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2. 
4. Applicant Information
6. Applicant Name
8. Phone Number
9. Email Address
13. Food Truck Information
15. Do you have an city-issued Food Truck Permit for this unit?

    1. Yes
    2. No*

    *A Location Permit cannot be issued without an approved Food Truck Permit

17. Business Name (as it appears on the Food Truck)
19. Truck Make and Model
20. License Plate State and Number
22. Name of Contact During Operations
23. Phone Number
27. Food Truck Location Information
29. Location that Food Truck Will be Located (address)

    Food Trucks are not permitted in residential areas

31. Start Date
    Start Date
32. End Date
    End Date
34. Written Consent From Property Owner*

    *Required for all Food Trucks located on private property

38. Code Requirements for All Food Trucks

40. 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.

    
    

46. 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. 

48. 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.
50. Electronic Signature
51. Date
    Date
55. Zoning Compliance Decision - For Staff Use Only

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

57. Signature
59. Decision:

    1. Approved
    2. Denied
60. Date of Approval
62. Comments
66. Ohio Department of Health Mobile Food License
68. A copy of a valid Ohio Department of Health Mobile Food License attached:

    1. Yes
    2. No
70. 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

72. Authorized Signature
74. Decision

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


77. 1. Receive an email copy of this form.
78. Email address

    This field is not part of the form submission.

79. Submit

* indicates a required field