Fillable CITY PARK ALCOHOL PERMIT APPLICATION (Lebanon Municipal Code (City of Lebanon)

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CITY PARK ALCOHOL PERMIT APPLICATION (Lebanon Municipal Code (City of Lebanon)

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The CITY PARK ALCOHOL PERMIT APPLICATION (Lebanon Municipal Code (City of Lebanon) form is 1 page long and contains:

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  • 8 check-boxes
  • 14 other fields

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File type: PDF

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CITY OF LEBANON PARK ALCOHOL PERMIT - 2020
CITY PARK ALCOHOL PERMIT APPLICATION (Lebanon Municipal Code 12.12.020
– 12.12.028)
Applicant Information
(Please print clearly):
Name of Applicant:
ODL #: (must provide to complete background check)
Name of Organization:
Daytime Phone:
Mailing Address:
Email:
City/State/Zip:
Emergency Contact Name & Number:
Event Information
Date of Event:
Times:
From: To:
Park Name & Location of Liquor Serving Area:
Describe in detail the park area in which you intend to distribute/consume alcohol (attach a diagram of the area):
Required Attachments (If Applicable):
Park Reservation Receipt (contact City Parks Reservations Line at 541-258-4917)
City Alcohol Permit Fee Receipt (paid at the same time as filing this application)
Certificate of Liability Insurance naming the City of Lebanon as additionally insured ($1 million coverage)
OLCC Liquor Application for Temporary Use or Special Event License (required for licensed OLCC customers)
I AM AT LEAST 21 YEARS OF AGE AND HAVE THE AUTHORITY TO REPRESENT THE ORGANIZATION LISTED. I
UNDERSTAND THAT I MUST SUBMIT THE REQUIRED ATTACHMENTS LISTED PRIOR TO PERMIT APPROVAL.
Applicant’s Signature Date
FOR CITY RECORDER’S OFFICE USE ONLY
Passed Background Check Police Notified Maintenance Notified Provided Permit to Post
City Recorder’s Office
925 Main Street
Lebanon, OR 97355
(541)258-4264
kscheafer@ci.lebanon.or.us
City Received
Date / /
By:
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CITY PARK ALCOHOL PERMIT APPLICATION (Lebanon Municipal Code (City of Lebanon)

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Completed 23 January 2021

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