Freezer Truck Application
Owner/Owner Agent Name
*
Freezer Truck Name
*
Owner/Owner Agent Address
*
Mailing Address
Street Address Line 2
City
State
Zip
Owner/Owner Agent Email Address
*
example@example.com
Owner/Owner Agent Phone Number
*
Items Sold
*
By singing this application you agree to the Platte County Missouri Government Ordinances Chapter 230: Food Service Establishments and Retail Food Establishments and Missouri Food Code. The Platte County Food Protection Ordinance can be found at plattecountyhealthdept.com.
*
Date
*
/
Month
/
Day
Year
Date
Permit Fee
*
prev
next
( X )
Permit Fee
$25.00
$
25.00
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Submit
Should be Empty: