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2. Mobile Food Establishments & Food Caterers Operating at Special Events
   
4. If not operating within permit guidelines, you must apply for a Temporary Permit.
6. Business Information
8. Permit # *
10. Business Name*
12. Contact Name*
13. Contact Phone*
15. Email Address*
17. Event Information
19. Event Name
21. Event Address*
23. Coordinator Name*
24. Coordinator Phone*
26. Coordinator Email Address*
28. Event Start Date*
    Event Start Date
29. Event End Date*
    Event End Date
33. Food Caterers Booth Information
    All Food Caterers must provide information on each booth that is set up at the Special Event.
35. Booth 1 - Booth Name
36. Booth 1 - Menu
38. Booth 2 - Booth Name
39. Booth 2 - Menu
41. Booth 3 - Booth Name
42. Booth 3 - Menu
44. Booth 4 - Booth Name
45. Booth 4 - Menu
47. Booth 5 - Booth Name
48. Booth 5 - Menu
50. Booth 6 - Booth Name
51. Booth 6 - Menu
53. Booth 7 - Booth Name
54. Booth 7 - Menu
56. Booth 8 - Booth Name
57. Booth 8 - Menu
59. If you have additional booths, please attach a separate sheet
61. Disclaimer
    Information entered on this form will be retained by Maricopa Environmental Services Department and is a record as defined by Arizona law. This form will be provided without redaction in response to a public record request unless any of the information is exempt from release under Arizona law.
Leave This Blank:


63. 1. Receive an email copy of this form.
64. Email address

    This field is not part of the form submission.

65. Submit Submit and Print

* indicates a required field