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HomeMy WebLinkAbout039-590-019 PRED24-0007 FoodPlanCheckApplicationPrimary Contact: Owner Applicant Plan Preparer Other (attach contact info) Infra-structure Plan Preparer Owner Business Fees Food Facility Plan Check Application Date: _ Amount: Check No. Receipt No. $1,181 (Facility > 5,000 sq.ft.) $786 (Facility < 5,000 sq.ft.) $261 (Pre-packaged food- New or remodel) $392 (Minor Remodel, i.e. bathroom remodel, change in hood, walk-in addition, wall removal, etc.) Name: Location Address: Mailing Address: Phone: Email: ______________________________ Name: Mailing Address: Phone: Email: ______________________________ Name: Mailing Address: Phone: Email: ______________________________ Proposed number of customer seats: _______ Located within incorporated town/city ______ Yes Square footage of food facility: _________________ No Served by city/public water system? Yes No Served by a city/public sewer system? Yes No Note: Please verify that the zoning and associated requirements, the wastewater disposal sys- tem, and the water supply are adequate for the type and size of the food facility proposed. I certify that the information in this application is complete and accurate and that I have been provided and have reviewed Butte County’s Food Facility Plan Check Resource Guide. Signature Date Printed Name Updated: December 30, 2023