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
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: