Fillable MOBILE FOOD VENDOR PERMIT APPLICATION (City of Hickory)

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MOBILE FOOD VENDOR PERMIT APPLICATION (City of Hickory)

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The MOBILE FOOD VENDOR PERMIT APPLICATION (City of Hickory) form is 2 pages long and contains:

  • 1 signature
  • 6 check-boxes
  • 22 other fields

Country of origin: US
File type: PDF

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City of Hickory
PO Box 398, Hickory, NC 28603
(828) 323-7410
planning@hickorync.gov
Rev. 10/2018 Mobile Food Vendor Application Page 1 of 2
MOBILE FOOD VENDOR PERMIT APPLICATION
Name of Applicant:
Applicant’s Address:
Applicant’s Email:
Applicant’s Telephone Number(s):
Name of Business:
Business Address (if different from above):
Business Telephone Number(s):
Type(s) of food to be sold:
Environmental Health Permit # (if applicable):
Additional Employees/Volunteers Employee/Volunteer Address
Rev. 10/2018 Mobile Food Vendor Application Page 2 of 2
The following items must be attached or included with the application and fee:
Criminal background check report that complies with the Mobile Food Vendor
Guidelines for the Vendor and all Vendor employees/volunteers (see the Food Truck
webpage for more info).
Colored photographs of all four sides of the mobile food unit or pushcart must be
attached. Dimensions and width of each Mobile Food Unit shall also be provided.
Full-face photograph of the Vendor, Vendor’s employees, and Vendor’s volunteers
taken within 30 days of the application submission date must be attached.
A copy of any permits or approvals required by the County Department of
Environmental Health and/or North Carolina Department of Agriculture that has permitted
the Vendor must be attached.
A copy of the Certificate of Insurance listing the City of Hickory as an additional insured
must be provided (see the Food Truck webpage for more info).
A copy of the menu (that includes all items to be sold).
By signing this application, you affirm that you have provided all required materials
and have read and understood the Mobile Food Vendor Guidelines and will abide by
them; failure to do so may result in the revocation of this permit.
Applicant’s Signature:
Date of Application:
************************************************************************
For Office Use Only
Planning Director or Designee Signature:
Approval Date:
Expiration Date:
Permit Number:
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MOBILE FOOD VENDOR PERMIT APPLICATION (City of Hickory)

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Completed 17 February 2021

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