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Get and Sign Mobile Food Vendors Food Establishments Food 2021-2022 Form
LHD USE Delete License Fee Exempt State Yes No Fee Exempt Local Fee Exempt Veteran LHD Retain copy of Act 359 Veteran s License License Limitation STFU Last 2 Fee Inspection Dates Seasonal Establishment Amount Received check if seasonal LHD No. Civil Division Receipt No. Check No. Signature of Health Department Representative Food Service License Application Instructions to Applicant Renewal Application A. Review Sections 1-4 for accuracy. Please review the pre-printed application and make any...
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