Food Service Permit Application

Food Establishment Permit Application

Application Type:   Original   Renewal


Establishment Name:    Phone: 

Establishment Address: 

Owner's Name:            

Fax: 

Owner's Address:          

Email: 

Number of Employee's:      

City: 

State:                   

Zip Code: 


Food Handlers Information:

Name:                  Name: 

Name:                  Name: 

*** One Certified Food Handler per Shift. Please Attach Copy of Certificates***


Please Check One:

Restaurant Daycare/Schools Convenience Store Other: 


Printer Name of Owner/Manager:     

Person Filling out Application: 

Date of Application: 

OFFICE USE ONLY

Permit Number: ___________________

Permit Fee:            $400        

Approved by:   ____________________

Account Number:  100-453-4335

City Stamp Here

 

 

 

 

 

Please send permit fee of $400.00 and copies of all food handlers certificates to:


City of Glenn Heights   Building Permit and Inspections Department    2118 S. Uhl Rd. Glenn Heights, Texas 75154    Phone Number: 972-223-1690 Ext. 451   Fax Number: 972-274-5110



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