Single-Event Mobile Food Unit Permit Application

Single-Event Mobile Food Unit Permit Application
A completed temporary food permit application is to be submitted 10 business days prior to the event. If application is not submitted 10 business days prior to event, you may be required to come to the health department during normal business hours.
Owner/Owner Agent Name
Establishment Name
Address for Owner/Owner Agent

Mailing Address

Street Address Line 2

CityState

Zip
Owner/Owner Agent Email Address
example@example.com
Owner/Owner Agent Phone Number
Event Name
Event Location Street Address/Nearest Intersection
Event Dates
Desired Date and Time for Inspection
This is not gurantee of date and time of inspection.
Menu Items
Will any food be prepared before the event?
Do you have a commissary?
If yes to having a commissary, please attach commissary agreement, permit and most recent inspection.

Cancelof
Food CANNOT be served or sold until permit has been granted. Permit will not be granted until after inspection is completed.
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, both can be found at plattecountyhealthdept.com. If application is not submitted 10 business days prior to event, you may be required to come to the health department during normal business hours.
Date

MonthDayYear
Date

$25.00

Total

Food CANNOT be served or sold until permit has been granted. Permit will not be granted until after inspection is completed.