Temporary Food Service Establishment and Mobile Food Unit Application/Permit
Person in Charge
*
Establishment Name
*
Address for Person in Charge
*
Mailing Address
Street Address Line 2
City
State
Zip
Email Address
*
example@example.com
Phone Number
*
Event Name
*
Event Location Street Address/Nearest Intersection
*
Event Dates
*
Desired Date and Time For Inspection
*
Menu Items
*
Will any food be prepared before the event?
*
Yes
No
Do you have a commissary?
*
Yes
No
If yes to having a commissary, please attach commissary agreement, permit and most recent inspection.
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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 Health Department Food Protection Ordinance and Missouri Food Code. The Platte County Food Protection Ordinance can be found at plattecountyhealthdept.com.
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Date
*
/
Month
/
Day
Year
Date
If application is submitted less than 14 days prior to the event, additional fees will apply.
My Products
*
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( X )
Permit Fee
$
25.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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