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*
YesNo
YesNo
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. *

Clear
Date*

MonthDayYear
Date

Permit Fee*

Permit Fee

$25.00

Total

$0.00

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