S:\FORMS\Planning\word\Mobile Vending Permit Application Form.doc
PO Box 458 * Veneta, OR 97487 * 541-935-2191 * Fax 541-935-1838 * www.venetaoregon.gov
Mobile Vending Permits are non-transferable and only valid on site designated on permit application.
Type of Permit: NEW RENEWAL Permit #:
Permit Fee: $50.00 / Annual Renewal Fee: $50.00 Received Date:
Receipt #:
Applicant Name (if not owner): Daytime Phone
Mailing Address: Email:
Property Owner Name: Daytime Phone:
Mailing Address:
1. Vendor Location and Address: __________________________________________________________________
2. Nature of Business/ Product(s) being sold: ________________________________________________________
3. Days and Hours of Business Operation: ___________________________________________________________
Required Submittals:
a. Picture of the mobile unit attached.
b. Site Plan complying with Veneta Land Development Ordinance No. 493, Section 7.04(2) attached.
c. Will a portable sign be used: No Yes If Yes, submittal and approval of Sign Permit is required.
d. Mobile Food Vendors only: The mobile food unit complies with applicable Oregon Health Authority (OHA) Mobile
Food Unit license requirements.
e. Lane County Environmental Health
License #1:
License #2:
License #3:
License #4:
Lane County Environmental Health License #:
f. Submit business registration and fee to City of Veneta within three (3) days per permit approval and prior to
occupancy of site.
I HEREBY STATE THAT THE FACTS RELATED IN THE ABOVE APPLICATION AND THE PLANS AND DOCUMENTS SUBMITTED HEREWITH ARE TRUE,
COMPLETE, CORRECT, AND ACCURATE TO THE BEST OF MY KNOWLEDGE.
Applicant Signature: Date:
Owner Signature: Date:
(if not applicant)
Temporary Use Application
for Mobile Vending Unit
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signature
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signature
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APPLICATION FEES & DEPOSITS
Fees and deposits are intended to cover the full cost for processing applications. They are not intended to cover the cost
for interpretation of ordinances or for long-range planning. Applicants seeking development which requires more than one
type of review (such as site plans and conditional use permits) must pay all applicable fees and deposits. Applicant
acknowledges and agrees that Applicant’s failure to pay City costs over the base fee amounts, as charged monthly by the
City, may result in the City pursuing any or all legal remedies available, including but not limited to liening Property in the
amount owed; prosecution for violation of the City’s current fee resolution and City land development or division
ordinances; issuance of a stop work order, non-issuance of building permits for Property, or cessation of related
proceedings; set-off against any reimbursement owed; and turning amounts owed over to a collection agency.
Application Deposits: Certain application fees are represented by a deposit amount. Applicants shall be charged for actual processing costs
incurred by the City. City staff time shall be monitored for applications which require a deposit in lieu of a non-refundable fee. Any unused portion
of the deposit shall be returned to Applicant upon completion of the application process, conditions of approval, and any ensuing appeals. Any
additional costs incurred beyond the deposit amount shall be charged to and paid by Applicant on a monthly basis. Applicant agrees that
Applicant’s failure to pay these amounts triggers City’s option to pursue any or all remedies, as listed above.
Application Fees: Fixed fees are non-refundable and are based on average application processing costs rounded to the nearest $25.
Technical Review/Publication Deposit: The actual costs charged to the City for technical review of land use applications, including but are not
limited to City’s planning, public works, engineering, administration, legal, wetland specialists, geologists, biologists, arborist, and any other services
provided in processing Application, shall be charged to Applicant, at the rate(s) charged to the City. In addition, the actual costs of preparing and
mailing notices to abutting property owners or others required to be notified, the costs of publishing notices in newspapers, and any other mandated
costs shall be charged to Applicant. Such costs shall be adjusted as soon as the specific amounts are known. Applicant agrees that any
deficiencies shall be collected from Applicant, and that Applicant’s failure to pay these amounts triggers City’s option to pursue any or all remedies,
as listed above.
.
Applicant: Owner(s):
Required Attachments: Required Approvals:
_____ Site plan Application complete:_____________________
_____ Any required state or local permits and licenses
_____ Property owner consent agreement Lane Fire Authority: _____________________
Planning: _____________________
Permitted in Zoning District: Yes______ No______
_________________________ _________________ _________________
Authorized Signature Date of Issue Expiration Date
FOR CITY USE ONLY