Mobile Food Vendor Application

Prefer a paper copy?

Mobile Food Vendor Application mailto: Gary Knarr, Zoning Administrator
245 West 4th Street
Williamsport, PA 17701

Application fee

$250 There is a $250 fee associated with the Mobile Food Vendor Application. Please send in payment (check/money order) after the application has been submitted. See Fee Schedule for more information.

Application Information

Instruction to applicants: Complete the form by filling in all information. Supporting documentation MUST accompany the signed application when submitted. Please submit the following

Completed application
Copy of health license
Copy of business license
Copy of valid Serve Safe certificate
Hold Harmless waiver signed by the owner
Insurance policy (coverage of not less than One Million dollars per occurrence)

Applicant Information

Business Name *

Tax ID # *

Business Address *

City *

State *

Zip *

Contact First Name *

Contact Last Name *

Phone *

Alternate Phone

Email *

Vehicle Make *

Vehicle Model *

Vehicle Year *

Vehicle License Plate *

Vehicle Registration Date *

Compliance Information

As the applicant, I hereby agree and understand that it is my responsibility to oversee all parties affiliated with this Mobile food unit's vending operation and to insure compliance with all policies, rules, regulation and of the city of Williamsport and other relevant procedures and laws. I understand that any violation may result in cancellation and/or revocation of this permit. I understand that the permit is non-transferable and must be displayed at all times.

Applicant Signature:

Mobile Food Vendor Application