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2021 Request for Food Service Variance -- Jefferson County Public Health

  1. REQUEST FOR FOOD SERVICE VARIANCE
    JCPH may grant a variance to any section of the regulations when: (1) No health hazard would exist as a result of this action; (2)The variance is consistent with the intent of these regulations.
  2. Statutory Authority:
    RCW 43.20.050. 92-08-112 (order 261B) WAC 246-215-270 Jefferson County Code Title 8.05
  3. Variance Request
    A variance is an exception from the general rule or regulation and as such must be accompanied by sufficient reasoning to justify granting its approval. The following questions will assist in the evaluation of the variance request. Attach additional sheets, diagrams, etc. as necessary.
  4. Attach any additional information (reports, studies, maps, illustrations, leases, permits, etc.) that may further describe the proposed variance in addition to the site plan.
  5. By typing my full name, I hereby declare that I am the applicant or authorized representative and the information provided in this application is true and correct to the best of my knowledge. Furthermore, I acknowledge that I cannot proceed with the proposal until JCPH has approved the variance.
  6. For Official Use Only
  7. Resolution:

    ___ Granted

    ___ Denied

  8. Signature:

    ______________________________

    EH Manager/Director

  9. Date:

    _______________

  10. Leave This Blank:

  11. This field is not part of the form submission.