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HomeMy Public PortalAboutDoc_2010129 chus 102LICENSE CLASSIFICATION FEE CHECK Retail Beer /Wine Package Sales Only, Consumption on Premises Prohibited 350 J f Retail Beer /Wine Sale by Drink for Consumption on Premises Only 575 f /r y f Retail Liquor Sale by Package Only, Consumption on Premises Prohibited 850 Names and Home Addresses of Owners, Partners or Corporate Officers with Ten Percent (10 Interest in Business Retail Liquor Sale by Drink for Consumption on Premises Only 1,250 Home Addresses Retail Liquor Sale by Package Drink both in One Building under One Ownership 2,000 Social Security Sunday Sales of Alcoholic Beverages 150 Wholesale Beer 765 Wholesale Liquor 1,500 ,-1G k-C 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 U 1 Location j4 3 2 Zoning t� J f Police Mailing Address C 0 C f /r y f City Council itC Business Name l6 /�'/16,� 41r--- /t C W L.__� U 1 Location j4 3 2 A t� J f Mailing Address C 0 C it 6 Phone 0 -7 fi b -9---(ie Q 3 Email Names and Home Addresses of Owners, Partners or Corporate Officers with Ten Percent (10 Interest in Business Names (attach additional pages if neces sry) Date of Birth Home Addresses City, State, Zip Social Security 1,1W AM 1 Ir ,-1G k-C 11 k 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: n Notary Public Is business incorporated? State of Incorporation r Date Incorpor,pted l r i Names of landlord of the busin location fY)v Lk C �1 46-- Address 3 Phone 7 t 2 7 v 7 (if What other business is conducted at this location? /V 6 h c Has application been made for required State and Federal Licenses? £4 Has applicant, any person connected with, or any person having an int1rest in this business: o ever been convicted of any violation of law other than for a traffic violation? C' 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? N Li (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? y L 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 IS AND ARE HEREBY SWORN TO ME TO BE TRUE UNDER PENALTY OF LAW. Applicant Signature Date S�florn and subscribed before me this 15 y1 day of 1V OV 1 `V 0 DIANNE OTTO Notary Public, Chatham County, GA My Commission Expires November 6, 2014 Aooroval Signature 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. Date