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Type of Food Facility Proposed: <br /> Choose one of the below <br /> Food Establishment Annual Permit Fee <br /> 16.23 1 -20 Seating.Capacity $260 <br /> 16.24 21,-50 Seating Capacity $260 <br /> 16.25 51 - 100 Seating Capacity $280 <br /> 16.26 101 + Seating Capacity $300 <br /> 16.28 Licensed Healthcare Facility $250 <br /> Food Processing Establishment without Seating Capacity <br /> 16.12 1 - 500 Total Square.Feet 4 $260 <br /> 16.13 501 - 1,100 Total Square Feet R $260 <br /> 16.14 1,001.+Total Square Feet $280 <br /> Grocery Store <br /> 16.20 < 25 Total Square Feet(Incidental Foods) $75 <br /> 16.16 < 1,000 Total Square Feet $180 <br /> 16.17 > 1,000 Total Square Feet(Food Prep Area) $210 <br /> 16.19 > 1,000 Total Square Feet (W/Multiple Depts.) $350 <br /> 16.15 < 2,000 Total Square Feet (Prepackaged Only) $175 <br /> 16.18 > 2,000 Total Square Feet(W/Prepackaged Only) $200 <br /> 16.80 Commissary(Storage, Major Cleaning - MFPU) $225 <br /> 16.81 Commissary(Storage, Minor Cleaning -Vehicle/Cart) $175 <br /> 16.90 Satellite Food Distribution Facility $125 <br /> 16.60 Ice Plant $150. <br /> 16.07 Produce Stand $150 <br /> 'r <br /> Additional Information Regarding this Facility: <br /> I? _ ,<u, CVs Q%u6 SatoQLES `b . PeoQLT5 • 6:FGRAyz <br /> u RFU am, P a.b01 c-ro-6 you►-r ATPD Lo-i--a-L6t eu-no iks <br /> 3 ST Mid ptTAM- W M Pt M MOJft, SHP" MGX <br /> EHD 16-01 5 PLAN CHECK GUIDE <br /> 11-7-07 <br />