Office Use Only
If submitting a New Joint Permit application, please attach a copy of the collaborating permit application here.
If submitting a Modified Permit Application, please enter the original permit application number here.
Please print completed application, have property owner sign here and submit original signed application to City of Modesto Economic Development.
PROPERTY OWNER’S AFFIDAVIT: I hereby certify under penalty of law that I am the owner of the above-referenced property and
authorize the temporary outdoor restaurant operations as described herein.
Check all permit conditions that apply
Please identify streets and address ranges affected
Complete electronic or hard copy set of the entire permit application package as defined
in this document. Hard copies may be requested by the City as needed.
☐ Signed Indemnification Agreement (Exhibit 1) and provided evidence of valid insurance for
expanding on to Public-Rights-of Way (City owned property).
☐ Written permission with signature from property owner (if on private property).
☐ Copy of City of Modesto Business License.
☐ Copy of City of Alcohol Beverage Control (ABC) licensing and Map. If applicable.
☐ Site Plan with accurate, dimensioned, scaled drawings showing the business storefront,
storefronts adjacent to the business, and the full sidewalk, street, and parking area in the
proposed permit area. Size and font must be legible.
Delineate and dimension the area proposed for the permit. Delineate existing tree wells, light poles, utility poles, bus benches, newsstands and
Show and label all proposed furniture and appurtenances requested to be placed
within the proposed permit area.
Provide north arrow, scale, street name, business address, and business name.
Provide all property lines on plan.
Application is hereby made for a temporary permit to operate an outdoor business subject to the City
Manager’s (or designee) sole consideration and approval and in accordance with standards set by the State of
California, Stanislaus County Public Health, Americans with Disabilities Act, and Alcohol Beverage Control
Please print completed application and submit original signed application to City of Modesto Economic Development.
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