[E/H HOME PAGE] [FEE SCHEDULE]
[FORMS/APPLICATIONS] [QUESTIONS-ANSWERS]
Name of Organization:
Contact person:
Day Phone:
Mail permit to:
Or fax permit to:
LOCATION OF CONCESSION:
(911 address, include town)
Source of water will be:
Method of wastewater disposal will be:
Menu is attached, on back, or on following page if this form being faxed.
I have read and understand the Caroline County Health Department Guidelines for Class II Food Handling
Applicant's Signature:____________________________ Date: