Action Center / Application For Mobile Food Unit Special Occurrence Permit / Davenport, Iowa

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Application For Mobile Food Unit Special Occurrence Permit

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* Denotes a required field

To have an on-street mobile food vendor in front of a business, the business must obtain a special occurrence permit from the City of Davenport. Only one special occurrence permit may be issued for a particular date.

Please Do Not Complete The Following Field

This is a “special permit” and is required in addition to any other city business license the applicant or licensee may hold or be required to hold. Special occurrence permits are subject to City Council approval at a regularly scheduled City Council meeting. All vendors operating under special occurrence permits must have valid Mobile Food Unit Public Permits.

Date(s) of Operation*

Time(s) of Operation*

Iowa State Sales Tax ID*

SSN 1-SSN 2-SSN 3

Business Name*

Owner/Operator Name*

Address 1*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Primary Phone Number*

Phone Area Code-Phone 3-Phone 4 ext Extension

Email Address*

Confirm Email Address*

Emergency Contact Name*

Phone Area Code-Phone 3-Phone 4 ext Extension

Emergency Contact Phone*

Phone Area Code-Phone 3-Phone 4 ext Extension

Exact Location of Request*

Is this request connected to an event at your business?*

Yes No

Type of Food to be Sold*

I agree to abide by all regulations of the Mobile Food Unit policy as outlined in Chapter 5.19 of the Davenport Municipal Code. I understand that only one vendor may occupy the on-street space at a time, and I will ensure that no mobile food vendors are occupying space that is not outlined in this application package. I hereby swear (or affirm) under penalty of perjury that the representations made by me in this application are complete, true and accurate, to the best of my knowledge and belief, and that I am authorized to execute this application.

Signature of Applicant*

Check box if you agree with the statement above.