Liquor License Local Consent Application Utah County

Transcription

1 It is the applicant s responsibility to complete all Applicant sections and to receive approval from the Sheriff s office prior to submitting this application to our office for approval. It is also the applicant s responsibility to contact the Alcoholic Beverage Compliance Division for approval. TO THE BOARD OF COUNTY COMMISSIONERS OF UTAH COUNTY, UTAH: Pursuant to the Laws of the of Utah and the Ordinances of, the undersigned hereby makes application for local consent for the following: Restaurant Airport Lounge Private Club Banquet to sell liquor in outside the limits of incorporated cities and towns and herewith submits the following information which is hereby certified to be true: Person or Entity Requesting License Description of business or activity from which liquor will be City Zip Phone ( ) ( ) dispensed: Name of Business Business Address Mailing Address City Zip Phone ( ) ( ) List management and ownership information: (If partnership list all partners, if corporation list all shareholders owning 20% or more of the outstanding shares, all officers and all directors; if any other legal entity list all officers, members, managers, partners, directors and all owners holding 20% or more ownership interest in such legal entity. Each listed person must also complete a separate Applicant s Section II. Attach additional sheets if necessary). Manager/Operator Page 1 of 6

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3 Applicant s Section II Under penalty of perjury, the undersigned personally certifies, represents, and warrants to as follows: That I am of good moral character and have never been convicted of, pleaded guilty to, pleaded no contest to, nor forfeited bail on any of the following: any felony under or Federal Law, any violation of any or Federal law or local ordinance relating to the sale, manufacture, distribution, warehousing, adulteration, or transportation of alcoholic beverages, intoxicating liquors, drunken driving, driving under the influence, driving while intoxicated, keeping a gambling or disorderly house, or any crime involving moral turpitude. That I am not a member of any partnership, corporation, or legal entity, of which any partner, member, director, manager or officer lacks any such qualifications. I have complied with the requirements, and possess the qualifications specified in Code Chapter 3 and the Utah Alcoholic Beverage Control Act, for the type of license requested. I agree that if a license is issued that it shall be subject to revocation as provided in the above ordinances. Respectfully Submitted, COUNTY OF UTAH) STATE OF UTAH) Signature being first duly sworn on oath, deposes and says: That he/she is the applicant above named, that he/she has read the foregoing application for local consent for the following license: Restaurant Airport Lounge Private Club Banquet approval to sell liquor; that he/she knows the contents thereof; and that the statements contained therein are true. Subscribed and sworn to before me this day of A.D., 20. My Commission Expires: Residing at: Notary Public Page 3 of 6

4 Applicant s Section III The following information must be provided to the Board of County Commissioners for their consideration in granting local consent. NOTE: The Board of County Commissioners may have additional factors or circumstances that will need to be addressed prior to or during the County Commission meeting. Attach additional pages, if necessary. 1. Condition of the premises for which the consent is requested: 2. Square footage of the premises: 3. Parking availability (number of spaces): 4. Type of tourist traffic you expect: 5. Location, number of, and mileage from other state store, package agencies and outlets: 6. Demographics and estimated population to be served: 7. Premises cannot be located closer than the minimum proximity requirement to the property boundary of a school, church, library, playground or park. (200 feet to be measured in a straight line from the nearest entrance of the proposed outlet to the nearest property boundary and 600 feet to be measured from the nearest entrance of the outlet by following the shortest route of either ordinary pedestrian traffic, or where applicable, vehicular travel along public thoroughfares, which ever is the closer.) Do you comply with this requirement: Are any of such facilities located within 1,000 feet from the premises: If yes, describe the location and distance to such facilities: 8. Applicants qualifications to manage and operate a facility with a liquor license, including but not limited to management experience, past retail liquor experience, and the type of management scheme employed by the applicant: 9. What is the nature or type of facility or operations, including but not limited to, the type of menu items offered and emphasized, whether the facility emphasizes service to an adult clientele or to minors: 10. Hours and days of operation? 11. Seating capacity of the facility? 12. Gross sales of food items? 13. Attach a copy of all documents submitted or to be submitted to the Alcoholic Beverage Control Commission. Page 4 of 6

5 UTAH COUNTY SHERIFF DEPARTMENT SECTION Approved This is to certify that I have personally examined the above and forgoing Application for consent to sell liquor, and I have no information which would indicate that the statements therein contained are not true; and I know of no reason why the License applied for should not be granted. Sheriff of By Deputy Sheriff Disapproved This is to certify that I have personally examined the above and foregoing Application for consent to sell liquor, and disapprove for the following reasons: Sheriff of By Deputy Sheriff UTAH COUNTY COMMISSION SECTION ACTION ON APPLICATION FOR LOCAL CONSENT: Comments/Conditions/Reasons for Approval or Disapproval: Approved Disapproved By: Chairman Commission Date: Page 5 of 6

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