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2. 
4. Applicant Information
6. Company Name
7. Name on Truck
9. Company Owner's Name
10. Contact Name
12. Owner's Address
13. Contact Address
15. Owner's Phone Number
16. Contact Phone Number
18. Owner's Email
19. Contact Email
21. Truck License Plate Number
22. Truck Color
24. Truck Make/Model
25. Truck Size (LxWxH)
27. Description of Items to be Sold
31. Code Requirements for All Food Trucks

    1.    Food trucks are not permitted in residential districts. (See Code Table 154.04-2: Principally Permitted Uses)

    2.    No person may operate a food truck in the City of Tipp City without a food truck permit issued by the City.

    3.    The food truck vendor must obtain expressed written consent of the property owner to locate/operate a food truck on private property.  

    4.    The written consent must be kept in the food truck at all times that the food truck is on the property.

    5.    Food trucks and vendor locations will be maintained in a clean and sanitary condition at all times. 

    6.    The food truck vendor is responsible for the proper disposal of waste and trash associated with operation. 

    7.    Electric, gas, and water will be self-contained within the food truck.

    8.    One Temporary Sidewalk Sign is permitted in accordance with Code § 154.11(K)(5)

    9.    The zoning must be approved 48 hours prior to operation of the food truck.

    
    

35. Ohio Department of Health Mobile Food License*

    Please upload a valid Mobile Food License

37. Applicant's Signature

    I certify that, to the best of my knowledge, the information contained in this form and within any attachments is correct and truthful. Furthermore, I certify that I am the food truck owner or a duly authorized agent of the owner for this application. I understand that knowingly falsifying this information may be grounds for the denial or revoking of this application and any subsequent review applications. 

39. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
41. Electronic Signature
42. Date
    Date
46. Zoning Compliance Decision - For Staff Use Only

    The signature below authorizes the zoning was approved as part of this application

48. Signature
50. Decision:

    1. Approved
    2. Denied
51. Date of Approval
53. Comments
57. Ohio Department of Health Mobile Food License
59. A copy of a valid Ohio Department of Health Mobile Food License attached:

    1. Yes
    2. No
61. Tipp City Fire and Emergency Services Review - For Staff Use Only

    To schedule:  Contact Fire and Emergency Services at 937-667-9199 or 937-506-3950

63. Authorized Signature
65. Decision

    1. Approved
    2. Denied
66. Date of Decision
Leave This Blank:


68. 1. Receive an email copy of this form.
69. Email address

    This field is not part of the form submission.

70. Submit

* indicates a required field