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Food Establishment Application Business Information: Date Sales Tax ID # Business Address State Zip Business Phone Name of business Type of business Sq ft Business Owner Information: Name____________________________________________E-mail_________________________________________ Mailing Address: Name Phone Address City State Zip Property Owner Information: Name Phone Address City State Zip General Information: Preparers Name Position Emergency Contact Phone Health Permit Information: Permit # Health Permit Fee Description Quantity Fee New Application Fee $162.00 Restaurant - less than 1,000 sf $162.00 Restaurant - greater than 1,000 sf $487.00 Grocery Store - less than 12,000 sf $324.00 Grocery Store - greater than 12,000 sf $487.00 Convenience Store with deli $324.00 Convenience Store without deli $162.00 Nursing Home / Bar / Bakery $324.00 Day Care – Licensed Capacity $324.00 Class I Mobile Units / Snack Bars $162.00 Class II Mobile Units $324.00 Class III Mobile Units $162.00 Class IV Mobile Units $81.00 School Cafeterias $487.00 Concession Stand/ Snow-Cone Stand/ Seasonal Permit $162.00Swimming Pool (number of pools, hot tubs, & spas) @ $162.00 each New TABC Application Fee $162.00 Retailers TABC Permit 50% of TABC Fee Food Establishment Application Consumer Health Division 401 N. Elm St * Denton, Texas 76201 PHONE 940-349-8360 FAX 940-349-7208