HomeMy WebLinkAboutFoodtruckapp2016APPLICATION FOR A FOOD TRUCK PERMIT
FOOD TRUCK NAME____________________________
APPLICATION RECD
PROOF OF INSURANCE RECD
CITY OF IOWA CITY
Questions should be directed to the Building Department’s Office, at 319 356-5123
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APPLICATION FOR FOOD TRUCK PERMIT
If the applicant is not a natural person (for example, a partnership, an LLC, or a corporation), please
complete the addendum.
1. Applicant’s Name:
FIRST LAST
2. Address:
STREET APT# CITY State ZIP CODE
3. Email Address: ________________________________________________________________
4. Phone number:
5. Are you currently an established Food Truck____ Restaurant____
(check all that apply)
6. If an established food truck business,
Name of truck or cart_____________________ Number of years in business_________________
List markets, festivals, or any other events or locations where food truck sold food:
______________________________________________________
______________________________________________________
______________________________________________________
7. Description of truck: Attach a photo of you truck as it appears today. Also, please provide
dimensions. Details of signage must also be submitted. All trucks must be equipped with a
#5 multi-purpose fire extinguisher.
8. List types of fuel and size of tanks (if applicable) used for cooking.
___________________________________________________________________________
9. Indemnification Agreement:
The applicant agrees to:
Pay on behalf of the City all sums which the City shall be obligated to pay by reason of any
liability imposed upon the City for damages of any kind resulting from use of public property and
the public right of way, whether sustained by any person or persons, caused by accident or
otherwise and shall defend at its own expense and on behalf of the City any claim against the City
arising out of the use of public property and the public right of way.
Applicant agrees to provide the certificate of insurance to the City by the last working day prior to the
first day of vending operation.
_______________________________________ _____________________________
Signature of Applicant Date
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If the applicant is not an individual, the person signing this application acknowledges that he or she
has the authority to act on behalf of the group that is requesting the permit.
Applicant: Return completed application to:
Building Division Office
City of Iowa City
410 E. Washington Street
Iowa City, Iowa 52240
Any questions can be directed to Jann Ream in the Building Division office at 319-356-5123.
Applicant agrees to follow all administrative rules and policies concerning Food Truck operations and
understands that failure to comply with these rules and policies may result in the revocation of the
permit.
____________________________________________ ______________________________________
Signature of Applicant Date
Appeal Rights
Any party aggrieved by the City Manager’s or designee’s decision to grant or deny a permit unde r this
Chapter may appeal the determination to the City Council if, within five (5) working days after the decision, the
party files a written notice of appeal with the City Clerk. In such event, a hearing shall be held by the City
Council no later than the next regularly scheduled meeting, assuming the appeal is filed in time to allow notice
of said appeal in accordance with Chapter 21 of the Iowa Code.
FOR CITY USE ONLY:
NOTICE OF DECISION GRANTING OR DENYING THE APPLICATION
The application is approved. __________
The application is denied because ________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
____________________________________________ ______________________________________
City Manager or Designee Date
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ADDENDUM TO APPLICATION FOR FOOD TRUCK PERMIT
To be completed only if applicant is not a natural person (for example, a partnership, an LLC, or a
corporation).
1. If the applicant is a partnership, list all partners and the share of partnership distribution.
____________________________________________ ______________________________________
Name of Partner % share in partnership distribution
____________________________________________ ______________________________________
Name of Partner % share in partnership distribution
____________________________________________ ______________________________________
Name of Partner % share in partnership distribution
2. If the applicant is a corporation, list all shareholders and their percentage ownership.
____________________________________________ ______________________________________
Name of Shareholder % of stock owned
____________________________________________ ______________________________________
Name of Shareholder % of stock owned
____________________________________________ ______________________________________
Name of Shareholder % of stock owned
3. If applicant is a limited liability company, list all members and their membership interest.
____________________________________________ ______________________________________
Name of Member Membership interest
____________________________________________ ______________________________________
Name of Member Membership interest
____________________________________________ ______________________________________
Name of Member Membership interest