Application for Refreshment Vehicle Licence

Township of Selwyn

Application for Refreshment Vehicle Licence

This is a dynamic form: as you complete the form, questions and required information will change. Do not print this form, you will receive a PDF copy by email when you click submit. 

Before starting this application, please make sure you have the following information in a digital format, ready to upload:

All Applications:

• Inspection report: Health Unit
• Inspection report: Fire Department
• Inspection Report: Gas/Propane Installer
• Certificate of $2 Millions Liability Insurance
• Pictures of the Unit (inside and outside)
• Road Authority Approval

New Applications only:

• Site Plan (location of vehicle, signage, seating, parking facilities, garbage containers, etc.)
• Letter or Permission from Property Owner and/or Occupant or Tenant (if applicable)
• Planning Department Approval

Special events only: Contact Amy Stevenson, Recreation Services Administrative Assistant at (705)-292-9507 ext. 243. 

Personal information on this form is collected under the authority of the Municipal Act, Section 11. All names, addresses and comments will be included in material available to the public in accordance with the provisions of the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA). Questions about the collection of this information should be made to: Clerk Township of Selwyn Address: 1310 Centre Line, Selwyn, Ontario, K9J 6X5 Telephone: 705-292-9507 extension 221

Owner Information

Refreshment Vehicle Information

Application Fees

Attachments

Acknowledgement:

I hereby acknowledge if a licence is granted, that:

1. Upon notice to the Applicant, this permit may be revoked at any time by the Township in accordance with Section 6 of By-law 2023-038. The Health Unit may require the applicant to close the premises where it is determined there is a health hazard, in accordance with the Health Protection and Promotion Act.
2. The Applicant shall and hereby does assume all liability arising out of the operation of the Refreshment Vehicle at the above noted location. The Applicant agrees to indemnify and hold harmless the Corporation of the Township of Selwyn, its agents, servants, employees and officials from any claims, actions or suits which might be brought against the said Refreshment Vehicle Operator and the Township of Selwyn arising from the said operation of the Refreshment Vehicle in any manner whatsoever or any error, negligence or omission of the Refreshment Vehicle Operation, its agents, servants, or employees.

Submitted: N/A