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Coordinator App 2024
576-B -14 (REV 7/24) TEMPORARY FOOD FACILITY/COMMUNITY EVENT ORGANIZER’S APPLICATION Application Submission Date: Organizer Fee Vendors Fee Fees Paid: 1-5 $368.00 6-10 $682.00 11-15 $995.00 16-20 $1,310.00 21-25 $1,623.00 26-30 $1,937.00 31-35 $2,251.00 36-40 $2,563.00 1.Name of Event: 2.Location of Event: 3.Dates and Times of Event: 4.Event Organizer Name:41-45 $2,878.00 46-50 $3,191.00 Address: 51+ $3,505.00 Phone No: Email Address: 5.Number of Food Booths: 6. Name of Each Food Booth and Operator: a.Business Name:Phone Number: Email: Operator Name:Mailing Address: b.Business Name:Phone Number: Email: Operator Name:Mailing Address: c.Business Name:Phone Number: Email: Operator Name:Mailing Address: d.Business Name:Phone Number: Email: Operator Name:Mailing Address: e.Business Name:Phone Number: Email: Operator Name:Mailing Address: f.Business Name:Phone Number: Email: Operator Name:Mailing Address: g.Business Name:Phone Number: Email: Operator Name:Mailing Address: h.Business Name:Phone Number: Email: Operator Name:Mailing Address: i.Business Name:Phone Number: Email: Operator Name:Mailing Address: Valid 7/1/24- 6/30/25 576-B -14 (REV 7/24) Please use the rest of this page or attach a separate page for a site plan drawing. Be sure to include locations of food booths, shared utensil washing facilities, restrooms with hand washing stations, shared janitorial facilities and garbage disposal facilities. 7. Date, Time, Location of Pre-event Meeting with Food Vendors: 8. Date and Time of Event Setup: 9. Describe Restroom Facilities (Type, Number, Location) 10. Will Electricity be Provided to Booths? 11. Describe Potable Water Supply: 12. Describe Wastewater Disposal System: 13. Describe Garbage Disposal Facility: 576-B -14 (REV 7/24) Additional Vendors j.Business Name:Phone Number: Email: Operator Name:Mailing Address: k.Business Name:Phone Number: Email: Operator Name:Mailing Address: l.Business Name:Phone Number: Email: Operator Name:Mailing Address: m.Business Name:Phone Number: Email: Operator Name:Mailing Address: n.Business Name:Phone Number: Email: Operator Name:Mailing Address: o.Business Name:Phone Number: Email: Operator Name:Mailing Address: p.Business Name:Phone Number: Email: Operator Name:Mailing Address: q.Business Name:Phone Number: Email: Operator Name:Mailing Address: r.Business Name:Phone Number: Email: Operator Name:Mailing Address: s.Business Name: Phone Number: Email: Operator Name:Mailing Address: t.Business Name:Phone Number: Email: Operator Name:Mailing Address: u.Business Name:Phone Number: Email: Operator Name:Mailing Address: v.Business Name:Phone Number: Email: Operator Name:Mailing Address: w.Business Name:Phone Number: Email: Operator Name:Mailing Address: x.Business Name:Phone Number: Email: Operator Name:Mailing Address: