Form Center • Edina, MN • CivicEngage

Special Event Food Stand Application

Steps

1. Application Details This section is complete This section is incomplete
2. Food Handling Procedures This section is complete This section is incomplete
3. Insurance This section is complete This section is incomplete
4. Submission This section is complete This section is incomplete

Application Details

A special event food stand is a food establishment which is used in conjunction with celebrations and special events, and which operates no more than three times annually for no more than ten total days. All food stands must operate in compliance with the Minnesota Food Code and Edina City Code. Application must be submitted five days before event.
Food Code
Minnesota Food Code
City Code
Edina City Code
Name of Event*
Address of Event*
Date(s) of Event*
Time(s) of Events*
Owner Name*
Phone Number*
Owner Address*
City*
State*
Zip Code*
Owner Email*
Person in charge of Food Operation*
Contact Email*
Contact Phone Number*
Application Fee
Application Fee
Price
Quantity
Shipping Cost
Taxable
Provide your Minnesota Tax ID Number. If a Minnesota Tax ID Number is not required, explain why.*
Provide a Federal Tax ID or Social Security Number.*
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Food Handling Procedures

List all other food licenses or permits currently held by this operation at the time of application. If any of these licenses or permits have been suspended or revoked, please provide an explanation.*
List ALL food and beverage items to be served:*
Where will food be obtained?*
How will food be prepared, chilled and stored prior to the event?*
Mechanical refrigeration is required for potentially hazardous foods; ice filled coolers are not permitted for food storage. Home kitchens may not be used.
What is the method of transporting food, including type of vehicle and types of electric or insulated food transport containers?*
List equipment to be used to maintain food above 135° F and below 41° F.*
Mechanical refrigeration is required for cold storage of potentially hazardous foods; coolers and ice are not permitted.
Where will food be kept during the event? *
Food must be kept a minimum of 6 inches off the floor and protected from contamination.
Describe facilities for washing hands:*
Include soap and single-use towels at the hand-washing station/sink.
Note
*A handwash station/sink capable of providing warm, continuously running water, is required
Describe facility for washing utensils. *
All utensils must fit into the sinks or containers used for warewashing. Provide three labeled buckets big enough to accommodate the largest utensil. Wash Bucket: Dish soap and warm water. Rinse Bucket: Clean water. Sanitizer Bucket: Sanitizer and lukewarm water. Air Dry.
Example
Utensil Washing
Provide three labeled buckets big enough to accommodate the largest utensil.
1. Wash Bucket: Dish soap and warm water
2. Rinse Bucket: Clean Water
3. Sanitizer Bucket: Sanitizer and lukewarm water.
4. Air Dry
Food Safety Tips for Temporary Events
Provide a metal stem thermometer to measure cooking and cold holding temperatures. The thermometer should have a range from 0°F to 220°F. Also, provide thermometers in each cooling unit to ensure they are maintained at 41°F or below.
Cook all potentially hazardous foods to an internal temperature of 165°F before serving. Any food held hot for service must be maintained at 135°F or higher.
Wash hands before handling food; after handling raw meat; or after eating, drinking, smoking, or using the toilet. No eating, drinking, or smoking in the food stand.
Protect any food on display from contamination by customers.
Temporary food stands must cease operation in adverse weather unless the stand is equipped with a cover and three sides for protection.
Call 952-826-0370 with any questions regarding temporary events in the City of Edina.
Identify water source for the food stand or vehicle:*
Describe the method of waste water disposal*
Describe type of protective enclosure, if any (tent, trailer, etc). Approved flooring must be provided (concrete, asphalt, tight wood, or other cleanable material.*
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Insurance

Insurance Company Name
Please do not provide the name of the insurance agent.
Policy Number
Expiration Date
I am not required to have workers' compensation liability coverage because:
1. I have no employees.
2. I am self-insured (include permit to self-insure below).
3. I have no employees who are covered by the workers' compensation law (these include: Spouse, Parents, Children, and certain farm employees).
Upload a certificate of insurance or permit to self-insure.
I certify that I have provided proof of coverage or I am not required to have workers' compensation liability coverage.*
1. I agree.
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Submission

THE MINNESOTA DATA PRACTICES ACT requires that we inform you of your rights about the private data we are requesting on this form. Private data is available to you, but not to the public. We are requesting this data to determine your eligibility for a license from the City of Edina. Providing the data may disclose information that could cause your application to be denied. You are not legally required to provide the data, however, refusing to supply the data may cause your license to not be processed. Under MS 270.72, the City of Edina is required to provide the Minnesota Department of Revenue your MN Tax ID Number or Social Security Number. This information may be used to deny the issuance, renewal or transfer of your license if you owe the Minnesota Department of Revenue delinquent taxes, penalties, or interest. The Department of Revenue may supply information to the Internal Revenue Service. In addition, this data can be shared by Edina City Staff, the State of Minnesota Driver License Section, Hennepin County Auditor, Bureau of Criminal Apprehension, Hennepin County Warrant Office, Ramsey County Warrant Office, the Minnesota State Auditor and if required by a court order. Applicant’s residence address and telephone number will be considered public data unless you request this information to be private and provide an alternative address and telephone number below. Your acceptance below indicates the applicant has cation indicates applicant has read and understands their right regarding Data Practices.
Please confirm you agree to the above Data Practices Act. *
1. I agree.
I request that my residence address and telephone number be considered private data. My alternative address and telephone number are as follows:
Address
Telephone Number
I certify that the information provided on this form is accurate and complete. *
1. If I am submitting this form on behalf of a business, I certify that I am authorized to sign on behalf of the business.

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