Application Date: _______________
Approval Date: _________________
APPLICATION FOR CITY COUNCIL APPROVAL TO SERVE ALCOHOLIC
BEVERAGES AT A SINGLE PRIVATE EVENT
NAME/ORGANIZATION________________________________________________________________________________________
ADDRE
SS ___________________________________________________________________________________________________
P
HONE NUMBERS_____________________________________________________________________________________________
DATE/TIME OF EVENT__________________________________________________________________________________________
L
OCATION OF EVENT___________________________________________________________________________________________
D
ESCRIPTION OF EVENT________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
NATURE/QUANTITY OF ALCOHOLIC BEVERAGES TO BE SERVED: BEER AND WINE ONLY
NUMBER OF ATTENDEES ANTICIPATED____________________________________________________________________________
SECURITY ARRANGEMENTS______________________________________________________________________________________
____________________________________________________________________________________________________________
PARKING ARRANGEMENTS______________________________________________________________________________________
____________________________________________________________________________________________________________
_______________________________________________
Signature of applicant
_______________________________________________
Received?
Date:____________________
Sent to City Council?
Date:____________________
Conditions for Approval, if any:_____________________________________________________________________
_______________________________________________________________________________________________
RHPD Notified? Date:____________________
Date signed by applicant
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