Transcription of FOOD SERVICE LICENSE APPLICATION - …
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FOOD SERVICE LICENSE APPLICATION - …
FI-230 (1/2018). 1. Check one: 2. Check one: FOOD SERVICE LICENSE . Renewal LICENSE _____ Fixed Establishment APPLICATION . ____ APPLICATION _____ Mobile Michigan Department of Agriculture & Rural Development ____ New Owner As required by Act 92, Public Acts of 2000, as amended _____ Mobile Commissary For LICENSE year ending: ____ New Est. or New _____. Location Special Transitory Food Unit (STFU). April 30, 2019. LICENSE No. L2000ID. Mailing Address (Number & Street, Box or Route) 5. Applicant Information - MUST BE COMPLETED. I certify that this information is accurate Signature Date X. City State Zip Code Printed name of owner or authorized agent 3. Business & Owner Information Name of Establishment or Business (type or print) Title E-Mail Establishment Address (Number & Street, Box or Route) Establishment Phone No.
Michigan Department of Agriculture & Rural Development Food Service License Application Instructions to Applicant Renewal Application A. Review Sections 1 …
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