Fillable STATE OF KANSAS COMMON CONSUMPTION AREA PERMIT APPLICATION (Kansas Department of Revenue)

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STATE OF KANSAS COMMON CONSUMPTION AREA PERMIT APPLICATION (Kansas Department of Revenue)

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  • 23 other fields

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A
LCOHOLIC BEVERAGE CONTROL
109 SW 9
th
STREET
P.O. BOX 3506
T
OPEKA KS 66601-3506
STATE OF KANSAS
DEPARTMENT OF REVENUE
P
HONE: 785-296-7015
F
AX: 785-296-7185
www.ksrevenue.org/abc.html
ABC-836 (Rev. 07/18)
Page 1 of 1
COMMON CONSUMPTION AREA PERMIT APPLICATION AND AGREEMENT INSTRUCTIONS
WHO CAN APPLY FOR THIS PERMIT?
Any Kansas resident, city, county or entity.
WHAT CAN I DO WITH THIS PERMIT?
A permitted Common Consumption Area allows for possession and consumption of alcoholic liquor in accordance with the ordinance or resolution.
REQUIREMENTS TO OBTAIN A KANSAS COMMON CONSUMPTION AREA PERMIT
A. Common Consumption Area Permit Application and Agreement (ABC-836).
B. $100.00 C
ommon Consumption Area Permit Fee.
C. A copy of the ordinance or resolution authorizing the Common Consumption Area.
INSTRUCTIONS TO COMPLETE THE COMMON CONSUMPTION AREA PERMIT APPLICATION AND AGREEMENT (ABC-836):
1. Permit Type
a. New Pe
rmit. Check the “New Permit” box if you do not have a Kansas Common Consumption Area Permit or if your Kansas Common Consumption
Area Permit has been expired for more than 30 days.
b. Renew Permit. Check the “Renew Permit” box to renew your current Kansas Common Consumption Area Permit.
2. Section 1. Complete the Application Information.
3. Section 2. Complete the Common Consumption Area Information.
4. Section 3. Draw a complete diagram of the premises for which you are seeking permit approval or attach your drawing to the ABC-836 form, provided it
is not larger than 8½” X 11”.
a. The are you are seeking permit approval for must comply with the ordinance or resolution.
b. The diagram must include the physical barriers or line of demarcation of the Common Consumption Area boundary.
5. Sign and date the Common Consumption Area Permit Application and Agreement form, print your name and title.
6. Complete the attached Common Consumption Area Permit Voucher.
a. New Permit. Check the “New Permit” box, enter the name as it appears on the Common Consumption Area Permit Application and Agreement and
check the box to indicate your $100 Permit Fee is attached.
b. To Renew Permit. Check the “Renew Permit” box, enter your Common Consumption Area Name, Common Consumption Area Permit Number and
check the box to indicate your $100 Permit Fee is attached.
7. Make your check payable to the “Kansas Department of Revenue”.
8. R
eturn the original completed Common Consumption Area Permit Agreement, a copy of the ordinance or resolution, the Request to Participate in a
Common Consumption Area (ABC-838) and $100 Common Consumption Area Permit Fee to the ABC Licensing Unit.
Al
l approved Common Consumption Area Permits are posted to the ABC Active Liquor Licensee Database on the ABC website. To view your permit
information, go to: http://www.kdor.ks.gov/apps/liquorlicensee/Active.aspx
You may direct your questions to the Licensing Unit at 785-296-7015 or e-mail to KDOR_ABC.Licensing@ks.gov
S
TATE
OF
K
ANSAS
A
LCOHOLIC BEVERAGE CONTROL
109 SW 9
th
STREET
P.O. BOX 3506
T
OPEKA KS 66601-3506
D
EPARTMENT OF REVENUE
PHONE: 785-296-7015
FAX: 785-296-7185
www.ksrevenue.org/abc.html
ABC-836 (Rev. 07/18)
Page 2 of 3
COMMON CONSUMPTION AREA PERMIT APPLICATION AND AGREEMENT
☐New Permit ☐Renew Permit
SECTION 1 – APPLICATION INFORMATION:
Entity Type:
☐Corporation ☐In
dividual ☐Organization ☐Partnership ☐Other:
Organization Name or Individual Applicant Name FEIN/SSN
Applicant Contact Person Phone Number E-mail Address
Applicant Mailing Address City County State Zip Code
Individual Only – Home Street Address City County
State
KS
Zip Code
SECTION 2 – COMMON CONSUMPTION AREA INFORMATION:
☐I have attached a copy of the ordinance or resolution.
Common Consumption Area DBA Name
Common Consumption Area Location Address
City
County State
KS
Zip Code
The above named applicant or organization, does hereby make application for a Common Consumption Area Permit to allow possession and consumption of alcoholic
beverages in the designated area. In making this application, the above named Common Consumption Area Permit holder agrees that:
a. I
t is liable for violations that occur within the boundaries of the Common Consumption Area. However, licensees within a Common Consumption Area shall be
liable for violations of all liquor laws governing the sale and consumption of alcoholic liquor that occurs on the licensee’s premises.
b. It will not allow any person to remove any open container of alcoholic liquor from the boundaries of the Common Consumption Area.
c. It will abide by all the provisions of the Kansas Liquor Control Act and the Rules and Regulations promulgated thereunder.
d. It will abide by all the provisions of the ordinance or resolution.
e. It will display the Common Consumption Area Permit on the permitted premises.
S
TATE
OF
K
ANSAS
A
LCOHOLIC BEVERAGE CONTROL
109 SW 9
th
STREET
P.O. BOX 3506
T
OPEKA KS 66601-3506
D
EPARTMENT OF REVENUE
PHONE: 785-296-7015
F
AX: 785-296-7185
www.ksrevenue.org/abc.html
ABC-836 (Rev. 07/18)
Page 3 of 3
SECTION 3 – COMMON CONSUMPTION AREA DIAGRAM:
Check the appropriate box then in the space below, in ink, draw a sketch of the boundaries for the proposed permitted area where alcoholic liquor will be
possessed and consumed. Architectural drawings are not accepted.
Check one: ☐Diagram drawn ☐8½” X 11” drawing attached
Under penalties of perjury, I declare the information contained in this document a true, accurate and complete disclosure of information.
Authorized Signature Date
Printed Name Printed Title
ABC OFFICE USE ONLY:
☐ $100 Permit Fee Received Date by
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STATE OF KANSAS COMMON CONSUMPTION AREA PERMIT APPLICATION (Kansas Department of Revenue)

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Completed 24 August 2020

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