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HomeMy Public PortalAbout090_010_Agenda Request-Bubba Gumbo's-Alcohol & Entertainment MAYOR fit,6 114 CITY MANAGER Jason Buelterman s: 4, Diane Schleicher CITY COUNCIL CLERK OF COUNCIL Wanda Doyle,Mayor Pro Tern Janet LeViner Bill Garbett 1 Paul Wolff .:J CITY ATTORNEY Rob Callahan • Edward M.Hughes Monty Parks , ' wool' Barry Brown CITY OF TYBEE ISLAND City Council Agenda Item Request Agenda Item Requests and supporting documentation must be submitted to the Clerk of Council by 4:00P111 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: March 12, 2015 Item: Alcohol and Entertainment License Request: Beer and Wine/Sunday Sales -Entertainment Explanation: _Bubba Gumbo's -Food and Beer and Wine Service 4 Old Hi hwa 80 Old T bee Road Budget Line Item Number(if applicable): Paper Work: X Attached* Audio/Video Presentation** * Electronic submissions are requested but not required. Please email to i1eviner(,citvoftybee.org. ** 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/Email:472-5072 / sshaver @cityoftybee.org Comments: Date given to Clerk of Council February 26, 2015 .0.Box 2749—403 Butler Avenue,Tybee Island,Georgia 31328-2749 (866)786-4573—FAX(866)786-5832 www.cityoftybee.org 0 0,. 43\acp cfano sillarkze use nsi4c r .. ' ' * Date eQ,,5—-15 `` CITY OF TYBEE ISLAND Renewal 1 1,, 1.41,-4 BUSINESS LICENSE APPLICATION I Libense# Business Name PU - 6 ainA0 1 Location a f a1/G l cLa,,L er ll�. f-G R.e: I Haling Address c 0'.J 5 57/ . 4-4 �� 6n 3 i 6- 1 Phone /742 — 351 6—Q 49 Emal 7-$/4Z�.�•o J e- % Ca Federal ID# Sales Tax I©; ' NAICS Code OrSSN* /f ", t, 3SS j Business Type(ccc/ one): Sole Proprietor Partnership Corporation } Non-Profit Other: l Names and Home Addresses of Owners Partners or Corporate Officers - Names Home Address C State Zi■ Titre 4/AG a/MUD /5 &796-6 / -i}-r.,64 519IZ5 A. A ' ' I .� . _ i ' Arafd i /7-1"6- . ' _ 4 Ali/ f Describe the business you would like to license: Has this business or anyone connected with this business been cited or cha ed with any violation of Georgia Law,Federal Law,Local Ordinance,or any Rule or Regulation of the State Revenue Commissioner or any Rule or Regulation of the City or County within the past 12 months?(ciroewre) YES or NO(If YES,include details) 1()D Any business that requires state licensing must present state license when applying. It is the applicant's responsibility to ensure zoning conformance. If there is a question as to whether the location is zoned correctly please contact the City Marshal at 912-472-5098 or the Zoning Department at 912-472-5033. A schedule of regulatory fees is attached. Application for alcohol license requires a different form and city council approval. Application for live or recorded entertainment requires a separate form,annual review and aty council approval. Are you transporting your customers/clients as part of your business?(Land or Water) NO Any business that transports clients/customers must provide a proof of insurance,i,e,declaration page showing expiration date of policy. Applicant Signature (PC±1)' Date Printed Name CI- 1 ti 1/1 c I I I �r r Filmi,1 i El/ Received by _ i1 ! _. _ . Date ,,7.' c S.-116 ROUTING APPROVAL BY DATE FEES City Manager 1 Administrator REQUIRED 1000 Occupational Tax 125.00 Zoning Approval REQUIRED3 2. I2.i ( l 9999 Administration Fee 10.00 Insurance Policy Required for l YES or NO $100.Transportation Fee CITY OF YBEE ISLAND ��" T ALCOHOL LICENSE APPLICATION 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 Beerne-Package Sales Only,Consumption on Premises Prohibited $ 350 for a license shall be a Retail Beer/Wine-Sale by Drink for Consumption on Premises Only 575 V citizen f the United Retail Liquor-Sale by Package Only,Consumption on Premises Prohibited 850 Staa etes s, a residers of Ctratham County, and Retail liquor-Sale by prink for Consumption on Premises Only 1,250 owner of the business Retail Liquor-Sale by Package&Drink both in One Building under One Ownership 2,000 or if a corporation, Sunday Sales-Sale by Drink for Consumption on Premises Only 150 partnership or other Sunday Sales-Package Sales Only 50 legal entity is the Wholesale Beer _ 765_ owner, a substantial Wholesale Liquor 1,500 and major stockholder Wholesale Wine 150 or the applicant may be Distiller,Brewer,or Manufacturer of Alcoholic Beverages 300 the manager of the Special Event-Public or Private Property-Beer,Wine(no current license)per event 50 business charged with Special Event-Public or Private Property-Beer,Wine(no current license)3 days 100 the regular operation of Special Event-Public or Private Property-Beer,Wine(holding current license)per event 10 .4 said business on the Special Event-Business Property-Beer,Wine,Liquor(no current license)per event 50 premises for which the Special Event-Business Property-Beer,Wine,Liquor(no current license)3 days 100 license is issued. Special Event-Business Property-Beer,Wine,Liquor(holding current license)per event 10 Business Name ,4,J iil. o 44a 5 t /� q-/5r 7 .L�r' per, Location y-- f e,-,b iT�L 4 ;IJ b' L,1! — di 4, 1 [J Mailing Address Phone I Email Names and Home Addresses of Owners,Partners or Corporate Officers with Ten Percent(10%)Interest in Business Names(attach additional pages if necessary) Date of Birth 1 Home Addresses City,State,Zip Social Security# AP-I//'T/ 5 1111 45 5-f L// --- 9/ e--/A/ 7- 1 : r 1,9/A-76-7416-S ,r /+C/ ,4-',..z-: . . If special event,date(s)of event Name of event: / Is business incorporated? ✓ State of Incorporation 64 Date Incorporated r� 3 Address `/ / 7 7 5/ •Silt/Phone M 4 Names of landlord of the business location �..t>��.t(- „,,,q,.4..) � � ” �� � � ,277 What other business is conducted at this location? 1442-7.1)113-/ 3'9-/ roge x ' ,41-A,i";.7 Has application been made for required State and Federal Licenses? AV Has applicant,any person connected with,or any person having an interest in this business: o ever been convicted of any violation of law other than for a traffic violation? 4%0 o ever served time in prison or other correctional institution? /o[;? o ever had an alcohol beverage license suspended or revoked at any time in any location? /UV (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? If yes,submit additional affidavit, ALL OF THE FOREGOING INFORMATION IS HEREBY GIVEN AND ALL OF THE FOREGOING STATEMENTS ARE HEREBY MADE ON OATH WILLFULLY, KNOWINGLY,AND ABSOLUTELY,AND THE SAME I5 AND ARE HEREBY SW ORN TO ME TO BE TRUE UNDER PENALTY OF LAW. Applicant Signature .{ - 'i: Date 1 /3o/ Approval Signature Date 01 ' ,,i�,� r city Manager Sworn,to and subscribed be, e -this '-' — day of ^Al , l'\ Zoning , Police . - City Council Not. y Public r CITY OF TYBEE ISLAND Fee $50 ENTERTAINMENT LICENSE APPLICATION A late penalty of 1098 she be assessed for a ate„h cc*- Chapter 34,.Article 17f. Entertainment Licenses renewal payment made air March 31. Business Name &a ,? - � 7 Business Location 4. ©G1) ckt) Da -rytteig Mailing Address ^� �4/6" 67- ieA4vD. Business Phon /, `:�.`"- other PlicIfIVO /-6-0)2 i' I Email Pr5+1,1:41 041- 64404 WZIt f Federal ID# State Sales Tax ID# } pe/c- I NAICS Code Business Type(circle one): Sole Proprietor Partnership Corporation Non-Profit Other: Names and home addresses of Owners,Partners or Corporate Officers Name Home Address City,State,Zip yTitle ehte 72-/A/ tf • 6- 5 --74-0-20v4-fire 6 The nature of any and all commercial activities conducted at the location: A-37)4/1/.11i Proposed hours of operation: e20/ /Vr fZ7340/4111/26- l Describe any efforts to mitigate iimcts on neighbors or occupants of nearby properties: lua Syr Contact Information for the designated manager or contact person available twenty-four hours a day for any operational issues. The license holder must notify the City of Tybee Island immediately of any change to this designated contact information. Naina, Physical Address r one Has this business or anyone connected with this business been cited or charged with any violation of Georgia Law,Federal Law,Local Ordinance,or any Rule or Regulation of the State Revenue Commissioner or any Rule or Regulation of the City or County within the past 12 months?(dale one) YES or NO (If YES,list details below) Applicant Signature� e � - Date l /S Printed Name ig a ■ S �`� f Illfff�.11 . .... Date iR- J�( Received by s 1.. ROUTE APPROVE or DENY SIGNATURE DATE RECOMMENDED RESTRICTIONS/CONDITIONS City Manager Planning&Zoning Mgr. Police Chief Fire Chief Mayor/City Council Date of consideration: Approved with restrictions or conditions: Reason for denial: Date mailed to applicant: 403 Butler Avenue, P.O. Box 2749,Tybee Island, Georgia 31328-2749 (912) 786-4573 FAX(912) 786-5832 www.cityoftvbee.org The CONSENT FORM is required for ALL alcohol license applications. CONSENT FORM I HEREBY AUTHORIZE THE TYBEE ISLAND POLICE DEPARTMENT TO REQUEST ANY CRIMINAL BACKGROUND HISTORY RECORD INFORMATION PERTAINING TO ME WHICH MAY BE IN THE FILES OF ANY STATE OR LOCAL CRIMINAL JUSTICE AGENCY. BE IT FURTHER UNDERSTOOD THAT THE PURPOSE OF OBTAINING THIS INFORMATION IS TO SATISFY THE REQUIREMENTS SET FORTH BY THE MAYOR AND COUNCIL OF THE CITY OF TYBEE 7.-)0/Q00 ISLAND,REGARDING AN ALCOHOL BEVERAGE LICENSE APPLICATION. /-99-77 ,19 C BIRTH OF k E FULL NAME(PRINT) ,_q/J ' S 7 - — ADDRFcS SOCIAL SECURITY NUMBER 73.,"9-Li A-4). J4/ c 3/9/05--- CITY,STATE,ZIP SIGNATURE I DATE 4 The ACKNOWLEDGEMENT is required for all LIQUOR BY THE DRINK alcohol license applications. ACKNOWLEDGEMENT I declare knowledge and understanding of Municipal Code Section 58-80: There is levied an excise tax on the sale of distilled spirits by the drink in the amount of three percent of the charge to the public for the beverage. t r r, , ,.4. .......Agfr --' 1/ 3 0/// SIGNATURE 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 COUNTY OF CHATHAM CITY OF TYKE ISLAND AFFIDAVIT I, j 4 ; L ?-)uur rI C , 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 be P :LS CC C ..1146-4'i ,Tybee Island, Georgia. I am the,f ,9-yl, / ,r\ of the establishment known as x !ui i9-6 ,�r7r3• 5 7 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. s IGNATURE DATE Approved Denied ----7)._i tel of Police Date It 0 14r H .f,: , . File