Helper City Municipal Corporation
Alcoholic Beverage License Application
Class A License – Retail Beer
License
Class B License – Restaurant Beer License
Class
C License - Tavern License
Class D License – Cabaret License
Recreational
Beer License
Name of Applicant __________________________________SS#_______________________________
Age __________ DOB __________________ Phone ______________Cell Phone __________________
Currant Address ______________________________ City/State/Zip ____________________________
All addresses for the previous five (5) years _________________________________________________
____________________________________________________________________________________
Are you a
Have you ever been convicted of any felony or of any law or ordinance relating to alcoholic beverages, or drunken driving, or of keeping a gambling or disorderly house, or in the case of application for a Class C or D license, of any misdemeanor involving moral turpitude? _____ yes ______no If yes, please explain ____________________________________________________________________________________
____________________________________________________________________________________
- If the applicant is a partner ship, association or corporation the above information is required with respect to each partner, association member or corporate officer and director.
- If the establishment for which the applicant seeks a license will be managed or operated by a person other than the applicant, the manager or operator must submit an application for the purpose of a background investigation.
- Applicant for class A,B,C or D are required to submit one copy of there Criminal History, which can be obtained from the State of Utah or Helper City Police Department for Review and in accordance with section 5-2 of the Helper Municipal Code. If the applicant is a partnership, Association, or Corporation, A Criminal History is required with respect to each partner, Association Member, Corporate Officer, Director, Manager, or Operator.
- If applying for a Class A,B,C,or D License, what is the address where you wish to be licensed:
___________________________________________________________________________
___________________________________________________________________________
- If applying for a Recreational Beer License, what dates do you wish to have your license for, what is the name of the location, and what is the address of location:
Dates: ____________________________________________
Location Name: ____________________________________
Location Address:___________________________________
Is this event open to the general public? _________________
By signing below, I am stating that all Information provided above is true and correct to the best of my knowledge.
Signature: __________________________________________ Date: __________________
Applicant Signature
---------------------------------------------------------------------------------------------------------------------
Below
to be completed by
THIS AGREEMENT is
made and entered into by and between
Corporation of the State of
(Licensee Name)
hereinafter referred to as “Licensee”.
WHEREAS, City has considered the application of Licensee and approval thereof has been
granted subject to the execution of this agreement by licensee;
NOW THEREFORE, City hereby grants a ______________________________ license to the licensee. By signing below, licensee agrees to abide by all of
the ordinances of
violation of any provisions of
----------------------------------------------------------
Recreational Beer License Information below
The Recreational beer license herein granted shall be effective and valid only for the date of _____________________, 20___, or from the
period of ___________________, 20___, to ________________________, 20___.
Licensee shall be entitled to sell beer under the authority of this license only at ____________________________________ between
the hours of __________________ & __________________ on the day or dates set forth above for the purpose of
_________________________________________________.
-------------------------------------------------------------------
1. City acknowledges receipt of the appropriate fee as consideration for execution of this
Agreement and the issuance of the Beer License.
2. Licensee will not permit the beer to be sold, dispensed, or served by anyone under 21 years of Age, or served by anyone under 21 years of age except as provided by State Law.
3. All licenses required hereunder shall be in addition to any business or other license required by State Law or Helper City Ordinance.
4. Recreational Beer Licenses: No person under the age of twenty-one (21) years of age may sell or serve beer. All sales and deliveries under this license shall be made directly to the consumer.
5.
Licensee and its agents shall in all respects comply
with the provisions of the Alcoholic Beverage Control Act as set forth in Title
32A of Utah Code Annotated and shall hold
By signing below, I am stating that all Information provided above is true and correct to the best of my knowledge.
Signature: __________________________________________ Date: __________________
Licensee Signature
Mayor of Helper: ____________________________________ Date: __________________
Chief of Police ______________________________________ Date: __________________
Approved: ____________ Denied: ___________
Attest:
City Recorder _______________________________________ Date: __________________
Licensee: When completed, please turn form into
rev: 03/05