City of Emmetsburg Mobile Food Unit Application
Application/Permit Year
*
Name of Business
*
Name of Primary Contact
*
Permanent Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Email
example@example.com
Description of Mobile Food Unit
*
Description of Kitchen Facilities, Cooking Facilities, Preparation Area, and Safety Features
*
Mobile Unit Size (Size of Vehicle and/or Trailer)
*
Length
Width
City
State / Province
Postal / Zip Code
Location of Mobile Food Unit in Emmetsburg
*
Owner of Property where the Mobile Food Unit will be
*
License Fee and Required Information:
License Fee: $500 (expires 12/31 of each year)
*
My $500 license fee has been submitted to City Hall
I agree to submit my license fee to City Hall after completing this form (Send/deliver to Emmetsburg City Hall, 2021 Main Street, P.O. Box 417, Emmetsburg, IA 50536)
Copy of Inspection Certification
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Photos of Front, Side, and Back of Unit
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Written Consent of Property Owner
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Vehicle Registration
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Surety Bond: $1,000
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Insurance Requirements:
General Liability: $500,000 Per Occurrence/$1,000,000 Aggregate
Property Damage: $500,000
Proof of Insurance
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Signature of Applicant
*
Clear
Preview PDF
Submit
Should be Empty: