Type Full Name :

Sign With Hand

Last Name

Name of Establishment

Food License Number

Establishment Information

Certification

Days of Operation

Utensils and Plates to be used for Al Fresco Dining

Self

Required Attachments

Begin typing Address and select from the populated drop-down

Regular

Hours of Operation

Number of Tables

First Name

Number of Chairs

Owner Details

Waiter

Address 2

See Link

ZIP

Signature *

I do hereby certify and affirm under penalty of perjury that I have read and understood the rules and procedures above and that all statements contained in this application are true

Service of Food

{[PNAME]}

Phone Number

Single service (plastic)

Describe provisions for waste disposal:

(Waste disposal must comply with N.J.A.C. 8:24-5.5)

Please complete this "Hold Harmless Agreement" before submitting the application See Link

(Single service articles must comply with N.J.A.C. 8:24-4.11)

Please read §305-38 carefully
Attach pictures of your Al Fresco setup, making sure to show:

(a) live plantings

(b) portable type enclosures to define the perimeter of the area to be used

(d) location of doors to your building and adjacent property

(e) all proposed tables, seats and otherstructures

(f) the hold harmless agreement

See Link

Address

305-40 Application For License
305-41 Regulations And Property Maintenance
305-42 Outdoor Equipment
305-43 Reservation Of Rights And Immunities
305-44 Revocation Or Suspension Of License
305-45 Enforcement
305-46 Violations And Penalties

City

State

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{[CITY]}, {[STATE]} {[ZIP]}
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