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2. The application fee is $10.
4. Name of Applicant
6. Business Name
7. Type of Business
9. Business Address
11. City
12. State
13. Zip Code
15. Phone Number
16. Email Address
18. Dates & Hours of Sale
    Dates & Hours of Sale Start Date

    Dates & Hours of Sale Start Time

    —

    Dates & Hours of Sale End Date

    Dates & Hours of Sale End Time
20. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
22. Electronic Signature
28. CC: Matthew J. Hintze, Chief of Police; Brian Ribarro, Construction Code Official/Zoning Officer
32. 
Leave This Blank:


34. 1. Receive an email copy of this form.
35. Email address

    This field is not part of the form submission.

36. Submit

* indicates a required field