Health Permit Application

CITY OF MESQUITE HEALTH DIVISION
1515 N Galloway Ave, MesquiteTX 75149
Phone: 972-216-8138
Fax: 972-216-6908

Contact Information

Name of Establishment

Address of Establishment

Name of Event/Location

Temporary Dates of Operation

Location of Food Preparation

First Name

Last Name

Email Address

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Owner of Business

Address Line 1

Address Line 2

City

State

Postal Code

Phone Number

Previous Vendor

Yes
No

Yes

Food Being Conveyed

Temp Control?

Yes
No

Yes

How?

Vendor Type

Permit Type

Enter Farmers Market

Date Begin

Permit Period

Amount Due

Are you selling products that require verification (i.e. salsa)? Please contact the health department directly at 972-216-8138.

Submit