CITY OF INDEPENDENCE, MISSOURI

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CITY OF INDEPENDENCE, MISSOURI APPLICATION PROCEDURES EXPANSION OF LICENSED PREMISES OR TRANSFER TO NEW LOCATION 1. APPLICATION - (form furnished) - To be completed by sole owner, principal managing partner if business ownership is a partnership, or by the Managing Officer if business ownership is a corporation or an LLC. Answer all questions in full. To be filed in duplicate by applicant. An original signature and notarization is required on each copy. 2. FEE - If making payment, other than by credit card, a bank draft, money order, certified check, or cashier's check payable to the City of Independence is required in the amount of $35.00 plus $10.00 for each duplicate liquor license to be reissued. 3. COPY OF LEASE AGREEMENT - The lease agreement must be executed to the sole owner, all partners if business ownership is a partnership, or to the corporation or LLC if the business ownership is either a corporation or LLC. The lease agreement must reflect the lease term, monthly rental, options to renew, if any, and special conditions. Any assignment of lease must bear written approval of lessor. If the property is being purchased, or is owned by the applicant, a copy of the warranty deed or deed of trust, in the name of the sole owner, all partners if business ownership is a partnership, or in the name of the corporation or LLC if business ownership is a corporation or LLC. If the property is being purchased by an individual, a lease agreement must be executed from the individual to all partners of the partnership if the business ownership is a partnership, or to the corporation or LLC if the business ownership is a corporation or LLC. 4. PHOTOGRAPHS - A recent photograph of the exterior of the premises. 5. DIAGRAM OF PREMISES - Five copies of drawings of the floor plan of the premises with specifications of all fixtures contained therein. All drawings or plans shall be on no larger than 8-1/2" by 14". 6. CERTIFIED SURVEY (example provided) Five copies of a survey of the subject property must be provided from a registered engineer or land surveyor which shall show the dimensions and location of the proposed licensed premises. The distances from the proposed structure to the property lines, curb cuts and number of parking spaces available must also be shown. The survey shall also show all surrounding properties with property lines and property use within 185 feet and 300 feet, measured separately. The location of all and any residential or commercial structures must be indicated along with their use. If the use is health or medical related use must clearly indicate the type of service provided. The survey must also indicate any parks, playgrounds, libraries or museums. If there is a hospital, school, church, or other building regularly used as a place of religious worship within 100-300 feet of the premises proposed for transfer or expansion, no license shall be issued unless approval is granted by a two thirds majority of the City Council. However, in the event a school, church or other building regularly used as a place of worship is within 100 feet of the proposed premises a license will not be issued. All other licenses shall be issued upon approval by the majority of the City Council. Zoning of all properties/lots must be shown on this survey. You may contact Anne Verhulst for this zoning information. Her office is located on the second floor of City Hall and phone number of (816) 325-7411. Surveys shall be no larger than 8'1/2" by 14". 7. PROPERTY OWNER LIST - A list of the names and addresses of all property owners within the 185 feet and

300 feet of the premises must be provided at time of application. All properties must be identified on the survey through an alpha system with letters coinciding with the property owner list. NOTE: Item 7 may be obtained from the Jackson County Division of Assessment. There are also some title companies or survey companies who will obtain the lists for a fee. The list must be accompanied by the survey referred to in Item 6. The completed application will take approximately six to eight weeks to process. After review by the City staff, the application will be forwarded to the City Council for consideration. A City approval letter will be mailed for the applicant to submit with their application for transfer or expansion of licensed premises to the State of Missouri Division of Liquor Control. The City of Independence Liquor License will be mailed. CITY OFFICE STATE OFFICE COUNTY OFFICE Independence License Division Division of Liquor Control Jackson County Collections 111 East Maple 615 East 13th Street Liquor/Amusement Section Independence, Missouri Kansas City, Missouri 306 West Kansas Telephone: 816-325-7079 Telephone: 816-889-2574 Independence, Missouri Telephone: 816-881-4403

LICENSE DIVISION CITY OF INDEPENDENCE 111 East Maple Independence, MO 64050 (816) 325-7079 Date APPLICATION FOR EXPANSION OF LICENSED PREMISES APPLICATION FOR TRANSFER OF LICENSED PREMISES The undersigned (individual owner) (partnership) (corporation) (LLC) hereby makes application for: Select One: [ ] An expansion of licensed premises [ ] A transfer of licensed premises 1. Licensed Business Name 2. Current Business Address 3. Applicant s or Individual Owner s Name 4. Address 5. If corporation or LLC, corporate or LLC name and address 6. If partnership, names and addresses of partners 7. Total dimensions of proposed expanded area in which alcoholic beverages will be served or dispensed: 8. If application is for transfer to a new location: Street Address and legal description of proposed new location: Name and address of property owner: Name and address of any person having a leasehold or interest therein as landlord or tenant I, or we, (please print) Of lawful age, and duly sworn upon my (our) oath, swear that the answers and information given in this application are true and complete to the best of my (our) knowledge and belief. Subscribed and sworn to before me this day of, 20 My commission Expires: Notary Public