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Food Establishment Permit Application

  1. Type of Establishment*

    Select one.

  2. Type of Ownership*

    Check one

  3. Permit Agreement Statement

    In consideration of issuance of this permit I understand and agree to familiarize myself and comply with all laws and ordinances applicable to operation of said business and further agree to permit unrestricted access to an authorized representative of the Environmental Services – Food Safety Division for the purpose of conducting inspections necessary to verify with applicable regulations. I understand that by typing my name I am signing this legal document.

  4. FOR OFFICE USE ONLY

  5. Leave This Blank:

  6. This field is not part of the form submission.