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Applications for local health permit shall be in writing on a form approved by the Health Officer and signed by the applicant and shall include the items of information as follows:

A. Name and address of the applicant.

B. Name and address of the establishment or enterprise for which the permit is sought, including, in the case of multiple locations, the names and addresses of each enterprise or establishment.

C. The general nature of the business of each enterprise or establishment.

D. The number of persons working in each enterprise or establishment on a representative day, being the median number evidenced by social security tax returns during the preceding year.

E. The calendar year for which the permit or permits are sought.

F. The amount of inspection fee accompanying the application.

G. The date of the application. (Formerly 3.16.060)