Type Full Name :
Sign With Hand
Phone # *
State *
Out of State
Market Type
Retail Food Details
Registration Type *
Name of Food Prep/Source
First Name *
Foods prepared/sourced at another location? *
Route Time
Property Address
Please provide the Name, Address, Telephone# of the all applicable service providers. *
Please provide name(s) of person(s) who attended Food Handlers Training Course and date of certification. Current food handlers certification required. Please attach copies. *
I certify that the information stated on this application is true and complete to the best of my knowledge and I understand that any willful, false statements are cause for rejections of this application.

It is further understood that this license is granted only to the ownership listed on this application for the period stated.

Place, Business and Ownership is NOT TRANSFERABLE in any form. Failure to cooperate the business in compliance with Chapter 24 of the New Jersey State Sanitary Code and any and all other applicable laws and regulations of the State of New Jersey and the Borough of Elmwood Park may result in revocation of the License, and/or additional fees.

I understand that any change in the information in this application, any alternations or additions, new construction, or equipment, must be approved by the Health Department and other municipal offices prior to such action. The Health Department must be notified of fires, flooding or other incidents causing interruption of operation.

Business Name *
Last Name *

Now you can pay your Application Fee from the comfort of your home or office by using our online payment service.   Credit cards accepted: MasterCard, Discover, American Express or Visa.  A per transaction service fee of 2.65% or $3.00 minimum will be charged by the payment processing company for this service.

The Borough of Lodi also accepts electronic check payments using our online payment service.   Payments will be charged to your checking or savings account at your bank.  You will need your 9-digit routing number, as well as your account number from your personal checks.   A per transaction service fee of $1.50 will be charged by the payment processing company for this service.   IMPORTANT: When Payment Options appears, click on the 'Switch to Pay with Check' link and then continue entering your information.

You will be sent instructions on how to use this payment feature once your application is reviewed.

Payment may also be made in the form of a check or money order made out to "The Borough of Lodi" and mailed or hand-delivered to:
Borough of Lodi, Health Department
Lodi, NJ 07644

Category Fees
Store Milk $26.25
Pet Shops $262.50
Beauty/Nail Salon/Barbershop $52.50
Laundry/Dry Cleaning/Laundromats $78.75
Laundry/Dry Cleaning/Commercial Plant $262.5
Catering/Mobile Truck $89.25
Bakery/Pastry Retail $525.00
Supermarket $787.50
Delicatessen/Grocery/Convenience Store/Mini Mart $262.50
Wholesalers $525.00
Food Establishments (Number of Seats)
(0-50) Seats $262.50
(51-100) Seats $315.00
(101-200) Seats $367.50
(201 or more) Seats $420.00
If establishment is owned by an out of state entity, please provide details.
Number of Seats *
Business Category *
Address *
Contact Person
Route Location
Fee Schedule
If Other
Contact Number
Phone # *
Restaurant Type
Amount Due
Ownership Type
{[CITY]}, {[STATE]} {[ZIP]}
Is this for a 1 day food truck festival?
Application Fee
Entity Name (if applicable)
Applicant Signature *
Retail Food Owner Details
City, State, ZIP
Description of goods to be sold *
Payment may be made in the form of a check or money order made out to "The Borough of Lodi" and mailed or hand-delivered to:
Borough of Lodi, Clerk's Office
Lodi, NJ 07644

Store Milk? *
  • Two passport sized pictures of each person selling food
  • Proof of insurance Accord Form
    • Personal Injury - $100,000 per person
    • Personal Injury - $300,000 per occurrence
    • Property Damage - $50,000
  • Board of Health "Satisfactory" Inspection Certificate
    • (call to arrange for inspection 732-341-9700 x 7475)
  • Permission letter from the property owner where you are selling from. The property must be at least 500' from an existing food store or food vendor. Does not apply to ice cream vendors traveling on roadways.
City *
Documentation that must be provided:
  • Food Manager Certificate for food establishments;
  • Shop Licenses/Practitioner Licenses for Beauty Salon, Barber, Manicure;
  • Certificate of Veterinary Supervision - Pet Shop/Kennel/Shelter
How do you wish to pay? *
Email *
Mobile Type
Health/Business License
Service Fee (if applicable)
Vital Information Survey
Type the street number and name and press Enter to select the Address *
Regional Office Name