Local permits & fees

Madison County, MO Food Facility Permits

Restaurants and food trucks.

Madison County Health Department · department site →

Fees change often — always confirm the current amount with the department before you budget.

Confirm the authority for your exact address. Some cities run their own health division, and building, planning, fire, sewer/grease and business-license approvals are separate even when Madison County Health Department issues the health permit.

About 20 food & drinking establishments operate here, serving a population of about 12,698. (U.S. Census 2023 estimate; County Business Patterns 2022, NAICS 722)

Last verified: 2026-08-18 — we re-confirmed the serving authority, its contact, and that the fees below match the current published schedule. Fee schedules may carry an earlier effective date (shown per fee); local ordinances & amendments aren’t individually reviewed, so confirm current rules with the authority having jurisdiction.See something out of date? Report an update →

Restaurant / food-facility permit

Food Establishment Permit

Fee not published online — contact the department.

Madison County HD (Fredericktown) provides sanitation inspections of food establishments, taverns, caterers, grocery stores, mobile and temporary food stands and school cafeterias; environmental services are supported by the St; Francois County Health Department (573-431-1947); No permit fee amount is published; contact 573-783-2747

Plan review — required

Fee not published online.

Reach the department

Phone(573) 783-2747

Emailteresa.rehkop@lpha.mo.gov

Office105 Armory Street, Fredericktown, MO 63645

Websitemadisoncountymohealth.com →

Inspection grading

How inspection results are scored/posted here is pending verification — ask the department.

Food truck / mobile permit

Mobile Food

Fee not published online — contact the department.

Mobile and temporary food stands are inspected; no separate mobile fee published

How to apply

See the department site above.

Fees/payment and forms are on the department site; application steps vary by concept — see the checklist below.

Local food-service market

About 20 food & drinking establishments serve ~12,698 residents in Madison County — one per ~635 residents, sparser than the Missouri average (one per ~610).

U.S. Census 2023 population; County Business Patterns 2022 (NAICS 722).

Equipment your Madison County plan review will check

Health-department plan review looks for specific, code-compliant fixtures. Compare spec-filtered options, then confirm counts and sizes with your local requirements. See the full list in what equipment a commercial kitchen requires.

Compartment sinks

3-bay wash / rinse / sanitize — sized to your menu

Hand sinks

required in prep, cook & warewashing areas

Grease traps / interceptors

sized by drainage fixture units

Reach-in refrigeration

cold-holding at 41°F or below

Work tables & surfaces

NSF-listed, non-absorbent

Hoods & ventilation

over cooking equipment; make-up air

Dishwashers

high-temp or chemical sanitizing

Nearby counties

Permit costs and rules change at the county line — compare Madison County with its neighbors.

Bollinger County, MO

Restaurant permit: See page

Iron County, MO

Restaurant permit: See page

Perry County, MO

Restaurant permit: See page

St. Francois County, MO

Restaurant permit: See page

Wayne County, MO

Restaurant permit: See page

How to open: typical permitting sequence

This is a typical sequence — confirm the exact sequence with your authority having jurisdiction.

Confirm whether Madison County or another local jurisdiction (city/district) handles your exact address.
Confirm zoning and permitted use.
Prepare your menu and scaled plans.
Include an equipment schedule with ANSI/NSF spec sheets.
Submit water-heater and hood documentation.
Pay plan-review fees.
Respond to plan-check corrections.
Obtain Environmental Health plan approval.
Obtain building, plumbing, mechanical and fire approvals.
Schedule rough-plumbing, pre-final and final health inspections.
Pay the operating-permit / application fees.
Receive approval before storing or preparing food.

Frequently asked questions

Is plan review required in Madison County?

Yes — plan review is required before you build or remodel a food facility.

Do I need a commissary for a food truck in Madison County?

In most cases, yes — most mobile units must operate from an approved commissary; confirm exemptions with the department. Mobile and temporary food stands are inspected; no separate mobile fee published

Who issues food permits in Madison County?

Food permits here are issued by Madison County Health Department. See the department site for current details.

Are city building and fire approvals separate?

Yes — building, plumbing, mechanical and fire approvals are always separate from the health permit and are often handled by different offices.

Missouri statewide rules

Who licenses you, reciprocity, and the state regime.

What equipment you need

Build a tailored equipment checklist for your concept.

Permits & plan review, explained

The stack of approvals before you open.

Sources: www.madisoncountymohealth.com · health.mo.gov · observed 2026-08-21