Application for Temporary Expansion of Licensed Premises
Description
Application must be submitted to the Clerk’s Office. Upon approval, the original retail alcohol
beverage license must be brought to the Clerk’s Office to have the temporary expanded licensed
premises description added to the retail license as an addendum. Any licensee that wishes to extend
its premises onto adjacent private property shall provide written authorization from the neighboring
property owner. Any licensee that wishes to extend its premises onto City property must provide a
certificate of insurance including liquor liability and a separate additional insured endorsement
naming the City of Green Bay before any approval of this application can be granted. Any licensee
that wishes to extend its premises onto City right-of-way must submit a revocable occupancy permit
from the Department of Public Works, issued pursuant to Green Bay Municipal Code section 9.27,
along with its application.
Pursuant to Green Bay Municipal Code section 33.03(5), I am applying for a temporary expansion
of the current licensed premises description on my City-issued regular retail alcohol beverage
license, and in support thereof provide as follows:
APPLICANT INFORMATION
Are you requesting this temporary expansion of licensed premise through December 31, 2020 in
accordance with Green Bay Municipal Code section 33.03(5)? Check one: Yes No
Applicant Licensee (Name of Corporation, LLC, Partnership, Sole Proprietor, etc.):
________________________________________________________________________________
Trade Name: _________ Phone Number:_____
Address of Premises:___
Agent Name: _________ Email:______________________________
PREMISES DESCRIPTION
Description of Area to be included as part of the Temporary Expansion of Licensed Premises
Description (PLEASE INCLUDE AND ATTACH A SEPARATE ILLUSTRATION OR
DIAGRAM OF THE LAYOUT OF THE AREA):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
_____________________ ____________________
___________________________________________________________
_______________________
I have submitted the following proof that I have the right to occupy the area described above:
Lease
Deed
Written authorization from property owner
Revocable Occupancy Permit
Other:
