Form DFS-202 "Application for a Permit to Operate a Temporary/Fee Exempt Food Service Establishment as Required by Krs 219.011 Et Seq" - Kentucky

What Is Form DFS-202?

This is a legal form that was released by the Kentucky Department of Public Health - a government authority operating within Kentucky. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2006;
  • The latest edition provided by the Kentucky Department of Public Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DFS-202 by clicking the link below or browse more documents and templates provided by the Kentucky Department of Public Health.

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Download Form DFS-202 "Application for a Permit to Operate a Temporary/Fee Exempt Food Service Establishment as Required by Krs 219.011 Et Seq" - Kentucky

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DFS-202 (11-06)
Print Form
TEMPORARY
FEE EXEMPT
APPLICATION FOR A PERMIT TO OPERATE A
FOOD SERVICE ESTABLISHMENT AS REQUIRED BY KRS 219.011 et seq.
No person shall operate a food service establishment without having a permit issued by the Cabinet
County:
Temporary Permit Fee:
$
Cash
Check
Money Order
Date of Application:
FEE EXEMPT:
Temporary Dates of Operation:
If changes since last application indicate:
Name:
Previous Name:
Owner:
Previous Owner:
Previous Address:
Address:
City:
State:
Zip:
City
State
Zip Code
The applicant hereby grants the right of inspection to Cabinet for Health Services representatives during normal working hours.
Signature of Applicant:
Date Received:
Local Permit Number:
Approved By:
Date Approved:
Signature and Title
DFS-202 (11-06)
Print Form
TEMPORARY
FEE EXEMPT
APPLICATION FOR A PERMIT TO OPERATE A
FOOD SERVICE ESTABLISHMENT AS REQUIRED BY KRS 219.011 et seq.
No person shall operate a food service establishment without having a permit issued by the Cabinet
County:
Temporary Permit Fee:
$
Cash
Check
Money Order
Date of Application:
FEE EXEMPT:
Temporary Dates of Operation:
If changes since last application indicate:
Name:
Previous Name:
Owner:
Previous Owner:
Previous Address:
Address:
City:
State:
Zip:
City
State
Zip Code
The applicant hereby grants the right of inspection to Cabinet for Health Services representatives during normal working hours.
Signature of Applicant:
Date Received:
Local Permit Number:
Approved By:
Date Approved:
Signature and Title