Fillable LICENSE APPLICATION FOR ITINERANT RESTAURANT MUNICIPAL CODE SECTION (City of South Bend)

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LICENSE APPLICATION FOR ITINERANT RESTAURANT MUNICIPAL CODE SECTION (City of South Bend)

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The LICENSE APPLICATION FOR ITINERANT RESTAURANT MUNICIPAL CODE SECTION (City of South Bend) form is 4 pages long and contains:

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For all municipal business license questions, contact: Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.9216 • F: 574.235.9021
LICENSE APPLICATION FOR – ITINERANT RESTAURANT
MUNICIPAL CODE SECTION – 4-45 (SEE ALSO 4-46)
DEFINITION:
Itinerant restaurants include any restaurants which operate for a temporary period of time, not
to exceed two (2) weeks, and include, but are not limited to, those operated in conjunction with
a fair, carnival, circus, public exhibition, or similar gathering.
IF DESCRIPTION DOES NOT APPLY, SEE:
Food Vending Vehicle (§4-25)
Restaurant (§§4-45 & 4-46)
GENERAL INSTRUCTIONS:
1. Print legibly and complete all sections to ensure efficient processing.
2. Assemble all required information and materials before filing application.
3. Thoroughly review all applicable Municipal Code Sections listed above.
4. Include $5.00 license application fee payable to City of South Bend.
5. License fee payable to City of South Bend due at issuance - $75.00 per location, per event.
6. Add $30.00 to license fee for Live Entertainment.
7. See §4-46 if live music/entertainment provided.
8. See §4-45(c) for fee waivers.
9. License expires two (2) weeks from issue date.
REQUIRED INFORMATION AND MATERIALS:
1. Health Permit pursuant to inspection and approval by County Health Officer.
2. St. Joseph County Health Department Plan and Review Application for new facilities.
3. Fire and Building Department Inspections as required by City Controller.
4. Valid certificate signed by Sealer of Weights and Measures if food to be sold by weight or
measure.
5. Must comply with minimum sanitation requirements as specified by Indiana State Board of
Health, Regulation HFD 17 and all changes and amendments (available on file with City
Clerk).
6. See §4-46 if live entertainment/music is to be provided.
For all municipal business license questions, contact: Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.9216 • F: 574.235.9021
LICENSE APPLICATION FOR – ITINERANT RESTAURANT
MUNICIPAL CODE SECTION – 4-45 (SEE ALSO 4-46)
APPLICATION PROCESS:
1. Review Municipal Code Sections 4-45 & 4-46 thoroughly.
2. Submit Application with $5.00 Processing Fee.
3. Inspection and approval by the County Health Officer, as evidenced by a valid Health Permit
4. Inspections by the Fire Department and Building Department as required.
5. Applicants desiring to sell food by weight or measure shall file a valid certificate signed by
the Sealer of Weights and Measures that all scales and measures to be used in said business
have been tested and approved, at the time of making application.
6. License issued upon approval and payment of the license fee.
1
For all municipal business license questions, contact: Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.9216 • F: 574.235.9021
LICENSE APPLICATION FOR – ITINERANT RESTAURANT
MUNICIPAL CODE SECTION – 4-45 (SEE ALSO 4-46)
I. APPLICATION TYPE Check One: New Renewal
II. BUSINESS DATA
A. Business Name:
B. Business Address:
City: State: Zip:
C. Mailing Address (If different from above):
City: State: Zip:
D. Business Telephone Number:
E. Business Fax Number:
F. E-Mail Address:
G. Proposed location of Itinerant Restaurant:
H. Proposed Dates of Operation:
III. PERSONAL DATA
A. Applicant's Legal Name:
B. Residential Address:
City: State: Zip:
C. Residential Telephone Number:
D. Cellphone Number:
E. Position with Business:
F. E-Mail Address:
For Office Use Only
Application Filed Fire Dept. Approval
Application Fee Paid Health Dept. Approval
Sent to Dept. License Fee Paid
Building Dept. Approval License Number
Not Approved
Reason
2
For all municipal business license questions, contact: Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.9216 • F: 574.235.9021
LICENSE APPLICATION FOR – ITINERANT RESTAURANT
MUNICIPAL CODE SECTION – 4-45 (SEE ALSO 4-46)
IV. GENERAL QUESTIONS
A. Will food be sold by weight or measure:
Yes No
If yes, please attach certificate from the Sealer of Weights and Measures.
B. Is your restaurant operated by a not-for-profit fraternal organization, service club, or
religious, educational, or charitable institution:
Yes No
If yes, what is the name of the organization, club, or institution:
C. Do you provide music or other live entertainment:
Yes No
If yes, what is the type of live entertainment:
V. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION
VI. AFFIRMATION
I, hereby, certify and affirm that all of the information I have given in this application is true and
accurate to the best of my knowledge. I further certify that I have in no way attempted to
mislead the City in this application by omitting facts known to me. I have read and understand
the regulations of the Itinerant Restaurant license found in the City of South Bend Municipal
Code, Sections 4-45 and 4-46.
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LICENSE APPLICATION FOR ITINERANT RESTAURANT MUNICIPAL CODE SECTION (City of South Bend)

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Completed 16 July 2020

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