HomeMy Public PortalAboutDoc_2010129 docsBusiness Name L 1
04 d hfl Dads i
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Location ft in A Sire
Mailing Address a
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Phone c .6
E(lC'S 1 all 13 e x Q., yvvyj C ¢?ttn
Names and Home Addresses of Owners, Partners or Corporate Officers with T n Percent Interest in Business
Names (attach additional pages if necessary)
Date of Birth
Home Addresses
City, State, Zip
Social Security
iha iLuidi i
1,250
ag4o�,h -r it Nu
b 313Zi
2,000
150
Wholesale Beer
765
Wholesale Liquor
1,500
LICENSE CLASSIFICATION
FEE
CHECK
Retail Beer /Wine Package Sales Only, Consumption on Premises Prohibited
350
Zoning
Retail Beer /Wine Sale by Drink for Consumption on Premises Only
575
X(
Retail Liquor Sale by Package Only, Consumption on Premises Prohibited
850
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Retail Liquor Sale by Drink for Consumption on Premises Only
1,250
)C
Retail Liquor Sale by Package Drink both in One Building under One Ownership
2,000
Sunday Sales of Alcoholic Beverages
150
Wholesale Beer
765
Wholesale Liquor
1,500
Wholesale Wine
150
Distiller, Brewer, or Manufacturer of Alcoholic Beverages
300
Special Event Public or Private Property Beer, Wine (no current license) per event
50
Special Event Public or Private Property Beer, Wine (no current license) 3 days
100
Special Event Public or Private Property Beer, Wine (holding current license) per event
10
Special Event Business Property Beer, Wine, Liquor (no current license) per event
50
Special Event Business Property Beer, Wine, Liquor (no current license) 3 days
100
Special Event Business Property Beer, Wine, Liquor (holding current license) per event
10
City Manager
Zoning
416
Police
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1
1MICIIJ
City Council
CITY OF TYBEE ISLAND
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:
M Date Incorporated
Names of landlord of the business location 6 1 y Address Phone
What other business is conducted at this location? N1A-
Is business incorporated? Stat� of Inporporation
Has application been made for required State and Federal Licenses? \PS
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? iJ/
o ever served time in prison or other correctional institution?
o ever had an alcohol beverage license suspended or revoked at any time in any location?
(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 INFORM TIO IS HEREBY GIVEN AND ALL OF THE FOREGOING STATEMENTS ARE HEREBY MADE ON OATH
WILLFULLY, KNOWINGLY, AN r AB 1 LY, AND THE SAME IS AND ARE HEREBY SWORN TO ME TO BE TRUE UNDER PENALTY OF LAW.
Applicant Signature 1 Date 1 0
Sworn and •scribed
GEORGE B. B ERON
Notary Public, Chatham County, GA
1 i
My Commission Expires July
roval
Notice: The applicant
for a license shall be a
citizen of the United
States, a resident of
Chatham County, and
owner of the business
or if a corporation,
partnership or other
legal entity is the
owner, a substantial
and major stockholder
or the applicant may be
the manager of the
business charged with
the regular operation of
said business on the
premises for which the
license is issued.
Signature
Date