire Hydrant Systems $5,000 per hydrant Hydrant Testing/Fire Flow Test $200 per trip/test Hydrant Testing/Fire Flow Witness $45 per trip/test Installation of Private Fire Service Mains $150 each Installation of Private Fire Hydrants $50 per riser Aerosol $75 Alcohol Licensing Inspection $75 Amusement Buildings $50 (30 days) Aviation Facilities $75 Battery Systems $50 Carbon Dioxide Systems $75 Carnivals/Fairs (Tent/Air Supported Structure not included)$50 per event Cellulose Nitrate Film $75 Combustible Dust Producing Operations $75 Combustible Fibers $75 Compressed Gases $75 Covered Mall Buildings based on event duration 1 year $100 < = 30 days $75 Day Care or Group Home Fee per capacity 1-49 $75 50-150 $120 > 150 $175 Dry Cleaning Plants $75 Exhibits and Trade Shows $50 (30 day permit) Exhibits and Trade Shows (After Hours)$80.00 Explosives 30 day $150 > 30 days $300 Division 1.1, 1.2, 1.3 $200 (30 day permit) Blasting $50 per event Transporting Division 1.1, 1.2, 1.3 $200 Division 1.4, 1.5 $100 (90 day permit) Flammable and Combustible Liquids fee by vessel capacity Flammable & Combustible Liquids Class I 5-25 Gallons $65 Flammable & Combustible Liquids Class I, II 25-1000 Gallons $250 Flammable & Combustible Liquids Class I, II, III > 1000 Gallons $450 Flammable & Combustible Change In Contents $75 Floor Finishing $50.00 Operation Of Fuel Dispensing Facility $75 Tanks (Above Or Below Ground)per tank Removal $100 Installation $100 Tank Testing $75 Abandonment $50 Foster Home Inspection (Other than NHCO DSS Foster Home)$40 Fruit & Crop Ripening $50 Fumigation & Thermal Insecticidal Fogging $50 OPERATING PERMITS/INSPECTIONS HYDRANTS Exhibit 2 Page 2 Fire Services Fee Schedule Fire Services Fee Schedule Gate $50 per gate Hazardous Materials Industrial Fee based on occupancy square footage Hazardous Materials < 2500 Sq. Ft.$75 Hazardous Materials 2501-10,000 Sq. Ft $100 Hazardous Materials 10,001-40,000 Sq. Ft $200 Hazardous Materials >40,000 Sq. Ft $300 High Piled Storage $75 Hot Work Operations/Cutting & Welding $50 Industrial Ovens $75 Lumber Yards/Woodworking Plants $75 Liquid Or Gas Fueled Vehicles/Equipment (Interior Static Display)$50 (30 day permit) Magnesium $75 Misc. Combustible Storage $75 Open Flames & Candles $50 Place of Assembly (Note: Church sanctuaries are exempt from permit fees)Based on occupancy Place Of Assembly 50-99 $75 Place Of Assembly 100-300 $125 Place Of Assembly 301-500 $175 Place Of Assembly >500 $250 Other Permits Required By Fire Code (specific to permits as result of ammended code during year) $75 Private Hydrant Systems $75 Private School $75 Pyrotechnic Special Effects Material - Indoors $200 Pyrotechnic Special Effects Material - Outdoors $150 Pyroxylin Plastics $75 Repair Garage/Service Station based on square footage of occupancy Repair Garage/Service Station <5000 Sq. Ft $75 Repair Garage/Service Station >5000 Sq. Ft $125 Rooftop Heliports $75 Spraying Or Dipping, Flammable Finishes $75 Storage Of Scrap Tires/Byproducts $75 Tent/Canopies/Air Supported Structures $50 each event Tent/Canopies/Air Supported Structures (Excess Of 15,000 Square Feet)$75 each tent/each event or 90 day permit Tent/canopies/Air Support Structures - After Hours/Weekend/Holiday $80 each event Tire Rebuilding Plants $75 Waste Handling/Junkyard, Waste Facility $75 Wood Products $75 Exhibit 2 Page 3 1 Subject:New Hanover County Public Health Fee Policy Date of Origin:July 1, 1984 Policy Number:N/A –Stand Alone Policy PURPOSE AND SCOPE: Identify fees for services provided by the Environmental Health and Health Promotion Divisions of the New Hanover County Public Health (NHCPH). Provide guidelines for collection of fees for the services. Provide guidelines for assessing fees for services provided in the Personal Health Services Division of the NHCPH and ensuring guidelines meet requirements for Title X funding for Family Planning. POLICY / PROCEDURE: TABLE OF CONTENTS SECTION I ENVIRONMENTAL HEALTH 2 SECTION II HEALTH PROMOTION Smoke Free Restaurant Fines Safe Kids Cape Fear Child Passenger Safety Seat Program 3-5 3 4 SECTION III PERSONAL HEALTH SERVICES 5-13 General Guidelines 5-9 Program Specific Information 9-11 Accounts Receivable 11-12 SECTION IV MISCELLANEOUS 13 References 13 Change History 13 Exhibit 3 Page 1 2 ENVIRONMENTAL HEALTH DIVISION A schedule of fees has been established for certain Environmental Health Division services. Payment is required prior to the provision of these services. Fees must be accompanied by the appropriate application and any other necessary documents or maps, and are payable ONLY in the Environmental Health Office OR through the US Postal Service. Staff SHALL NOT accept or agree to transport any payment of fees during their conduction of field work. Fees are collected and recorded by the management support staff in the office during the hours of 7:30 AM until 5:00 PM. A receipt shall be issued for each fee collected. In the event that all management support staff are away from the office for a period during the specified hours, an Environmental Health Specialist shall be designated by Environmental Health management staff to accept applications, collect fees and issue receipts. A daily deposit of collected fees shall be made between 3:00 PM and 3:30 PM with the appropriate Health Department management support staff person. 08/97 Exhibit 3 Page 2 3 SECTION II HEALTH PROMOTION SMOKE FREE RESTAURANT FINES Upon notification in writing of the third violation of the Act to Prohibit Smoking in Certain Public Places and Certain Places of Employment in accordance with G.S. 130A-22 (h1), the NHCPH shall impose an administrative penalty of $200.00 on the person who manages, operates, or controls the business in violation. The person who manages, operates, or controls the business has the right to appeal this decision to the local board of health. To pursue a formal appeal, a written notice of an appeal must be submitted to the local health director within 30 days of notification of the third violation. The notice of appeal must be filed in accordance with G.S.130A-24(b). A copy of G.S.130A-24 governing the appeal procedures shall be provided. Subsequent violations of the law are considered separate and distinct violations of the law; and the person who manages, operates, or controls the business in violation is subject to an administrative penalty of not more than two hundred dollars ($200). Each day on which a violation of this law or rule occurs may be considered a separate and distinct violation. Payment for Smoke Free Restaurant Fines shall be made within 30 days of the date of notice unless an appeal has been filed.For appealed fines, payment shall be made within 30 days of the appeal decision. Exhibit 3 Page 3 4 Safe Kids Cape Fear Child Passenger Safety Seat Program Safe Kids Cape Fear Child Passenger Safety Seat Program operates under the Safe Kids Buckle- Up Program with the primary goal to educate and instruct families on the proper use/installation of child restraints. To qualify for a child passenger safety seat (car seat) customers must: x Be a New Hanover County resident x Be on at least one type of assistance (Medicaid, WIC, Health Choice, Work First, Food Stamps) and show proof of assistance x Pre-register for class no later than two weeks prior to scheduled class x Pay cash at the time of registration. Foster parents are not eligible for child passenger safety seats. Grandparents and/or family members who have temporary custody of another family member’s child are not eligible as they fall under the category of foster parent. We do not accommodate child passenger safety seats for unborn children. Program rates which include child passenger safety education and hands-on installation teaching methods are based upon the following scale: x $30.00 – Harness seat (Convertible or Combination seats) x $15.00 – High Back Booster seat x $10.00 – Backless Booster seat To qualify for an additional or second (2nd) child passenger safety seat (car seat), customers must meet the guidelines noted above and one of the following: x Child must have outgrown safety standards of current car seat. x Be an initial seat for an additional child in the family, such as in the event of twins. Exhibit 3 Page 4 5 Program rates for a second (2nd) child passenger safety seat which include child passenger safety education and hands-on installation teaching methods are based upon the following scale: x $50.00 – Harness seat (Convertible or Combination seats) x $20.00 – High Back Booster seat x $15.00 – Backless Booster seat Program fees are due and payable at the time of pre-registration for the class. Failure to cancel or reschedule within two (2) weeks of scheduled class date will result in forfeiture of program fee. During Safe Kids Cape Fear Child Passenger Safety Seat Program special events, car seats will be provided based on availability in the event a child’s current car seat fails safety standards. The car seat will be provided at no charge from supplies donated by the State. SECTION III PERSONAL HEALTH SERVICES I. General Guidelines A. The fee system implemented by this organization has been approved by the New Hanover County Board of Health (NHCBOH). Implementation date was July 1, 1984. For the Women’s Preventive Health Section fee system was approved by the NHCBOH in October 1983. Revision Date: December 2005. B. The New Hanover County Public Health serves the public interest best by assuring that all legally required public health services are furnished for all citizens and then providing as many recommended and public health services as it can for those citizens with the greatest need. C. Services provided by Public Health will not be restricted or denied based on residency or inability to pay. Every effort will be made to provide services to patients at or below $150% of the Federal Poverty Level. Patients are not required to apply for Medicaid coverage in order to receive services provided by the NHCHD. D New Hanover County Public Health provides services without regard to religion, race, national origin, creed, gender, parity, marital status, age or contraceptive preference. Exhibit 3 Page 5 6 E. Unless confidentiality is a barrier, if a patient has any form of third-party reimbursement, to include Medicaid, Medicare and other private insurance, that payer must be billed for services, with the exception of flat rate charges. Medicaid will be billed as the payer of last resort. Patients must sign the Authorization and Assignment of Benefits Form for all third party reimbursement. F. Patients who are receiving Medicaid (Title XIX) will submit their Medicaid number for third party payment. Reimbursable visits will be claimed to Title XIX for payment and no further charges will be made to the patient with the exception of applicable co-pays which shall be collected at the time of service. G. Sliding fee scales will be applied in specified programs and will be based on the income and number of persons in the economic unit. The economic unit includes persons living in the household, related or non-related, who share their production of income and consumption of goods H. The New Hanover County Public Health (NHCPH) will require “proof of income” to reduce charges when applying the sliding fee scale. If a patient is unable to produce this required information, they will be placed on a 100% sliding fee scale status, for a period of thirty (30) days. Services will not be denied on day of appointment for failure to provide verification of income. If proof of income is provided within the thirty-day period, the patient will be billed accordingly. If proof of income is not provided within the established timeframe, the patient will be billed at 100% of the NHCPH fee(s). Client income is re-evaluated annually, upon change in income and when proof of income is required for other programs. Income reported through other programs offered in NHCPH may be used rather than re-verifying income. The NHCPH representative has the right to verify income information in all cases; however, the patient must read, understand, and sign the income statement in order for their income to be checked. The sliding fee scale does not apply to all services. Services with flat rate fees do not require proof of income. In extreme or unusual circumstances, the Health Director or designee may make exceptions. I. If a patient prefers not to produce required proof of income information, they will be placed on a 100% sliding fee scale status. However, the patient must read, sign, and date the waiver on the NHCPH Socio-Economic Income Statement. J.Payment of co-pay for third party billing is expected at the time of service for all chargeable services. Applicable deductible and co-insurance amounts will be billed to the patient upon receipt of insurance Explanation of Payment. Partial payment is accepted for all chargeable services, with the exception of flat fee services. Co-pays are not subject to sliding fee scale. Medicaid patients, effective November 1, 2010, are no longer exempt from co-pays with the exception of family planning patients, Exhibit 3 Page 6 7 pregnant women, children from birth through age 20 and patients receiving State mandated services. Payment for non-covered services is expected at time of service. Patient must have signed the Acknowledgment of Non-Covered Services form prior to receiving their service(s) to accept responsibility for payment of designated services. K.Co-payments assigned by third party insurances, which includes Health Choice, to Family Planning patients must be compared to total sliding fee charges for the total visit as if they had no insurance. Patient shall be charged the lesser of the two amounts. If patient falls in the 0% pay category on the sliding fee scale, the patient is not responsible for the co-payment. L.If a patient has a remaining balance on their account, a payment agreement and schedule will be established and signed by the patient. Patients who have demonstrated no “good faith” effort to pay may be subject to service restrictions with the exception of Family Planning services and those services provided to patients per State laws. M.Family Planning patients with delinquent balances will not be denied services nor have service restrictions imposed due to inability to pay. N.Family Planning patients with delinquent balances are not required to meet with the Health Director for purposes of collection of delinquent balances. O.Fees must be waived for individuals with family incomes above 100% of the Federal Poverty Level who, as determined by the service site project director, are unable, for good cause, to pay for family planning services (42 CF2 59.2). P.Payment in full is required at the time of service for vaccines not supplied by the State, with the exception of those billed to third party payors. Co-payments, co- insurance and non-covered services will be billed to the patient upon receipt of third party explanation of benefits. Q.For patients who demonstrated no “good faith” effort to pay on their account balance equal to or greater than $5.00 which is ninety (90) days or more past due, NHCPH will submit necessary information to the New Hanover County (NHC) Finance Department for the purpose of collecting such outstanding debt. NHC Finance Department will pursue payment of such outstanding debt through their internal collection process to include the North Carolina Local Government Debt Set-off Program. Exhibit 3 Page 7 8 R.If payment arrangements were made for unpaid balances, to include Family Planning, failure to make payments according to the payment plan within ninety (90) days will result in necessary information being submitted to the NHC Finance Department for the purpose of collecting such outstanding debt. S.North Carolina State Law prohibits charging patients for the following: Administration of vaccines (IMM) required by law; examination and treatment of STDs; and examination and treatment of tuberculosis (TB). x G.S. 130A-153(a) Local health departments shall administer required and State- supplied immunizations at no cost to uninsured or underinsured patients with incomes below two hundred percent (200%) of the federal poverty level. x NHCPH does not assess charges for administering vaccines to any patient regardless of income who qualifies for State-supplied vaccines. x G.S. 130A-144(c) The local health director shall ensure that control measures prescribed by the Commission have been given to prevent the spread of all reportable communicable diseases or communicable conditions and any other communicable disease or communicable condition that represents a significant threat to the public health. The local health department shall provide, at no cost to the patient, the examination and treatment for tuberculosis disease and infection and for sexually transmitted diseases designated by the Commission. x Patients receiving services for the examination and treatment of sexually transmitted infections (STI) or examination and treatment for tuberculosis (TB) are not assessed charges for these services. Non-related services provided during a STI or TB visits may be chargeable to the patient with exception of pregnancy testing. x Per the NCDHHS/DPH, health departments should strive to identify early pregnancy in all women of child bearing age when there is uncertainty –re: pregnancy status regardless of what type of service the client presents for and to assure the client is referred to the appropriate reproductive or maternity care whichever is indicated by the test results. x NHCPH has adopted the recommendation made by NCDHHS/DPH to provide pregnancy testing to women presenting for STD services who are unsure of their pregnancy status. Self-pay patients will be provided the pregnancy test at no charge. Medicaid and third party insurances will be billed our standard fees; however, any remaining balance indicated as patient responsibility from third party insurances will be disallowed and not charged to the patient. Exhibit 3 Page 8 9 x If patients receiving state mandated services (STI/ TB/ IMM) have insurance coverage, their insurance company will be billed the established fee unless the breach of confidentiality statement is signed by the patient requesting that third party billing not occur on the Authorization and Assignment of Benefits Form. If there is a balance remaining after payment is received from the insurance company, the patient will not be billed for this balance. x All laboratory tests processed by the State Laboratory will be provided at no charge to patients. Communicable Disease Control Program guidelines must be adhered to when tests are ordered. x Postpartum Assessment Home Visits, Newborn Assessment Home Visits, Intensive Home Visiting and Childbirth Classes will be billed to Medicaid. For non-Medicaid patients, Childbirth Classes will be billed to the client according to a public schedule of charges and placed on a sliding fee scale. Clients must provide proof of income to determine fee eligibility. For non-Medicaid clients, payment for Childbirth class is required at the time of service. T.If an insurance company pays for services rendered and payment is sent directly to the patient; the patient is responsible for payment to the NHCPH. In such instances, services may be restricted until said payment is received by the NHCPH. Exceptions to this rule are Family Planning services and those services provided to patients per State laws. U.Reimbursable visits, for patients with insurance coverage, will be billed to the insurance company. If there is a balance remaining after the insurance payment is received by NHCPH, the balance will be billed to the patient, unless otherwise mandated by law or through the Consolidated Agreement between the State of North Carolina and the New Hanover County Public Health. Sliding fee scale adjustments will be applied to balances according to program guidelines. V.A Collections, Small Balance Write-off and Bad Debt Write-off policy has been established. W.Fees, based on current cost or purchase of supplies, may be adjusted by the Health Director. New services may be added upon approval by the Health Director if the annual revenues for the service are not expected to exceed $5,000. Charges are based on cost analysis. X.Tests or vaccines recommended or required as part of the Employee Health Program will be administered at no charge to NHCPH employees or volunteers. Charges for Exhibit 3 Page 9 10 tests or vaccines will not be billed to the employees’ or volunteers’ private insurance due to administrative laws. Y.All clinic and in-house laboratory fees will be collected as part of the check-out process by the NHCPH Check-out Clerk. Laboratory fees for self-pay patients receiving out-sourced testing will be collected by the NHCPH Check-out Clerk. Out- sourced testing for patients with Medicaid will be billed directly by the private laboratory. Billing of out-sourced testing for patients with other third party insurance or self-pay status will be processed according to program guidelines by the NHCPH Billing Unit. Z.The Health Director, or designee, has the authority to waive or reduce fees for special projects or targeted populations. AA.Donations may be accepted from any patient regardless of income status as long as they are truly voluntary. There should be no “schedule of donations”, bills for donations, or implied or overt coercion. Donations are not a prerequisite for provision of any service or supply. Billing requirements are not waived because of client donations. BB.Upon receipt from the State, use of new Federal Poverty Levels (FPL) will be automatically implemented, as they apply to our various programs. Personal Health Services programs utilize the 101-250% of FPL scale with the exception of WIC. Currently, our WIC program uses the 101-185% of FPL scale. Mobile Dental Unit services slide to 60%. Patients falling at 0%, 20% and 40% on the sliding fee scale will be assessed fees at 60% of our standard fee for dental services. II. Program Specific Information A. Environmental Charges – Water Bacteriology 1. Samples collected by the Environmental Health division will be charged and the fee collected in the Environmental Health section. 2. On an as needed basis, the Environmental Health clerk will submit a report to the Laboratory Director listing total water sample revenues for the designated time period. 3. Fees for water samples not collected by the Environmental Health Division will be processed by the NHC Public Health Billing Unit. Exhibit 3 Page 10 11 4. Checks will be received by the Support Services Division and deposited to the appropriate account. B. Women’s Preventive Health 1. The WPH Program has established a method of directly assessing patient charges and collecting payments for clinical services in accordance with Title X regulations and the fee policy as established by New Hanover County Board of Health. Services are provided to all persons without regard to their income level, and the inability to pay is not a barrier to the receipt of these services. 2. There will be no minimum fee requirement or surcharge that is indiscriminately applied to all patients. 3. Clients whose documented income is at or below 100% of the Federal Poverty Level are not charged for services. Full charges will be assessed if patient income falls at or above 250% of the Federal Poverty Level. Proof of income will be required for Family Planning patients receiving services in the Women’s Preventive Health Program. A schedule of discounts has been developed for Title X (Family Planning) services. Eligibility for discounts is documented in the client’s record. A schedule of discounts has sufficient proportional increments to ensure income is not a barrier to services. The schedule of discounts is used for family incomes from 101%-250% of federal poverty level. 4. Patients, to include un-emancipated minors, seeking confidential services are “a family of one” and are to be considered on the basis of their own resources. In such cases, the patient’s income must still be reported through the patient data system. Third-party sources (e.g. Insurance, Title XIX) should be billed the established fee if eligibility criteria are met unless the breach of confidentiality statement is signed by the patient requesting that third party billing not occur. Charges to patients receiving confidential services will be based on the local fee schedule. 5. Charges may be made for supplies not required by the plan of contraceptive care based on cost of supplies. Charges for extra cycles of pills may also be made for self-pay patients. Charges for family planning services, to include supplies, will be billed based on sliding fee scale. However, non-family planning services will be charged according to locally established fee schedule and will apply to all patients. Exhibit 3 Page 11 12 6. Family Planning patients with Medicaid, Family Planning Waiver Medicaid and private insurance requesting birth control pills as their method will be provided a prescription to be filled at their local pharmacy. Self-pay patients will be charged for their supply of pills. Sliding fee scale applies to the charges. Clients with insurance who are seeking confidential services are considered self-pay. 7. If a self-pay patient reports she has lost her birth control pills or needs additional cycles of pills to provide continued coverage until her appointment, additional cycles of pills may be provided by order of the clinician. If the patient has lost her pills twice during the year, then an alternative birth control method may be considered. 8. If an insured patient loses her prescription or birth control pills, then the clinician may consider re-issuing the prescription. 9. The NHCPH Socio-Economic Data and Income Form is prepared from verified income information. Patient fee is determined using DHHS Women’s and Children’s Health Section sliding fee scale. 10. Family Planning patients shall receive a statement(s) directly, regardless of sliding fee scale percentage, at the completion of their visit at the checkout desk. The statement shall show the total charges, any allowable sliding fee discounts and payments made by the patient. If a third party is responsible, bills shall be submitted to that party. Third parties authorized or legally obligated to pay for clients at or below 100% of the federal poverty level are properly billed. Third party bills show total charges without any discounts unless there is a contracted reimbursement rate that must be billed per the third party contract. 11. Services provided that are not required Title X services are funded with other than Title X funds before applying Title X funds to those activities. 12. It is illegal for fees collected in family planning to be put in any fund other than a separate WPH account for use in the local WPH Program. ** **_____________________ Re: U.S. Department of Human and Health Services Public Health Service, D.H.H.S. Publication (OASH) 82-50,00 pg. 25, Found in Codified Fed. Reg. for FP #420FR59.5 (s) (8). C. Laboratory Exhibit 3 Page 12 13 1. Customer Care will register patient in the electronic health record system on private providers’ patients. 2. The Laboratory will indicate services rendered, to include diagnosis code, in the electronic health record system. 3. The patient will be directed to the checkout desk. D. Child Health Services 1. Children seen for Child Health Services will be charged in accordance with the NHCPH Sliding Fee. Medicaid, Health Choice and private insurance will be billed for eligible patients. Sliding fee scale will be applied to non-covered services, deductible amounts and co-insurance amounts. Co-pays are not subject to sliding fee scale adjustments. Exception is for blood lead screening for children receiving WIC as noted below. 2.Children receiving WIC services will be offered blood lead screening at “no charge.” Medicaid may be billed for the blood lead screening; and patients with dual coverage, private insurance will be billed and balances transferred to Medicaid as a crossover claim. Patients will not be charged for any remaining balances. IV.Accounts Receivable The Accounts Receivable Bookkeeping System includes: 1. The fee policy will be explained to each patient with explanations of purpose and details of procedure when the patient presents for services. Each patient is given an opportunity to pay and every effort will be made by the staff to collect total or partial payment or co-pay for third party billing on the day of the visits. Applicable deductible and co-insurance will be billed to the patient upon receipt of insurance Explanation of Payment. 2. Co-payments assigned by third party insurances, which includes Health Choice, to Family Planning patients must be compared to total sliding fee charges for the patients visit. Patient shall be charged the lesser of the two amounts. If patient falls in the 0% pay category on the sliding fee scale, the patient is not responsible for the co-payment. Exhibit 3 Page 13 14 3. Payment in full is required for flat fee services to include vaccines not supplied by the State, with the exception of those billed to third party payors. Co-payments, co-insurance and non-covered services will be billed to the patient upon receipt of third party explanation of benefits. 4. Provided that patient confidentiality is not jeopardized, statements in the amount of $5.00 and above showing total charges (less sliding scale discount) will be mailed to patients 45 days after their visit. Two additional statements with balance owed will be mailed if no payment or partial payment is made. 5. Statements will not be mailed to patients with account balances less than $5.00. The balances will be submitted to the NHC Finance Department for processing as a small balance write-off. 6.Patients who demonstrated no “good faith” effort to pay on their account balance in the amount of $5.00 or more which is ninety (90) days or more past due, NHCPH will submit necessary information to the New Hanover County (NHC) Finance Department for the purpose of collecting such outstanding debt. Additionally, such patient accounts will be flagged within our patient care management database as being in a collection status. 7.If payment arrangements were made for unpaid balances, to include Family Planning, failure to make payments according to the payment plan within ninety (90) days will result in necessary information being submitted to the NHC Finance Department for the purpose of collecting such outstanding debt. 8.Patients with account balances who have demonstrated no “good faith” effort to pay will be subject to service restrictions. Service restrictions will be at the discretion of the Health Director or designee and may include prioritizing or restricting appointments. Exception to this rule is Family Planning. Exhibit 3 Page 14 15 V. MISCELLANEOUS REFERENCES: NHCPH-Fee Schedules (Environmental Health, Clinical Services/Dental) NHCPH- Sliding Fee Scales NHCPH-Local Use Codes CHANGE HISTORY: Version Date Comments A 01/01/16 New Format –Many revisions made by recommendation of Ann Moore, DHHS Administrative Consultant B 06/22/17 Inserted –General Guidelines I. O and II. Program Specific Information B. Women’s Preventive Health 3. –revised to meet Title X guidelines. C 07/01/17 Environmental Health Division –EH Fee Schedule move to Fee Schedule folder in SharePoint. Personal Health Services –General Guidelines Q. -Removed information regarding administrative penalty for delinquent accounts. General Guidelines R. –Deleted G.S. 130A -162, G.S. 130A –178(a) and reference to letter from Dr. Levine and added G.S. 130A-144(c) all of which updated prior statutes. General Guidelines AA. –Revised to indicate use of 101-250% of FPL. Accounts Receivable 6.–Removed information regarding administrative penalty for delinquent accounts. Program Specific –D. Child Health –1. Added clarification of billing of services; 2. Added Blood lead screening; References –Added Environmental Health to NHCHD Fee Schedules. D 07/01/18 Personal Health Services - General Guidelines I. C. Added statement recommended by Administrative Consultant –no requirement for applying for Medicaid. Removed Patient Bill of Rights –now a stand- alone document. E 12/31/18 Updated Letterhead. Changed New Hanover County Health Department (NHCHD) to New Hanover County Public Health (NHCPH). Removed statement that customer care initiates an encounter form. Removed statement the Laboratory will indicate services rendered on encounter form Exhibit 3 Page 15 CPT /HCPCS Codes CPT /HCPCS Description NHCPH Fees 99202 New Pt Level II - Problem Focus 103.00$ 99203 New Pt Level III - Expanded 144.00$ 99204 New Pt Level IV - Detailed 210.00$ 99205 New Pt Level V - Comprehensive 260.00$ 99381 New Pt/Well Exam <1 Year 120.00$ 99381EP New Pt/Health Check <1 Year 120.00$ 99382 New Pt/Well Exam 1-4 Years 130.00$ 99382EP New Pt/Health Check 1–4 Years 130.00$ 99383 New Pt/Well Exam 5-11 Years 167.00$ 99383EP New Pt/Health Check 5-11 Years 167.00$ 99384 New Pt/Well Exam 12-17 Years 182.00$ 99384EP New Pt/Health Check 12-17 Years 182.00$ 99384FP New Pt/Family Planning 12-17 Years 182.00$ 99385 New Pt/Well Exam 18-39 Years 180.00$ 99385EP New Pt/Health Check 18-20 Years 180.00$ 99385FP New Pt/Family Planning 18-39 Years 180.00$ 99386 New Pt/Well Exam 40-64 Years 199.00$ 99386FP New Pt/Family Planning 40-64 Years 199.00$ 99387 New Pt/Well Exam > 65 Years 215.00$ 99211 Est Pt Level I – Minimal 40.00$ 99212 Est Pt Level II - Problem Focus 65.00$ 99213 Est Pt Level III – Expanded 87.00$ 99214 Est Pt Level IV – Detailed 133.00$ 99215 Est Pt Level V – Comprehensive 196.00$ 99391 Est Pt/Well Exam <1 Year 100.00$ 99391EP Est Pt/Health Check <1 Year 100.00$ 99392 Est Pt/Well Exam 1-4 Years 101.00$ 99392EP Est Pt/Health Check 1-4 Years 101.00$ 99393 Est Pt/Well Exam 5-11 Years 137.00$ 99393EP Est Pt/Health Check 5-11 Years 137.00$ 99394 Est Pt/Well Exam 12-17 Years 158.00$ 99394EP Est Pt/Health Check 12-17 Years 158.00$ 99394FP Est Pt/Family Planning 12-17 Years 158.00$ 99395 Est Pt/Well Exam 18-39 Years 154.00$ 99395EP Est Pt/Health Check 18-20 Years 154.00$ 99395FP Est Pt/Health Check 18-20 Years 154.00$ 99396 Est Pt/Well Exam 40 - 64 Years 170.00$ 99396FP Est Pt/Family Planning 40-64 Years 170.00$ 99397 Est Pt/Well Exam > 65 Years 188.00$ 90785 Interactive Complexity/Add-on 5.00$ 90791 Psychiatric Diagnostic Evaluation 180.00$ 90832 Psychotherapy, 16-37 minutes 75.00$ 90834 Psychotherapy, 38-52 minutes 115.00$ 90837 Psychotherapy, 53+ minutes 175.00$ 90839 Psychotherapy for Crisis, 30-74 minutes 180.00$ 90840 Psychotherapy for Crisis, each additional 30 minutes, maximum of two add-ons per 90839 90.00$ 90846 Family Psytx w/o patient 115.00$ 90847 Family Psytx w/patient 140.00$ COUNSELING CODES NEW PATIENT VISIT CODES ESTABLISHED PATIENT VISIT CODES PERSONAL HEALTH SERVICES ‐ FEE SCHEDULE CPT /HCPCS/LU CODES & FEES  Effective 07/01/24 Exhibit 3 Page 16 CPT /HCPCS Codes CPT /HCPCS Description NHCPH Fees 90853 Group Psychotherapy 40.00$ 96130 Psychological test administration; first hour 150.00$ 96131 Psychological test administration; each additional hour 120.00$ 96136 Psychological test administration and scoring; first 30 minutes 60.00$ 96137 Psychological test administration and scoring; each additional 30 minutes 60.00$ 98960 Education & Training for Patient Self-management Individual Face-to- Face – 30 minutes -$ 98961 Education & Training for Patient Self-management Group, Face-to- Face – 30 minutes -$ 98966 Non Face-to Face Nonphysican Telephone Services 5-10 minutes (Behavioral Health)15.00$ 98967 Non Face-to Face Nonphysican Telephone Services 11-20 minutes (Behavioral Health)30.00$ 98968 Non Face-to Face Nonphysican Telephone Services 21-30 minutes (Behavioral Health)40.00$ 99401 Prev Medical Counseling - 15 Min 40.00$ 99402 Prev Medical Counseling - 30 Min 76.00$ 99403 Prev Medical Counseling- 45 Min 113.00$ 99404 Prev Medical Counseling- 60 Min 144.00$ 99406 Smoking & Tobacco Cessation Counseling Visit: Intermediate, greater than 3 minutes, up to 10 minutes 20.00$ 99407 Smoking & Tobacco Cessation Counseling Visit: IIntensive, greater than 10 minutes 35.00$ 99411 Group Counseling - 30 Min 39.00$ 99412 Group Counseling - 60 Min 68.00$ 99429 Unlisted Preventive Medicine Service -$ 99361 Medical Conference (30 min)73.00$ 99362 Medical Conference (60 min)120.00$ 99441 Non- Face-to-Face Telephone Services 5-10 minutes 15.00$ 99442 Non- Face-to-Face Telephone Services 11-20 minutes 30.00$ 99443 Non- Face-to-Face Telephone Services 21-30 minutes 40.00$ LU102 Completion of “Record of Tuberculosis Screening” DHHS 3405 15.00$ LU125 PPD Reading/Placed Elsewhere (not TB contact or suspect)15.00$ J1050 DepoProvera Injection 130.50$ J7300 Paragard (IUD)1,050.00$ J7297 Liletta (IUD)(3 year IUD)820.00$ J7298 Mirena (IUD)(5 year IUD)1,113.00$ J7303 NuvaRing, each 175.00$ J7307 Nexplanon 1,146.00$ S9442 Childbirth Education Classes (per 1 hr. unit)10.75$ S4993 Birth Control Pills – all formularies 10.00$ T1001 Maternal Care Skilled Nurse Home Visit 96.00$ T1002 TB Control Treatment 25.00$ 11981 Insertion, non-biodegradable drug delivery implant 150.00$ 11982 Removal, non-biodegradable drug delivery implant 175.00$ 11983 Removal/re-insertion, non-biodegradable drug delivery implant 250.00$ 20552 Injection(s) single or multiple trigger point(s), 1 or 2 muscles 60.00$ 46900 Destroy Anal Lesion(s)240.00$ 54050 Destruction/Lesion/Condyloma 134.04$ 56501 Destroy Vulva Lesion (s)150.00$ 57170 Diaphragm Fitting 110.00$ 57452 Colposcopy w/o Biopsy 150.00$ 57454 Colposcopy w/Biopsy 220.00$ 57505 Endocervical curettage 160.00$ OTHER CLINIC SERVICES Exhibit 3 Page 17 CPT /HCPCS Codes CPT /HCPCS Description NHCPH Fees 57456 Colposcopy w/endocervical curettage 200.00$ 58300 IUD Insertion 130.00$ 58301 IUD Removal 150.00$ 86580 TB Intradermal Test 20.00$ 92551 Pure Tone Audiometry, air 30.00$ 92587 OAE Hearing Screening 70.00$ 96110 Developmental Delay/Autism & Autism Spectrum Disorders Screen 33.00$ 96127 Social-emotional/Mental Health Screen/CRAFFT Brief 33.00$ 96158 MH Health and Behavior Intervention, individual, initial 30 min 65.00$ 96159 MH Health and Behavior Intervention, individual, add'l 15 min 30.00$ 96160 Adolescent Health Risk Screen - age 11--20 33.00$ 96161 Maternal Depression Screening/Well Child Visit 33.00$ 99172 Vision acuity Screening – Color 30.00$ 99173 Vision Acuity Screening 30.00$ D0145 Oral evaluation for a patient under three years of age and counseling/Well Child Visit (Into the Mouthes of Babes)45.00$ D1206 Topical application of fluoride varnish/Well Child Visit (Into the Mouths of Babes)30.00$ 99188 Application of topical fluoride varnish by physician or other qualified health care professional/Well Child Visit (Into the Mouths of Babes)30.00$ 99501 Postpartum Assessment Home Visit 65.00$ 99502EP Newborn EPSDT Screen Home Visit 90.00$ 99502 Newborn Assessment Home Visit 68.00$ 90471 IMM Administration Single Dose 25.00$ 90471EP IMM Administration Single Dose ( Health Check)25.00$ 90472 IMM Administration- Each Additional Inj. 25.00$ 90472EP IMM Administration – Each Additional Inj. (HC) 25.00$ 90473 Imm Adm Fee/Intranasal/Oral 25.00$ 90473EP Imm Adm Fee/Intranasal/Oral (Health Check)25.00$ 90474 Imm Adm Fee/Inj + Intranasal/Oral 25.00$ 90474EP Imm Adm Fee/Inj + Intranasal/Oral (Health Check)25.00$ 95115 Immunotherapy, one injection 15.00$ 95117 Immunotherapy injections 20.00$ 96372 Injection (SC) / (IM)20.00$ G0008 Medicare Administration Fee (FLU)25.00$ G0009 Medicare Administration Fee (Pneu)25.00$ 90480 COVID-19 Administraton Fee 45.00$ M0201 COVID-19 Home Vaccine Administration Fee 45.00$ 90281 *Immune Globulin 30.00$ 90620 Bexero - Meningococcal vaccine, group B 245.00$ 90619 MenQuadif-Meningococcal vaccine, groups A,C,Y,W 175.00$ 90621 Trumenba - Meningococcal vaccine, group B 200.00$ 90625 VaxChora Cholera 300.00$ 90626 Tick-Borne Encephalitits Vaccine 0.25 ML 320.00$ 90627 Tick-Borne Encephalitits Vaccine 0.50 ML 320.00$ 90632 Hep A/Adult 85.00$ 90633 HEP A Pediatric / Adolescent 45.00$ 90636 HEP A/B Combination Vaccine 130.00$ 90647 Pedvax (Hib) 45.00$ 90648 Hiberix/ACT Hib/OMNI Hib (State)N/C 90651 Gardasil-9 290.00$ 90661 Flucelvax – Age 18+ (patients with egg allergies)35.00$ INJECTION/IMMUNIZATION ADMINISTRATION CODES VACCINE CODES Exhibit 3 Page 18 CPT /HCPCS Codes CPT /HCPCS Description NHCPH Fees 90674 Flucelvax-Age 4+ Quadrivalent IIV4 (patient with egg allergies)35.00$ 90662 Flu Vaccine – High Dose (Age 65+)75.00$ 90665 Lyme Disease vaccine, IM 55.00$ 90670 Prevnar/PCV-13 275.00$ 90677 Prevnar/PCV-20 300.00$ 90675 Rabies vaccine (Intramuscular)450.00$ 90680 Rotateq Vaccine 125.00$ 90685 Flu Vaccine/Pres Free/Age 6-35 mos. (syringe)35.00$ 90686 Flu Vaccine/Pres Free/Age 3+ yrs. (syringe)35.00$ 90688 Flu Vaccine/Regular/Age 3+ yrs. (multi-dose vial)35.00$ 90691 Typhoid Injectable 125.00$ 90696 Kenrix/Quadracel (Dtap,IPV) 140.00$ 90697 Vaxelis (Dtap,IPV, HIB, Hep B)160.00$ 90698 Pentacel (Dtap, IPV,Hib) 125.00$ 90678 Abrysvo (RSV) bivalent 300.00$ 90679 Arexvy (RSV) adjuvanted 300.00$ 90700 DTap 40.00$ 90702 DT (State)N/C 90707 MMR virus vaccine SC/jet 100.00$ 90710 ProQuad (MMR/Varicella)275.00$ 90713 Poliomyelitis vaccine SC 100.00$ 90714 Td 45.00$ 90715 Tdap (Tetanus, diphtheria, pertussis) vaccine) 55.00$ 90716 Chicken Pox (Varicella)175.00$ 90717 Yellow Fever 200.00$ 90723 Pediarix (Dtap, Hep B, IPV) 100.00$ 90732 Pnueumococcal vaccine 140.00$ 90734 Menactra Vaccine 150.00$ 90738 Japanese Encephalitis 360.00$ 90736 Zostavax 275.00$ 90744 Hep B/Pediatric (Age < 11 yrs)40.00$ 90745 Hep B/Pediatric High Risk (Age 11-18)N/C 90746 Hep B/Age 19+75.00$ 90739 Heplisav-B/Age 18+165.00$ 90750 Shingrix (Shingles)225.00$ 91322 Moderna Spikevax COVID-19 (Age 12 yrs & older)150.00$ 91321 Moderna Spikevax COVID-19 (Age 6 mos-11 yrs)150.00$ 91320 Pfizer Comirnaty COVID-19 (12 yrs & older)150.00$ 91319 Pfizer BioNTech COVID-19 (5 yrs-11yrs)100.00$ 91318 Pfizer BioNTech COVID-19 (6 mos-4 yrs)100.00$ 91304 Novavax COVID-19 (12 yrs & older)150.00$ 90611 Jynneos M Pox Vaccine N/C 36415 Venipuncture 14.00$ 36416 Fingerstick 14.00$ 81001 Urinalysis, auto, w/microscopic 12.00$ 81003 Urinalysis, auto, without microscopic 8.00$ 81025 Urine Pregnancy Test 11.00$ 82120 Amines- Wet Mount 10.00$ 82948 Glucose, quantitative,blood, reagent strip 20.00$ 83036 Hemoglobin A1C 20.00$ 85018 Hemoglobin 10.00$ 86592 Syphilis antibody, qualitative, RPR 18.00$ 86593 Syphilis antibody, quantitative 15.00$ IN-HOUSE LAB CODES Exhibit 3 Page 19 CPT /HCPCS Codes CPT /HCPCS Description NHCPH Fees 87210 Wet Smear 15.00$ 0353U Chlamydia/Gonorrhea, PCR N/C 0352U MVP assay (Multiplex Vaginal Panel)165.00$ 83020 90 Hemoglobin Electrophoresis N/C 83655 90 Blood Lead N/C 84030 90 Newborn Screening N/C 86618 90 Lyme Disease Antibody N/C 86666 90 Ehrlichia Antibody N/C 86703 90 HIV 1 & HIV 2 N/C 86709 90 HEP A IGM (Antibody) N/C 86757 90 Rickettsia Antibody (Rocky Mt Spotted Fever)N/C 86781 90 Treponema pallidum confirm, serum N/C 87116 90 TB Culture N/C 87118 90 Mycobacteria identification N/C 87206 90 TB Smear N/C 87252 90 Herpes Culture N/C 87265 90 Bordetella pertussis N/C 87340 90 HEP B Surface ag,E/A N/C 87521 90 Hepatitis C, NAAT – RNA Reflex N/C 87593 90 Infectious agent detection by nucleic acid (DNA or RNA); orthopox (monkey pox) N/C 80048 90 Basic Metabolic Panel 15.00$ 80051 90 Electrolite Panel 15.00$ 80053 90 Comp Metabolic Panel 15.00$ 80061 90 Lipid Panel 25.00$ 80069 90 Renal Panel 20.00$ 80076 90 Hepatic Panel 15.00$ 82040 90 Albumin 15.00$ 82150 90 Amylase 15.00$ 82247 90 Billirubin, Total 15.00$ 82248 90 Billirubin, Direct 15.00$ 82465 90 Cholesterol 15.00$ 82550 90 CK (Creatinine kinase – CK or CPK 20.00$ 82565 90 Creatinine 15.00$ 82728 90 Ferritin 25.00$ 82746 90 Folic Acid 25.00$ 82947 90 Glucose, quantitative 15.00$ 83036 90 Hemoglobin A1C (Wise Woman Only) 20.00$ 83540 90 Iron 15.00$ 83550 90 TIBC (Iron Binding Cap) 15.00$ 83615 90 LDH (Lactate dehydrogenase enzyme) 15.00$ 83718 90 HDL (High density lipoprotein) 15.00$ 84075 90 Alkaline Phosphate 15.00$ 84132 90 Potassium 15.00$ 84152 90 PSA 35.00$ 84175 90 Protein, Total 15.00$ 84439 90 T4, Free 20.00$ 84443 90 TSH 30.00$ 84450 90 AST/SGOT 15.00$ 84460 90 ALT/SGPT 15.00$ 84478 90 Triglycerides 15.00$ REFERRED LAB CODES - PRIVATE LAB STATE LAB CODES Exhibit 3 Page 20 CPT /HCPCS Codes CPT /HCPCS Description NHCPH Fees 84481 90 T3, Free 25.00$ 84520 90 BUN 15.00$ 85004 90 Differential & total WBC Count-TB Patients Only N/C 85048 90 Differential & total WBC Count-TB Patients Only N/C 85007 90 CBC with manual Diff-TB Patients Only N/C 85025 90 CBC with Diff 15.00$ 85027 90 CBC without Diff 13.00$ 85651 90 SED Rate, ESR 15.00$ 85660 90 Hbg Solubility (Sickle Cell Screen) 30.00$ 86480 90 Tuberculosis test, cell mediated immunity measurement of gamma interferon antigen response (Interferon Gold TB Blood Test)75.00$ 86694 90 Herpes Antibody (Patient Request) 40.00$ 86787 90 Varicella Titer/Employee Only-No Charge N/C 86803 90 Hepatitis C Antibody 25.00$ 87070 90 Culture, nose/throat,wound 15.00$ 87081 90 Culture GC, screening only 20.00$ 87086 90 Urine Culture 15.00$ 87491 90 Chlamydia NAA N/C 87591 90 Gonorrhea, NAA N/C 87593 90 Infectious agent detection by nucleic acid (DNA or RNA); orthopox (monkey pox) N/C 87624 90 HPV Reflex/Co-test 50.00$ 88141 90 MP Interpretation – Pathologist 25.00$ 88175 90 Pap Smear 40.00$ 99000 Handling Fee (One per visit)18.00$ 97802 Initial Assessment Med Nutrition Therapy (per 15 min)35.00$ 97803 Re-Assessment Med Nutrition Therapy (per 15 min)30.00$ 97804 Medical Nutrition Therapy, Group, per 30 min 20.00$ G0108 Diabetes Self-management, Individual, per 30 min 55.00$ G0109 Diabetes Self-management, Group, per 30 min 25.00$ G0270 Additional Medical Nutrition Therapy, Phys Order, per 15 min 35.00$ G0271 Additional Medical Nutrition Therapy, Group, Phys Order, per 30 min 20.00$ S9465 Diabetes Self-management, Registered Dietitian Visit, No Time/Unit 40.00$ S9470 Nutrition Counseling, RD Visit, No time/Unit 40.00$ 99211 Est Pt Level I – Minimal (Flat Fee) add test code 40.00$ 81025 Urine Pregnancy Test (Flat Fee)11.00$ Returned Check Fee (Collected by Finance)25.00$ 99071 Provision of Patient Supplies & Education N/C LU401 Miconazole/Generic Formulary – ($8.00 per tube)8.00$ LU401 Fluconazole/Generic Formulary - 150 mg ($2.00 per pill)2.00$ LU401 Replacement Diaphragm ($10.00 each) 10.00$ LU401 Delfen Foam or Generic Formulary (per tube/bottle)12.00$ LU401 Fluconazole or Generic Formulary 150 mg (per pill)2.00$ LU401 Prenatal Vitamins or Generic Formulary (each)N/C LU401 Plan B – Emergency Contraception 10.00$ D0120 Periodic oral evaluation 33.00$ D0140 Limited oral evaluation - problem focused 45.00$ D0150 Comprehensive oral evaluation - new/established patient 54.00$ WOMEN'S PREVENTIVE HEALTH SUPPLEMENTAL SUPPLIES MOBILE DENTAL UNIT CODES NUTRITION COUNSELING/DIABETES SELF-MANAGEMENT CODES WALK-IN PREGNANCY TESTING MISCELLANEOUS Exhibit 3 Page 21 CPT /HCPCS Codes CPT /HCPCS Description NHCPH Fees D0160 Detailed/extensive oral evaluation - problem focused, by report 80.00$ D0170 Re-evaluation-limited; problem focused (established patient; not post- operative)45.00$ D0210 Intraoral - complete series (including bitewings)82.71$ D0220 Intraoral - periapical first film 21.00$ D0230 Intraoral - periapical each additional film 18.00$ D0240 Intraoral - occlusal film 22.00$ D0270 Bitewing - single film 17.00$ D0272 Bitewings - two films 30.00$ D0273 Bitewings - three films 33.00$ D0274 Bitewings - four films 40.00$ D0330 Panoramic film 70.00$ D0470 Diagnostic casts 52.00$ D1110 Prophylaxis - adult (HC 14+) 55.00$ D1120 Prophyaxis - child 45.00$ D1206 Topical fluoride varnish; therapeutic application for moderate to high caries risk patients 30.00$ D1208 Topical application of fluoride 25.00$ D1351 Sealant - per tooth 45.00$ D1354 Interim caries arresting medicament application-per tooth $16.00 D1510 Space maintainer - fixed - unilateral 200.00$ D1575 Distal shoe maintainer-fixed-unilateral-per quadrant 220.00$ D1553 Re-cement or re-bond unilateral space maintainer-per quadrant N/C D1556 Removal of fixed unilateral space maintainer-per quadrant N/C D1557 Removal of fixed bilateral space maintainer-maxillary N/C D1558 Removal of fixed bilateral space maintainer-mandibular N/C D2140 Amalgam 1 surface - primary or permanent 90.00$ D2150 Amalgam 2 surfaces - primary or permanent 104.00$ D2160 Amalgam 3 surfaces - primary or permanent 120.00$ D2161 Amalgam four or more surfaces - primary or permanent 150.00$ D2330 Resin-based composite - one surface, anterior 175.00$ D2331 Resin-based composite - two surfaces, anterior 175.00$ D2332 Resin-based composite - three surfaces, anterior 190.00$ D2335 Resin-based composite - four or more surfaces or involving incisal angle 190.00$ D2391 Resin-based composite - one surface, posterior 175.00$ D2392 Resin-based composite - two surfaces, posterior 190.00$ D2393 Resin-based composite - three surfaces, posterior 190.00$ D2394 Resin-based composite - four or more surfaces, posterior 200.00$ D2930 Prefabricated stainless steel crown - primary tooth 164.00$ D2931 Prefabricated stainless steel crown - permanent tooth 176.00$ D2932 Prefabricated resin crown 191.00$ D2940 Sedative filling 45.82$ D2950 Core buildup, including any pins 113.19$ D2951 Pin retention - per tooth, in addition to restoration 27.49$ D2970 Temporary crown, fractured tooth 146.07$ D3220 Therapeutic pulpotomy (excluding final restoration 170.00$ D3221 Pulpal Debridement 210.00$ D3310 Root canal therapy - anterior (excluding final restoration)318.00$ D3320 Root canal therapy - bicuspid (excluding final restoration)375.00$ D3330 Root canal therapy - molar (excluding final restoration)460.00$ D4341 Periodontal scaling/root planing - four or more contiguous teeth per quad 115.00$ D4355 Full mouth debridement to enable comprehensive evaluation and dx 77.62$ Exhibit 3 Page 22 CPT /HCPCS Codes CPT /HCPCS Description NHCPH Fees D7111 Extraction, coronal remnants - deciduous tooth 62.00$ D7140 Extraction, erupted tooth or exposed root 110.00$ D7210 Surgical removal of erupted tooth 140.00$ D7220 Removal of impacted tooth, soft tissue 142.00$ D7230 Removal of impacted tooth, partially bony 187.00$ D7250 Surgical removal of residual tooth roots (cutting procedure)136.00$ D7270 Tooth reimplantation and/or stabilization of accidentally evulsed/displaced 238.00$ D7280 Surgical access of an unerupted tooth 214.00$ D7286 Biopsy of oral tissue - soft (all others)124.63$ D7450 Removal of benign odentegenic cyst or tumor – lesion diameter up to 1.25 cm 200.00$ D7510 Incision and drainage of abscess - intraoral soft tissue 167.88$ D9110 Palliative (ER) treatment of dental pain - minor procedure 49.05$ D9215 Local anesthesia N/C D9220 Deep sedation/general anesthesia - first 30 minutes 155.77$ D9230 Analgesia, anxiolysis, inhalation of nitrous oxide 125.00$ D9630 Other drugs and/or medicaments, by report 17.51$ Exhibit 3 Page 23 DESCRIPTION FEE ADD-ON FEES/COMMENTS Septic Systems Septic Improvement Permit $400.00 Septic System Construction Authorization (Type I, II, III(a), III(g) $200.00 Septic System Construction Authorization GS 130A-335 (a2) $80.00 On-Site Wastewater Evaluator (AOWE) Septic System Construction Authorization Septic Improvement Permit and Construction Authorization GS 130A-335 (a2)$240.00 On-Site Wastewater Evaluator (AOWE) Improvement Permit and Construction Authorization Septic System Construction Authorization (Type III(b), IV, V, VI)$832.00 First 1500 gal/day + $100 each additional 1500 gal/day + $100 x # of inspections / 20 years Septic System Permit Revision $250.00 Septic System Repair Permit $50.00 Existing System Inspection (Reuse Purpose/Addition)$200.00 Monitoring Soil Wetness/Wells $300.00 Per Season = January 1st-April 30th Re-inspection for lot not ready $70.00 Each additional site visit Engineer Option Permit (GS 130A-336.1(n)) $35.00 Authorized On-Site Wastewater Evaluator (AOWE) Permit Option $35.00 Wells Well Permit (including site evaluation & bacteriological water samples analysis)$350.00 Water Sample - Bacteriological $140.00 Water Sample - Bacteriological - resample $70.00 Water Sample - Chemical $140.00 Re-inspection after failed inspection at initial visit $70.00 Each additional site visit Food Food Service Plan Review: Prototype Restaurants & Food Stands NCDHHS - EH Section Approval Letter Non-prototype/Independent Restaurants, Food Stands & Mobile Food Units $250.00 Renovations/Changes $250.00 Changes in dimension of food preparation area, seating capacity or addition of room Transitional Permits Limited Food Service Establishment/Annual Fee $75.00 Temporary Food Establishment Permit $75.00 Pools Seasonal Swimming Pool - Operation permit $200.00 Seasonal (April 1st - October 31) Year Round Swimming Pool - Operation permit $400.00 Swimming Pool - Plan Review - (new and existing remodel construction)$250.00 Swimming Pool - Plan Review - (new and existing remodel construction) secondary and each resubmittal of rejected plans $250.00 Re-inspection after failed inspection at initial visit $100.00 Pool Light checks - night inspection $100.00 Chemical checks for Spas - Expos $75.00 per spa with water Tattoos and Body Piercers New Establishment Plan Review Tattoo or Body Piercier Shop $200.00 Temporary Tattoo Artist and/or Body Piercing Permit $150.00 Permit to operate 2 weeks or less Environmental Health Fee Schedule Effective 07/01/2024 Exhibit 3 Page 24 SHERIFF’S OFFICE ANIMAL SERVICES UNIT ANIMAL SERVICES UNIT FEES Cats/Dogs/Ferrets Spayed/Neutered Unaltered Cats/dogs/ferrets under 1 year of age 1 year registration $10.00 $ 10.00 Cats/dogs/ferrets 1 year of age or older 1 year registration $10.00 $ 20.00 Cats/dogs 1 year of age or older 3 year registration $25.00 $ 50.00 Any owner of a handicap helper dog, which is used for seeing or hearing purposes and can show proof of spay/neuter, shall receive a license free of charge. SPECIALTY REGISTRATIONS # of Cats/Dogs/Ferrets Registration Fee 05 –10 $ 45.00 11 –20 $ 70.00 21 –Over $100.00 Types of Specialty Pet Licenses (Fees above apply to each type): 1. MULTIPLE PET REGISTRATION Any combination of dogs, cats and ferrets All must be neutered or spayed. Good for one year (renewable on date of purchase) 2. SHOW BREEDER REGISTRATION Either dogs or cats (may not be combined). Do not have to be neutered or spayed. Good for one year (renewable on date of purchase). Kennel must participate in three AKC or UKC sanctioned events per year (proof to be shown) or equivalent for cats, or six in three years. 3. HUNTING DOG REGISTRATION Dogs only Do not have to be spayed or neutered Good for one year (renewable on date of purchase) Kennel must participate in three lawful or sanctioned events per year (proof when possible). Proof of N.C. hunting license No refund due to death or loss of ownership. Exhibit 4 Page 1 SHELTER $10.00 per day $15.00 per day bite animals/dangerous dogs ADOPTION Cats/Dogs $60.00 Other - Large $25.00 - Small $ 3.00 REDEMPTION All Animals Owner’s Offense 1st $ 20.00 2nd $ 60.00 3rd $100.00 4th $150.00 5th or more $250.00 MISCELLANEOUS FEES Euthanasia Fee $ 20.00 Breeder Permit $ 20.00 Owned Animal Pick-up $ 20.00 Collars/Leashes $ 5.00 ADOPTION REFUND POLICY Refunds for adoptions may be granted if the following conditions are met: 1. The adopted animal is returned. 2. The adopted animal is examined by a veterinarian within five working days from the adoption date and a health problem is noted. 3. The adoptee produces either a handwritten note or a computer generated report from the veterinarian stating the findings and date examined. The amount of refund will be the total of adoption fee and county license fee, if purchased and returned.The adoptee is responsible for any charges by the veterinarian. Exhibit 4 Page 2 CIVIL CITATIONS* Section/Description 5-1 (d) Interference with any Duly Appointed Agent $150.00 5-5 (A) County License Fee $100.00 (B) Rabies Vaccination $200.00 5-6 Keeping Stray Animals $25.00 5-7 Rabies Vaccination and Control $500.00 5-8 Wearing of Collar, Tags, & Identification $15.00 5-9, 5-4 (d) Dogs/Cats/Ferrets Running-at-Large*, Leash Requirement* First Violation $25.00 Second Violation $75.00 Three or More Violations $500.00 Unprovoked Dog Bite/Running Loose $500.00 5-10 Vicious Animals $500.00 5-11 Barking Dogs First Violation $50.00 Second Violation $100.00 Three or More Violations $250.00 5-12 Teasing and Molesting $100.00 5-13 Injuring Animals, Notice Required $100.00 5-14 Health and Welfare $300.00 5-15 Manner of Keeping & Treating Animals $300.00 5-16 (d) Sterilization of Cats & Dogs $250.00 5-16 (i) Animals imp./Judicial process/Admin. seizure $500.00 5-19 Interference with Trap or Cage $100.00 5-23 Collection of Cats and Dogs for Resale $500.00 5-25 Dogs prohibited at Mason Inlet* First Violation $ 25.00 Second Violation $ 50.00 Three or More Violations $ 75.00 5-26 Dogs Running-at-Large at Mason Inlet*(Same violation fees for Section 5-9, see above) 5-27 Proof of Sterilization/Animals Adopted in New Hanover County $500.00 5-28 to 29 Permit for Kennels $500.00 5-30 Restraint (Dog Tied Out) $250.00 5-31 Outside Enclosure $250.00 5-32 Public Nuisance First Violation $50.00 Second Violation $100.00 Three or More Violations $200.00 5-33 Responsible Breeder’s Permit $250.00 5-61 to 65 Dangerous Dogs/Potentially Dangerous Dog Violations $500.00 5-66 Responsible Breeding Permit $250.00 *The owner of an animal shall be subject to escalating fees. The fees are directed toward and against the owner. The purpose of the fee is to affect the conduct of the owner by seeking to have an owner responsibly maintain a sufficient restraint and confinement of their animal. Exhibit 4 Page 3