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Instructions for Applications for
Permit, Renewal Permit, or Inspection
uThere are separate application forms for food establishments, mobile food
units, daycares and temporary food events. Please complete the
appropriate application for your specific operation.
u
Permits
are not transferable from
one owner
to another owner or from one address to another. A
new application and fee must be remitted.
Permit fees are due by January 1 of each year for all
established permitted businesses.
Purpose of This
Application
Check “New” for one just starting up and give date you plan to open;
check “Renewal” for the annual renewal of permits; check “Change of
Ownership” if ownership has changed to another person/entity or if
owned by a corporation and the corporate structure has changed and
give date of the change; check “Amended” if there has been a change
of business name or physical location and indicate the date of the
change.
Business
Information Please type or print information
• Name of Establishment: The business name that you will “do business as”.
• Physical Location & Phone Number:
Actual physical
location of business operation (911 address, if known) with
directions for route addresses; indicate phone number at the place
of business. For mobiles also indicate a phone # on unit..
• Contact Person: Name of person in charge at the
location, i.e., owner, manager, or supervisor. Also indicate Title
of Contact Person.
• Email Address:
Email address
where important information should be sent. Your email address
will only be used to notify you of important information concerning
food rule changes and other County requirements.
• Operating Information:
The opening and
closing hours the business operates and days of the week the
business will be open. Also indicate the number of all workers at
the business location including owner and family, if applicable.
• Mailing Address: Address where notices,
renewals, or other correspondence are to be sent.
• Owner’s Name: The legal name of the owner of the business
and phone number where owner can be contacted.
• Owner Information for Corporation: President or Chief
Officer’s name and title.
Establishment Type and Fee Information Please type or print information
•Food
establishments, caterers, convenience stores, and daycares - Fee
due is determined by the number of people working including owner
and owner’s family, if applicable Please check the
appropriate box indicating number of all workers; then indicate the
payment in the column “Amount Paid”.
• Out
of county caterers, nursing homes, hospitals, and college food
service all have fixed fee amounts. Please indicate the appropriate
fee for your establishment type.
•
Pre-Operational Fee:
- An
application must be submitted to Cherokee County Health Department
before beginning operations for any new food
establishment, mobile food unit or daycare business. A
pre-operational inspection must be conducted before the permit will
be issued. This fee should be included in with the permit fee.
Contact the inspector at 903-683-2990 to schedule the
pre-operational inspection when business is ready to operate.
Please note $50.00 payment in column “Amount Paid”.
uAdministrative Late Fee: Permitted facilities that do not
remit their renewal application by January 31st or firms operating
without a valid permit must pay an additional $50.00 late fee before
permit will be issued. Note $50.00 payment in column “Amount Paid”.
•
Non-Profit businesses that are required to have an inspection by
their state licensing agency are now required to pay a $50.00
inspection fee in order to have their inspection conducted. Please
note $50.00 in the “Amount Paid”. Fee Exemption. Non-Profit
businesses must submit proof of IRS exemption to be exempted
from permit fee.
•
Total Fees Paid: Total the fees due and note in the column “Amount
Paid”.
•
Application Affidavit must be signed, dated and returned
with every application for food establishments, daycares and mobile
food unit permits.
EBe
sure to print your name and title, and sign and date at the bottom
of the page.D
Make checks or money order
payable to:
Cherokee County Health
Department
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Mail completed Application,
fee and Application Affidavit to:
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Cherokee County Health Department
593 North
Main Street
Rusk, Texas 75785
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If you need
assistance, please call 903-683-4688 and ask for permit application
assistance. |
