Type Full Name :
Sign With Hand
Day-time Phone #
Emergency Contact Phone #
Full Address of Exterminator
Establishment Details
Phone # of Exterminator
Registration Type
How often is garbage picked up?
{[CITY]}, {[STATE]} {[ZIP]}
Ext. 3006 {[APHONE]}
First Name
Emergency Contact Email
Brick & Mortar Only
Grease Trap
Property Address
Please provide name(s) of person(s) in charge
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 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.

Last Name
Category Fee
Retail Establishments regardless of size or food product sold and mobile food vendors $275
Vending machine licenses $275
Outside vendors for Township and non-Township sponsored special events 1 - 4 days $50 a day with a max of $175
Annual mobile vendors or vendors for Township and non-Township sponsored special events more than 4 days $275

  • Please be advised there is a $3.00 processing fee for Credit Card payments.

  • Please note that you will be contacted upon review of application and documentation, and at that time payment will be requested. Payment can be made via cash, check or credit card.
Evening Phone #
Full Address of Garbage Hauler
Emergency Contact Name
Name of Garbage Hauler
Establishment Category
Establishment Name
Phone # of Garbage Hauler
Name of Exterminator
Fee Schedule
Emergency Contact Details
If Other
Phone #
Application Fee
Ownership Type
DBA (Doing Business As) Name
Entity Name (if applicable)
Fee Due
Applicant Signature
Owner Details
Number of Days for the Event (Temp Vendor)
Description of goods sold
How often is cardboard picked up?
Late Fee
Documentation that must be provided:

  • All Food Manager's Certificates
  • Email
    Retail Food License
    Type the street number and name to select the Address
    Establishment Email
    License #
    Phone #
    City, State Zip