HD Event Organizer Application

Organizer Name:(Required)

First Last

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone:(Required)

Organizer Phone (7:45 am - 4:45 pm):(Required)

Additional Organizer Contact:

Name of Event:(Required)

Event Location:(Required)

Dates and Times of Event:(Required)

Date/Time Food Vendors Set-Up:(Required)

Onsite Coordinator(s) Contact Information:(Required)

Number of Anticipate Food Booths:(Required)

Will the organizer by supplying water to the food booths?:

Yes

If yes, what is the water source?

Public

Other

If other, explain:

Liquid waste/grease and garbage disposal method and schedules for pick-up (include business name if service is contracted):(Required)

Will the organize by supplying electricity to the food booths?(Required)

Yes

Number of toilet facilities provided:(Required)

Type of facilites.

Will hand washing facilities be provided adjacent to the toilets?(Required)

Yes

How Many?

Use space below to list ALL FOOD VENDORS that will be participating:(Required)

Please attach a map of the event grounds showing the location for each food booth, toilet facilities, water connections, etc.

STATEMENT: I hereby certify that the above information is correct and I fully understand that any deviation from the above without permission from Swain County Environmental Health may nullify the final approval and prevent the issuance of permits to participating vendors. I understand that a pre-opening inspection of each food vendor is required if the food vendor is not in compliance with 15A NCAC 18A. 2635 and a temporary food establishment permit will not be issued. I understand that if this application is incomplete it will be returned; if I do not correct and return to SCHD at least 15 calendar days prior to the event my application will not be considered.

Print Name:(Required)

First Last

Signature:(Required)

Date:(Required)

Comments are closed.

County Administration
Phone: 828-488-9273

Board of Elections
Phone: 828-488-6177

Building & Grounds
Phone: 828-488-9273 ext 2253

Building Inspections
Phone: 828-488-9273 ext 2268

Clerk of Court
Phone: 828-488-7400

Co-Op Extension Office
Phone: 828-488-3848

Health Department
Phone: 828-488-3198 x2002

Department of Social Services
Phone: 828-488-6921

See all Department Contacts here.

HD Event Organizer Application