G:\Zoning 2009\Forms and Sample documents\Website Documents\BTR\Affidavits\ café_aff Modified: 10.23.2012
City of Pompano Beach
Department of Development Services
Business Tax Receipt Division
100 W. Atlantic Blvd Pompano Beach, FL 33060
Cafe Affidavit
Phone: 954.786.4668 / 954.786.4633 Fax: 954.786.4666
State of Florida}
County of Broward}
I _______________________________ am the __________________________ of the proposed CAFE known as
(Print Name) (Title)
_______________________________ to be located at ______________________________________ in the City of
(Business Name) (Address)
Pompano Beach, Florida.
I hereby acknowledge that I have been given a copy of, understand and will abide by the provisions of Section
155.003 of the City of Pompano Beach Code of Ordinance which limits a CAFÉ to an establishment within an
enclosed building where the principal business is the serving of meals, meals are actually and regularly served to
patrons seated at tables, and the sale of only beer or wine is strictly incidental to the serving of food.
I also acknowledge that I have been given a copy of, understand and will abide by the provisions of section 155.069
(D) (4), of the City of Pompano Beach Code of Ordinance which provides that if my CAFÉ is located within 500
feet of a church or school there will be no window display or any sign indicating the sale of beer or wine visible
from the exterior of the building.
Signature: ________________________________
SWORN TO AND SUBSCRIBED before me this
____ day of _______________ 20 ____, in Pompano Beach, Broward County, Florida.
_____
_______________________________
Notary Public Notary Public, State of Florida
Seal of Office
___________________________________
(Print Name of Notary Public)
_______ Personally Known
_______ Produced Identification
Type of identification produced:
___________________________________
