BUSINESS LICENCE APPLICATION FOOD TRUCK Application for a Business Licence pursuant to By-law 129-14 of the City of Cambridge for a Licence to operate the following business. CATEGORY: FEE: Applicants Name: Title: Home: Address: City: Postal Code: Business Phone: Home Phone: Business Name: Proposed Business Address: City: Postal Code: Mailing Address If Different than above: City: Postal Code: The Business will operate in the City Have you ever been convicted of a Page 1 of 6
of Cambridge during the year: criminal offence: Please indicate year: Please indicate yes or no: or on the Following dates: If yes, indicate offence and date: If a partnership, name and address of all persons having a Proprietary Interest: Applicant s Signature: Issuance Date: Approved By: Total Licence Fees: Entered to Licence + For Office Use Only I certify that the information above is accurate and complete and understand that any false or incomplete information may invalidate my application and any permission, approval or permit I have been granted. Personal Information contained on this application is collected pursuant to the Municipal Act, S.O., 2001, C25 Section 150-162 and the City of Cambridge business licensing by-law and will be used for the purpose of issuing Business Licences. Questions about this collection should be directed to the Licensing Officer at the office of the Human Resources & Legislative Services/City Clerk, 50 Dickson Street, Second Floor, Cambridge, Ontario, or Phone 519-740-4680, Ext. 4581. Page 2 of 6
PLEASE OBTAIN THE FOLLOWING APPROVALS ZONING REPORT I certify that the proposed use is in conformity with the zoning regulations currently in force. Date: Zoning Administrator 519-740-4650 50 Dickson Street Third Floor FIRE INSPECTOR REPORT Date: Per: Fire Inspector 519-621-6001 1625 Bishop Street Comments: Page 3 of 6
***TRUCK*** MEDICAL OFFICER OF HEALTH REPORT Date: Per: Medical Officer of Health 519-883-2008 99 Regina Street South Waterloo, ON N2J 4J3 Comments: (Foods not approved by the Health Department) The Applicant must provide a menu for items to be prepared and sold from a food truck before receiving the Health Department s approval signature. Page 4 of 6
COMMUNITY SERVICES REPORT Date: Director of Community Services Operations 519-740-4681 50 Dickson Street First Floor Comments: ENGINEERING AND TRANSPORTATION REPORT Date: Manager of Transportation and Engineering 519-621-0740 50 Dickson Street Third Floor Comments: Page 5 of 6
EVERY APPLICATION FOR A LICENCE SHALL INCLUDE THE FOLLOWING: A Region of Waterloo Public Health approval signature A Technical Standards and Safety Authority field approval for all equipment and appliances that are not approved by the Canadian Standard Association or the Underwriter Laboratories of Canada A propane inspection by a certified gas fitter A Fire Safety approval signature from the City A zoning approval signature from the City A Community Services approval signature (if applicable) An Engineering approval signature (if applicable) A copy of the applicant s driver s license A copy of the owner ship of the food truck Proof of general liability insurance (by an insurer satisfactory to the City) in the amount of $2,000,000.00 naming the City of Cambridge and the Region of Waterloo as additional insured Proof of automotive liability insurance (by an insurer satisfactory to the City) in the amount of $2,000,000.00 on all vehicles used in food truck operations The dimensions of the food truck A plan for the containment and disposal of grey water, grease and garbage in a sanitary manner satisfactory to the City of Cambridge A description of the food menu Written permission from the owner of private property A sketch showing the location of the food truck as it relates to other buildings and structures on the property, when the food truck is placed on private property A photo of the food truck Page 6 of 6