Form Center

2. Mobile Food Unit Licensing Application

   Please fill out this form if you have a mobile food unit and you are interested in obtaining a license to operate in Roeland Park.

4. Application requests shall be filed with the City Clerk. No application request shall be accepted for filing and processing unless it conforms to the requirements of this Article. This includes a complete and true application, all required materials and information prescribed, and submittal of the appropriate fees.

   Unless otherwise provided herein, applications must be submitted not less than 14 calendar days prior to the proposed start date of the mobile food unit activities. The City reserves the right to reject any applications that have not been submitted in a timely manner.

   Applicant's Responsibility: Receiving approval of a mobile food unit license from the City shall not preclude, supersede, circumvent, or waive the applicant's responsibility to obtain any additional permits, licenses, and approvals for other applicable local, state, and federal regulations.

6. First Name*
7. Last Name*
9. Company Name (if applicable)
11. Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. Email Address*
20. Description of the kitchen facilities, cooking facilities, preparation area, safety features (such as, but not limited to, fire suppression system) of the mobile food unit:*
22. Make, model, and year of vehicle to be used and the license plate number:*
24. Overall size of the vehicle; length, width, height, and weight:*
26. Valid Kansas sales tax number:*
28. Address and Location Description Where Mobile Food Unit WiIl Be Operating*
30. Dates and Times Mobile Food Unit Will Be Operating*
32. Written permission from location where food truck will be operating*
34. Photographs of the mobile food unit from the front, side and back*
36. A current health inspection certificate from the State of Kansas*
38. Copy of Fire District or equivalent inspection certificate, if required:
40. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
42. Electronic Signature*

44. Such other information as the City of Roeland Park may require for purposes of conducting a background check and fingerprinting. If it is determined that a nationwide background check is required, the applicant may be responsible for the expense to complete the background check(s).

    Any application received shall be deemed withdrawn if it has been held in abeyance, awaiting the submittal of additional requested information from the applicant, and if the applicant has not communicated in writing with the City and made reasonable progress within 30 days from the last written notification from the City to the applicant. The application fee is nonrefundable. Any application deemed withdrawn shall require submission of a new application and fee(s) to begin a new review and approval process.

    Upon completion of the review process and a determination of compliance with the applicable regulations, the City Clerk will issue a mobile food unit license.

    Should the mobile food vendor change the mobile food unit, or the food and beverage offerings during the term of an issued license, that would change the designation of the mobile food unit to a higher licensing level, a new application and fire inspection shall be required.

Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

* indicates a required field