THIRD SCHEDULE
[Section 11 (1) and 18 (1)]
LIQUOR LICENSE APPLICATION - FORM OF NOTICE
Application for Liquor License
*
New
Renewal
Business Name
*
Trade License#
Liquor License# (for renewal)
I,
First Name
Last Name
Now residing at
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
in the town of San Pedro, do Hereby give notice that it is my intention to apply at the next licensing meeting to be holder for this district for a certificate for the issue of a
Type of License
license for the sale of liquor, in the building and appurtenances thereunto belonging situated at
Location
I have held a (if renewing)
Type of License
license before for (if renewing)
Number of years
Owner's Information
If owner is company (name of company)
Phone Number
*
Please enter a valid phone number.
Format: 000-0000.
Email
*
example@example.com
SUBMIT REQUIRED DOCUMENTS
FIRE DEPARTMENT INSPECTION
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HEALTH DEPARTMENT INSPECTION
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POLICE DEPARTMENT INSPECTION
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Newspaper Ad
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Signature
Date
-
Day
-
Month
Year
Date
Submit
Should be Empty: