TEMPORARY PERMIT APPLICATION
Form 10
City Clerk’s office 303-538-7230
9500 Civic Center Drive
Thornton, Colorado 80229-4326
RETAIL LIQUOR OR FERMENTED MALT BEVERAGE
PLEASE PRINT LEGIBLY AND USE BLACK INK
Name of Applicant:
(Corporation, Limited Liability Company, Individual, Partnership)
Trade Name of Establishment (DBA):
Address of Establishment:
Type of Liquor/Beer License:
Current Licensee:
Current Trade Name:
The following conditions need to be met in order for the Temporary Permit to be processed:
¾ The establishment currently has State and Local Liquor/Beer Licenses, and such licenses were valid at the
time the Transfer of Ownership Application was filed.
¾ The applicant has filed all Transfer of Ownership information as required by State and Local Licensing
Authorities with the City Clerk’s office.
¾ The applicant submitted the Temporary Permit Application within 30 days of filing the Transfer of Ownership
Application.
¾ The applicant submitted the $100.00 Temporary Permit fee to the City of Thornton.
¾ The applicant acknowledges the responsibility of having knowledge of the pertinent Colorado State Statutes
and Regulations as set forth in Title 12, Articles 46 and 47, C.R.S., as amended, and Chapter 42, Article II of
the Thornton City Code, as amended.
¾ The applicant understands that this permit, if granted, shall be valid for 120 days or until the Transfer of
Ownership has been granted, and the State and Local Liquor or Fermented Malt Beverage Licenses have
been issued, or the application has been denied, whichever comes first. If the license has not been granted
within this time period it is the responsibility of the applicant to apply for an extension of the temporary permit.
Signature of Applicant: Date Signed:
FOR OFFICE USE ONLY
Date Transfer Application accepted: Date Temporary Permit Application submitted:
(authority/city liquor forms/form 10/9.2004)
