HomeMy Public PortalAbout090_010_Taste of Tybee MAYOR a�a CITY MANAGER
Jason Buelterman Diane Schleicher
CITY COUNCIL CITY CLERK
Wanda Doyle,Mayor Pro Tem ` Janet LeViner
Barry Brown
Rob Callahan
f4Z, CI CITY ATTORNEY
Bill Garbett Edward M. Hughes
Monty Parks ,*
Paul Wolff
CITY OF TYBEE ISLAND
City Council Agenda Item Request
Agenda Item Requests and supporting documentation must be submitted to the Clerk of
Council by 4:0013111 on the Thursday prior to the next scheduled Council meeting. If this
form is received after the deadline, the item will be listed on the next scheduled agenda.
Council Meeting Date for Request: August 28, 2014
Item: Alcohol License Request-Special Event-Beer, Wine— Taste of Tybee. _
Explanation: _ Savannah Area Chamber of Commerce
Dates of event: September 25,2014
Budget Line Item Number(if applicable):
Paper Work: X Attached*
AudioNideo Presentation**
* Electronic submissions are requested but not required. Please email to
i lev in a r(a;c itv o ftv bee.o rg.
** Audio/video presentations must be submitted to the IT department at City
Hall
by 4:00PM on the Thursday prior to the scheduled meeting.
Submitted by: Sharon S. Shaver
Phone 1 Email: 912 472-50721 sshaver(a cityofybee.org
Comments:
Date given to Clerk of Council August 20, 2014
P.U. Box 2749—403 Butler Avenue,Tybee Island, Georgia 31328-2749
(866) 786-4573—FAX (866) 786-5737
www.cityoftybee.org
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CITY OF TYBEE ISLAND
ALCOHOL LICENSE APPLICATION s
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Application is hereby made for a license to do business within the City of Tybee Island as a dealer in alcoholic
beverages as indicated below:
LICENSE CLASSIFICATION FEE CHECK Notice: The applicant
Retail Beer/Wine—Package Sales Only,Consumption on Premises Prohibited S 350 a license shall be a
Retail Beer/Wine—`Sale by Drink for Consumption on Premises Only 575
citizen of the United
Retail Liquor—Sale by Package Only,Consumption on Premises Prohibited 850 States,ha a County,resident of
Retail Liquor—Sale by prink for Consumption on Premises Only 1,250 Chatham of the business
ins
owner of the hu5iineSs
Retail Liquor—Sale by Package&Drink both in One Building under One Ownership 2,000 or if a corporation,
Sunday Sales of Alcoholic Beverages 15(t
Wholesale Beer 765 partnership or other
legal entity is the
Wholesale Liquor 1,500 owner, a substantial
Wholesale Wine 150 and major stockholder
Distiller,Brewer,or Manufacturer of Alcoholic Beverages _ 300 or the applicant may be
,Special Event—Public or Private Property-Beer,Wine(no current license)per event 50 the manager of the
Special Event—Public or Private Property-Beer,Wine(no cur lent license)3 days 100 business charged with
Special Event—Public or Private Property-Beer,Mine(holding current license)per event 10 - the regular operation of
Special Event—Business Property—Beer,Wine,Liquor(no current license)per event 50 said business on the
Special Event—Business Property—Beer,Wine,Liquor(no current license)3 days 100 premises for which the
Special Event—Business Property—Beer Wine;Liquor(holding current license)per event _ 10 acense is issued.
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Business Name ,1E► ocir+..irMN . diTa llf.���.tr• 1 . 717 :
Location I.. � i �,.��/.�j.I ,�Cif�._ .J �t lZ 1
Mailing Acl,ress FAlar �, �t�r7 .'.v!■`,i.'�!'I/tl t ! i�I. i I`�.i�
Phone 'i�r !Lr �'1� J! ill : . .l �t a. tiii ; .Cote)
Names and Home Addresses of Owners,Partners or Corporate Officers with Ten Percent(10%)Interest in Business
Names(attach additio•al pages if necessary) Date of Birth Home Addresses City,State,Zip Social Security#fli
Is business incorporated? State. Incorporation Date Incorporated I r 1.f (/�
U d9fj/, CI' i
Names of landlord of the . -1 5s imam r�. • .il_l-rl t�a Address FP—, al ;�,t_ Phone 1t ar
What other business is conducted at this location? ■ A
Has application been made for required State and Federal II- - ?Li al P 1 Pi , k?.,!1 L' iii...t ti f
Has applicant,any person connected with,or any person having an Interest in this h "
o ever been convicted of any violation of law other than for a traffic violation?
o ever served time in prison or other correctional institution? 0. _
o ever had an alcohol beverage license suspended or revoked at any time In any location?, ii0
(if answer is yes,give details)
If this application is for RENEWAL of an existing license,enter License Number of existing license
If business is an eating establishment,are SUNDAY sales of alcoholic beverages contemplated? 0 If yes,submit additional affidavit.
ALL OF THE FOREGOI INFORMATION IS HEREBY GIVEN AND ALL OF THE FOREGOING STATEMENTS ARE HEREBY MADE ON OATH
WILLFULLY,KNOWIN NI) ,:c.. Y,AND THE SAME IS r I)ARE HER SWORN TO ME TO BE TRUE UNDER PENALTY OF LAW.
Applicant Signatu LI ,A..'--► Date 4 1 . 1
Approval Signature Date
City Manager
Soo. } o a- a'. before me this 4; -. day of r , if Zoning
p, Police
�l 1\Ir a i City Council
Notary 'uhlic
The CONSENT FORM is required for ALL alcohol license applications.
CONSENT FORM
I HEREBY AUTHORIZE THE TYBEE ISLIWD POLICE DEPARTMENT TO REQUEST ANY CRIMINAL BACKGROUND HISTORY RECORD
INFORMATION PERTAINING TO ME WHIO1 MAY BE IN THE FILES OF ANY STATE OR LOCAL CRIMINAL JUSTICE AGENCY. BE IT RIMER
UNDERSTOOD THAT THE PURPOSE OF OBTAINING THIS INFORMATION IS TO SATISFY THE REQUIREMENTS SET FORTH BY THE MAYOR
AND re to I OF THE CITY OF TYBEE ISLAND,REGARDING AN ALCOHOL BEVERAGE LICENSE APPLICATION.,ttiOxn V W
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FULL AME(PRINT) SEX / RACE / ETA-4 OF BIRTH
11t13 CtIbb 40,44 - - - - ■vivio 4
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CITY,STATE,ZIP -
`a
CITY, 'ATURE f DATE.
The ACKNOWLEDGEMENT is required for all LIQUOR BY THE DRINK alcohol license applications.
ACKNOWLEDGEMENT
I dedare knowledge and understanding of Municipal Code Section 58-80: There is levied an excise tax on the sale
of distilled-11 Is b the dri ` the amount of three percent of the charge the public for a beverage.
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[• RE DATE
The AFFIDAVIT is required if SUNDAY SALES of alcohol for consumption on premises are contemplated.
Food and beverage sales records prepared by a CPA are required to be furnished to the City upon request
STATE OF GEORGIA /)f) �{./
COUNTY OF CHATHAM ' `� �<
CITY OF TYBEE ISLAND - f S 73
AFFIDAVIT ,
I, , do hereby make this affidavit to be part of my application for an
alcohol beverage license in the City of Tybee Island to sell distilled spirits, malt beverages and/or wine for the
consumption on the premises in my eating establishment on Sunday. Said establishment is located at
Tybee Island, Georgia.
I am the of the establishment known as .
I hereby further state that at least fifty percent (50%) of the total annual gross food and beverage sales are
derived from the sale of prepared meals or food.
SIGNATURE DATE.."-R,4pprnLrlf Denied Chief of Police
Is / pa Date
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