Full Text
Form #3-B Revised 2.08.26 1 I Page Dawson County Alcohol Licensing 25 Justice Way, Suite 2222 I [PHONE REDACTED] I For-Profit Temporary/Special Event Alcohol Permit **Please submit the completed application and payment no earlier than 30 days prior to the event, and no later than 30 calendar days prior to your event date. Failure to submit within the timeline may result in the denial of application. This application is required when alcoholic beverages will be sold, served, furnished, or distributed by a business, event venue, caterer, or their agents during a special event. The maximum time limit for each temporary special event alcohol permit shall be a maximum three-day event. The maximum number of temporary special event alcohol permits that may be issued per parcel shall be 12 per calendar year with the following exception: there shall not be a maximum number of temporary special event alcohol permits on the property of an events center meeting the requirements of Dawson County Land Use (Chapter 121) for event centers. • The special event must receive approval from the Dawson County Sheriff's Office on crowd control, security measures, and traffic control measures. • The premises at which the special event is to take place must be within a commercial zone and approved by the County Manager. If the proposed location is NOT within a commercial zone or considered an approved Event Center, the approval must be obtained from the Board of Commissioners. • The premises where the special event shall occur must meet the distance from certain uses requirements of this ordinance. • Any employee or volunteer of the special event permit holder, working the special event in any position dispensing, selling, serving, taking orders or mixing alcoholic beverages shall be required to obtain an employee permit for the special event. Employees or volunteers dispensing or mixing alcoholic beverages must be 21 years of age or older. Employees of caterers must comply with the regulations established in this article of this chapter and must be 21 years of age. • The Sheriff, Alcohol Administrator, or Code Compliance staff may immediately revoke any temporary permit for a special event if alcohol sales may endanger the health, welfare, or safety of the public. • As a condition on the issuance of a temporary Special Event Alcohol Permit, the permit holder shall indemnify and hold Dawson County harmless from claims, demand, or cause of action that may arise from activities associated with the special event. • The Alcohol Administrator shall issue the temporary Special Event Alcohol permit to the applicant upon compliance with the terms hereof. • In the event that a Special Event Alcohol Permit is denied by the Alcohol Administrator, the applicant may appeal the decision to the Board of Commissioners. Submit copies of the following documentation with the application: (please check-off as completed) SECTION 1 — SPECIAL EVENT CLASSIFICATION (REQUIRED) Select the description that best matches the event location: ☐ Existing Alcohol Licensed Establishment Event ☐ Approved Event Center (Chapter 121 Land Use) ☐ Temporary Event at Non-Licensed Location (festival, fundraiser, outdoor event, etc.) ---PAGE BREAK--- For Profit Special Event Temporary Permit: Form #3-B Revised 2.08.26 2 I Page SECTION 2 — EVENT INFORMATION 1. Event Name/Type: 2. Event Sponsor/Host: 3. Event Location Address: 4. Dates of Event: 5. Hours alcohol will be served each day: 6. Estimated Attendance (best estimate): persons (Attendance estimates must be reasonably accurate. Significant deviation may result in permit suspension or denial of future permits.) 7. Will tickets be sold? ☐ Yes ☐ No 8. Indoor / Outdoor / Both: ☐ Indoor ☐ Outdoor ☐ Both 9. Alcohol Types: ☐ Beer ☐ Wine ☐ Liquor SECTION 3 — ALCOHOL SERVICE OPERATOR 1. Who will furnish and serve alcoholic beverages? (Select ONE) ☐ Venue Operator ☐ Licensed Caterer ☐ Event Organizer 2. Business Name: 3. Responsible Manager On-Site: 4. Phone: Email: 5. Georgia Alcohol License 6. Local Alcohol License (issuing jurisdiction): 7. Expiration Date: 8. Certificate of Insurance Attached: ☐ Yes ☐ No SECTION 4 — LAW ENFORCEMENT REVIEW If the anticipated attendance exceeds 100 guests, the plan must include the presence of at least one off-duty Dawson County Sheriff's deputy or certified law enforcement officer for the duration of the event. An additional officer shall be required for every 100 guests thereafter two officers for 101—200 guests, three officers for 201—300 guests, etc.), unless the sheriff's office determines otherwise based on the nature of the event. ---PAGE BREAK--- For Profit Special Event Temporary Permit: Form #3-B Revised 2.08.26 3 I Page All security and traffic documentation must be submitted to the Dawson County Alcohol Administrator with this application. The Alcohol Administrator will coordinate review with the Dawson County Sheriff’s Office. Permit issuance is contingent upon receipt of Sheriff’s Office approval. ☐ Security Plan Attached ☐ Traffic/Parking Plan Attached ☐ Off-Duty Deputy Required (if applicable) SECTION 5 — ALCOHOL DISTANCE COMPLIANCE AFFIDAVIT (Not required for alcohol licensed locations or Events Centers) 1. Distance separation from protected uses: proposed location must be located at least six hundred (600) feet (200 yards) from the property line any church, school, daycare, or treatment facility as required under the Dawson County Alcohol Ordinance for locations that do not already hold an annual alcohol license or approved Event Center land use. The applicant shall provide a map exhibit demonstrating the event location and nearest protected uses. 2. Acceptable documentation: Google Maps printout, GIS parcel map, site plan, or survey. 3. I hereby certify that the proposed event location complies with the minimum separation requirements of the Dawson County Alcohol Ordinance. 4. Applicant Initials: Map Exhibit Attached: ☐ Yes 5. Dawson County reserves the right to require additional documentation or deny the permit if compliance cannot be reasonably verified. SECTION 6 — INDIVIDUALS SERVING ALCOHOL All individuals pouring, mixing, or serving alcohol must possess a valid Dawson County Alcohol Employee Permit unless otherwise exempted by law. If a caterer or bartending company provides staff, write 'Provided by Contractor' and attach roster and permit verification. List of Employees for Event: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: ---PAGE BREAK--- For Profit Special Event Temporary Permit: Form #3-B Revised 2.08.26 4 I Page Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: Employee Name: Date of Birth: Alcohol Permit Permit Expires: ---PAGE BREAK--- For Profit Special Event Temporary Permit: Form #3-B Revised 2.08.26 5 I Page SECTION 7 —SPECIAL EVENT ALCOHOL APPLICANT CERTIFICATION/AFFIDAVIT: NOTE: Before signing this statement, check all answers and explanations to see that you have answered all questions fully and correctly. This statement is to be executed under oath and subject to the penalties of false swearing, and it includes all attached sheets submitted herewith. STATE OF GEORGIA, DAWSON COUNTY I, DO SOLEMNLY SWEAR, SUBJECT TO THE PENALTIES OF FALSE SWEARING, THAT THE STATEMENTS AND ANSWERS MADE BY ME AS THE APPLICANT IN THE FOREGOING APPLICATION ARE TRUE AND CORRECT. APPLICANT’S SIGNATURE I HEREBY CERTIFY SIGNED HIS NAME TO THE FOREGOING APPLICATION STATING TO ME THAT HE KNEW AND UNDERSTOOD ALL STATEMENTS AND ANSWERS MADE THEREIN, AND, UNDER OATH ACTUALLY ADMINISTERED BY ME, HAS SWORN THAT SAID STATEMENTS AND ANSWERS ARE TRUE AND CORRECT. DAY NOTARY PUBLIC FOR OFFICIAL USE ONLY: DATE APPLICATION AND FEE RECEIVED: DAWSON COUNTY MANAGER APPROVAL: Dawson County Manager DAWSON COUNTY COMMUNITY DEVELOPMENT REVIEW: Dawson County Community Development Director DAWSON COUNTY SHERIFF REVIEW: Dawson County Sheriff