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www.ci.belgrade.mt.us APPLICATION FOR CITY LIQUOR LICENSE 2022 BUSINESS NAME: MAILING ADDRESS: NAME OF APPLICANT: PHYSICAL ADDRESS (If different than above): BUSINESS PHONE: HOME PHONE: EMAIL ADDRESS: DESCRIPTION - EXACT NATURE OF BUSINESS: OPERATING HOURS: NO. OF EMPLOYEES: ANTICIPATED IMPACT ON TRAFFIC FLOW: TYPE OF SIGNS OR LIGHTS TO BE USED AT BUSINESS LOCATION: CONTRACTOR’S OR STATE LICENSE#: BONDING COMPANY: BUSINESS REFERENCES AND PHONE NUMBERS: 1. PHONE: 2. PHONE: 3. PHONE: EMERGENCY CALL OUT INFORMATION: 1. PHONE: 2. PHONE: ADDITIONAL INFORMATION: (ie-where is equipment stored) ATTACHED HERETO IS MY NON-REFUNDABLE CHECK/CASH IN THE AMOUNT OF $100.00 IN PAYMENT FOR LICENSE FEE. THIS APPLICATION FOR MY BUSINESS LICENSE IS MADE SUBJECT TO ALL THE TERMS AND CONDITIONS OF ORDINANCE 685 AND AMENDMENTS OF THE CITY OF BELGRADE. THIS LICENSE IS NOT TRANSFERABLE. ALL LICENSES EXPIRE ON DECEMBER 31 OF EACH YEAR. SIGNATURE OF APPLICANT DATE For Office Use Only: Police Zone Fire Mar. City Mgr Rec # Date PD Lic # Date Issued SIGN