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MOBILE RETAIL FOOD ESTABLISHMENT ADDITIONAL REQUIREMENTS AND CHECKLIST (City of Marietta)

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BROWSE CITY OF MARIETTA (GA) FORMS

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Page 1 of 9
MOBILE RETAIL FOOD ESTABLISHMENT ADDITIONAL REQUIREMENTS AND CHECKLIST
1. ____$8
9 Occupation Fee in Certified Funds (Cash, Money order, cashier’s check).
2. ____Co
py of Applicant’s Driver’s License (If Permanent Resident, need copy of both back
& front Permanent Resident Card)
3. ____Ap
proval from Cobb Environmental Health Department (770-435-7815) Copy of
Health Inspection report.
4. __
__Color pictures of Truck (front, back, and both sides)
5. __
__Copy of $1,000,000.00 liability insurance
6. ____Pr
ivate Employer Affidavit
7. ____Ci
tizenship Affidavit
8. ____LL
C or Articles of Incorporation documents
9. __
__Zoning Application Form (completed form to be emailed to Zoning)
10.____No
sale or offer for sale shall be made by any licensee between 9:00 p.m. and 6:30
a.m. within areas residentially zoned and between 10:00 p.m. and 6:30 a.m. in all other
zoning classes.
Last
First Middle
Number Street
City State Zip
City of Marietta, Business License Division
205 Lawrence Street, P. 0. Box 609, Marietta, Georgia 30061
Telephone: (770) 794-5520; Fax: (770) 794-5685
Account
#
Mobile Retail Food Establishment Application
Location Event Dates:
From To
1.
Name of Applicant
Address:
Telephone __________
Gender Height Weight
__
Eyes Hair
__
Date of Birth Place of Birth
Month /Day/ Year
City State Country
2.
Name and Address of Present Employer
3.
List your Employers for the Last Five Years:
Dates
From
To Name
4.
List of Residences for the Past Five Years:
Dates
From
To Name
Address City
Address
City
State
State
5.
Georgia Driver’s License Number:
6.
Has your driver's license ever been suspended? No
__ Yes_ _
If so, describe the circumstances and date
.
7.
Have you ever been convicted in any state of a felony, misdemeanor, or ordinance violation other than minor
traffic offenses? (Include conviction for DUI)
No
_____
Yes
__
If yes, give date and location of conviction, penalty imposed and nature of the charge?
8.
Have you ever had a judgment or conviction for fraud, deceit, or misrepresentation entered against you?
No ________ Yes
If yes, give
details
as
above
9.
List any licenses currently held or previously held by the applicant within the last five (5) years preceding
this date
relating to mobile retail food sales or a similar business
Page 2 of 9
10.
Have any prior licenses been suspended, revoked or not renewed by the issuing authority?
No _____ Yes _______
If so, give full details:
11.
If you are granted the license, list name and address of employer
12.
List the make, license plate number and VIN number of the vehicle
being used:
13.
What products do you intend to sell?
14.
Describe the method of selling ________________________________________________________________________________________
15.
Attach proof of liability insurance and Georgia motor vehicle record.
I understand that it is unlawful for any mobile retail food establishment to conduct business in any public right-of-
way. Initial ________
Indemnity Agreement. Any person or entity applying for rights with this application hereby indemnifies and
releases the City of Marietta, its agents, employees and elected officials from any and all liability against any and
all claims, actions and suits of any type whatsoever. Initial ______
PORTION TO BE COMPLETED IN THE PRESENCE OF A NOTARY
Executed in ___________________________________(city),
________________
(state).
_
,
being by me first duly sworn, deposes and says: that s/he is
the applicant above named; that s/he has read the foregoing application and that s/he knows the contents, thereof,
and that all matters and things therein set forth are true of her or his own knowledge; that any incomplete or false
statements could be grounds for denial; and s/he agrees to conform to all rules and regulations promulgated by the
City of Marietta in connection therewith.
D
ate of Application
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
______DAY
OF
,
20
_
NOTARY PUBLIC
My commission Expires:
Signature of Applicant
Printed Name of Applicant
RECEIVED BY: _________________________________
DATE/TIME: _______________________________
Page 3 of 9
Department of Development Services
205 Lawrence Street
Marietta, Georgia 30060
Phone (770) 794-5440 Rusty Roth, AICP, Director
ZONING APPLICATION FOR
MOBILE RETAIL FOOD ESTABLISHMENT
Food Truck Name:
Main Address:
Email:
Primary Phone: Secondary Phone:
Property Owner (Food Truck Location):
Address of property (Food Truck Location):
Zoning Classification:
Dates (MM/DD/YY)
Time (Open to Close)
Total Days:
Applicant’s Signature:
Date:
24 Hour Contact: Phone:
Email:
Email form to Planning and Zoning with Business License application submittal.
(Jasmine Thornton (Jthornto@mariettaga.gov) or Robin Osindele (Rosindel@mariettaga.gov)
CHECKLIST
✓ Apply for City of Marietta Business License
✓ Written permission of the property owner is provided.
✓ A sketch or site plan showing the location of food truck in relation to property lines, driveways, parking, buildings, etc.
No______
TO BE COMPLETED BY PLANNING AND ZONING DEPARTMENT
Has this use operated at the subject property previously? Yes (Dates)
DATE APPROVED: DATE DENIED:
________________________________________
Director of Development Services
Page 4 of 9
Affidavit Verifying Status (O.C.G.A.
§
50-36-l(e)(2) Affidavit)
Please read carefully before completing
•
Affidavit must be notarized prior to being submitted to the Business License Division.
The City cannot notarize this affidavit. ***
•
Include a copy of applicant's secure and verifiable identification document. A list of secure and verifiable documents is
provided by the Attorney General on the Georgia Department of Law· website.
By executing this affidavit under oath, as an applicant for a(n) Business License/Occupation Tax Certificate, as referenced in
O.C.G.A. § 50-36-1, from the City of Marietta, Georgia, the undersigned applicant verifies one of the following with respect to my
application for a public benefit:
1)
⃣
I am a United States citizen.
(Provide state issued identification document. Example: driver's license)
2)
⃣
I am a legal permanent resident of the United States.
(Provide copy of alien registration document)
3)
⃣ I am a qualified alien or non-immigrant under the Federal Immigration and Nationality Act with an alien number issued by
the Department of Homeland Security or other federal immigration agency. (Provide copy of alien registration document)
My alien number issued by the Department of Homeland Security or other federal
immigration agency is:
The undersigned applicant
also
hereby verifies
that
he
or
she
is
18
years of age or
older
and has provided
at
least
one
secure and
verifiable document, as required by O.C.G.A § 50-36-l(e)(l), with this affidavit.
The secure and verifiable document provided with this affidavit can best be classified as:
In making the above representation under oath, I understand that any person who knowingly and willfully makes a false, fictitious, or
fraudulent statement or representation in an affidavit shall be guilty of a violation of O.C.G.A. § 16-10-20, and face criminal penalties
allowed by such statute.
Executed in ______________________________ (city),___________________ (state)
SUBSCRIBED AND SWORN
BEFORE ME ON THIS THE
DAY OF ,20____.
Signature of Applicant
NOTARY PUBLIC
My Commission Expires:
Printed Name of Applicant
***This affidavit does not apply to an applicant applying for or renewing an application for a public benefit within the
same agency or political subdivision
if the applicant has previously complied with the requirements of Georgia Code
Section 50-36-2 by submission of a secure and verifiable document, as defined in Code Section 50-36-2, and a signed
and sworn affidavit affirming that such applicant is a United States citizen.
Page 6 of 9
Private Employer Affidavit Pursuant to O.C.G.A. § 36-60-6(d)
By executing this affidavit under oath, as an applicant for a(n) business license/occupation tax
certificate as referenced in
O.C.G.A. § 36-60-6(d), from the City of Marietta, Georgia, the undersigned applicant representing the private
employer known as
_______________________________________________________________________
[printed
name of private employer
i.
e
.
business name]
verifies one of the following with respect to my application for the above
mentioned
document:
1.
Check box (a) or (b) below
(a)
⃣ On January 1
st
of the below signed year the individual, firm, or corporation employed
more than ten (10)
employees.
(b)
⃣
On January 1
st
of the below signed year the individual, firm, or corporation employed
ten (10) or fewer
employees
.
***If the employer checked box (a) must fill out Section 2 below.
2.
By executing this affidavit, the undersigned private employer verifies its compliance with O.C.G.A. § 36-60-6, stating
affirmatively that the individual, firm or corporation has registered with and utilizes the federal work authorization program
commonly known as E-Verify, or any subsequent replacement program, in accordance with the applicable provisions and
deadlines established in O.C.G.A. § 36-60-6. Furthermore, the undersigned private employer hereby attests
that its federal work
authorization company identification number (not federal employer identification number) and date of authorization
are as follows:
Federal Work Authorization Company Identification Number
Date of Authorization
-----------------------------------------------------------------------------------------------------
In making the above representation under oath, I understand that any person who knowingly and willfully makes
a
false, fictitious, or fraudulent statement or representation in an affidavit shall be guilty of a violation of
O.C.G.A. § 16-10-20, and face criminal penalties allowed by such statute.
Executed on the_____Day of____________,20_________in___________________(City), ______________(State)
Signature of Authorized Officer or Agent of Company
Printed Name of and Title of Authorized Officer or Agent
SUBSCRIBED AND SWORN BEFORE ME
ON
THIS
THE_______
DAY
OF________________,20
NOTARYPUBLIC
My Commission Expires:
Page 7 of 9
ARTICLE 8-12-27 - MOBILE RETAIL FOOD ESTABLISHMENTS
8-12-27-10
- Definitions.
A.
Commissary shall mean an approved catering establishment, restaurant, or other approved place in
which food, containers or supplies are kept, handled, prepared, packaged or stored.
B.
Mobile retail food establishment shall mean a retail food establishment that reports to and operates
from a commissary and is readily movable, is a motorized wheeled vehicle, or a towed wheeled vehicle
designed and equipped to serve food.
C.
Pushcart shall mean a non-self-propelled vehicle limited to serving commissary prepared or
prepackaged food and non-potentially hazardous food, unless the equipment is commercially designed and
approved to handle food preparation and service. Pushcarts shall not be required to comply with mobile
vehicular safety requirements.
D.
Temporary retail food establishment shall mean a retail food establishment, other than a licensed
mobile retail food establishment or pushcart, that is not intended to be permanent and that operates at a fixed
location for a period of time as authorized within the zoning ordinance (Division 708)
9-12-27-20
- [License required.]
A.
It shall be unlawful for any person to sell, offer for sale, food of any type from a commissary, mobile
retail food establishment, pushcart or temporary food establishment without a license first having been
granted under this section, except for city sponsored events.
B.
An application for a license or a permit hereunder shall be submitted to the manager of the business
license department of the City of Marietta setting forth all information required hereunder and in compliance
with this ordinance. The business license manager may develop a form of application for the purpose of
compliance with this article. The review process for said application shall be conducted in conformity with
Marietta Code Section 8-4-080 as now existing or as may be hereafter amended.
10-12-27-30
- Prohibited conduct and requirements.
A.
The mobile retail food establishment shall not conduct business or operate under this article on the
public right-of-way.
B.
The mobile retail food establishment shall not operate on any private property without the prior
consent of the owners.
C.
The mobile retail food establishment shall maintain a $1,000,000.00 liability policy. Proof of
current liability insurance, issued by an insurance company licensed to do business in the state,
protecting the licensee, the public and the city from all claims for damage to property and bodily injury,
including death, which may arise from operation under or in connection with the permit.
Such insurance shall name the city as an additional insured and shall provide that the policy shall not terminate
or be canceled prior to the expiration dated without 30 days' advanced written notice to the city.
D.
The mobile retail food establishment shall not emit sounds, outcry, speaker, amplifier or
announcements while traveling on the public rights-of-way.
Page 8 of 9
E.
The mobile retail food establishment shall maintain all state licenses and follow all laws of the state
and county health departments.
F.
The license under which a mobile retail food establishment is operating must be firmly attached
and visible on the mobile retail food establishment or pushcart at all times.
G.
No sale or offer for sale shall be made by any licensee between 9:00 p.m. and 6:30 a.m. within areas
residentially zoned and between 10:00 p.m. and 6:30 a.m. in all other zoning classes.
H.
The mobile retail food establishment shall comply with all state, federal and local health and
safety regulations and requirements and shall obtain and maintain any and all licenses required by any
other health, organization or governmental organization having jurisdiction over this subject matter.
I.
The following safety regulations shall apply to any and all vehicles operating under this article or used
for mobile retail food establishments:
1.
Every vehicle shall be equipped with a reverse gear signal alarm with a sound distinguishable
from the surrounding noise level.
2.
Every vehicle shall be equipped with two rear-vision mirrors, one at each side, firmly attached to
the outside of the motor vehicle, and so located as to reflect to the driver a view of the highway to
the rear, along both sides of the vehicle.
J. The mobile retail food establishment shall sell food and non-alcoholic beverages only.
8-12-27-040 - Indemnity.
As part of the permitting process set forth herein, any person or entity receiving a permit
set forth herein shall execute an indemnity agreement indemnifying and releasing the
City of Marietta, its agents, employees and elected officials from any and all liability
against any and all claims, actions and suits of any type whatsoever.
8-12-27-050 - Appeals.
Appeals from the grant or denial of a license shall be filed and processed in accordance
with the procedures set forth in Marietta Code Section 8-4-080 as now existing or as may
be hereafter amended.
8-12-27-060 - Revocation and suspension.
The city shall have the right to revoke or suspend any license granted hereunder in
accordance with the procedures set forth in Marietta Code section 8-4-405 as now existing
or as may be hereafter amended and appeals from the revocation or suspension shall
likewise be governed by that section
.
Page 9 of 9
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MOBILE RETAIL FOOD ESTABLISHMENT ADDITIONAL REQUIREMENTS AND CHECKLIST (City of Marietta)

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