Application for Entertainment Permit
City Clerk’s Office
Restaurant/Bar/Cabaret Information
Restaurant/Bar/Cabaret Date _____________________________________
Licensee Name _________________________________________________
Licensee Phone ____________________ Email _______________________
Street Address __________________________________________________
Town/City ______________________________________________________
Brief Description of Entertainment Type Requested:
_______________________________________________________________
Day(s)/Time(s) Entertainment Will be Presented
_______________________________________________________________
Print Name ______________________________________________
Signature _____________________________________ Date ______
The Winooski Liquor Control Board Approved Denied
this application at their meeting on ____ /_____ /_____
In consideration of the activity noted above, no musical instrument, phonograph, sound-making
device or sound producing system or vocal activity shall exceed 100 decibels. Violation of this
Section may result in suspension of this permit. Licensees will not permit exhibitions of nudity for
the purposes of private or public entertainment upon the premises of licensed establishments. All
music, which is amplified for the purposes of patron dancing, will cease at 0200 hours. All forms
of approved entertainment will cease at 0200 hours. The applicant shall pay an annual fee based
upon the number of days per week he/she/it seeks entertainment. A fee of $25.00 per day for
each day of the week entertainment is sought shall be paid to the City Clerk upon the granting of
a permit, who shall promptly issue said permit.
Signed __________________________________________ /_____ /_____
Winooski City Clerk Date