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CITY OF DOUGLAS ONE DAY CATERING PERMIT APPLICATION Issued to Retail Liquor License holders only for the sale of liquor at a location other than the licensed premise. Please submit your application to the City Clerk a minimum of 14 calendar days prior to your event to ensure adequate time for processing and mailing. Required permit fees are non-refundable, even if a permit is not approved; deposit fees, if required, are refundable. INFORMATION REGARDING APPLICANT: Name of Retail Liquor Licensee and D/B/A: Name of Primary Contact Person: Address: City: Business Phone Number: Cell Phone Number: INFORMATION REGARDING EVENT: Type of event to be held: Number of people: Date permit will be used: Hours of permit: Location/address of event premise: Define Boundaries of permit area (attach map and diagram showing enclosed consumption and dispensing areas: Security/control/supervision measures to be used in addition to required wristbands (e.g. ID scanner; other means to check IDs; monitoring in place; limited number of entrance/exits; clear cups; etc.): ATTENTION: Any violations of the requirements of this permit may be considered by City Council in any subsequent Show Cause Hearing or Renewal Hearing as well as at time of annual retail liquor license renewal. Any person, organization, or licensee who is issued a permit hereunder, shall by operation of the issuance of the permit, indemnify and hold the City, its employees, agents and representatives, including members of the City Council in their representative capacities, harmless from any liability, loss or damage which may be incurred as a result of claims, demands, costs, or judgments arising out of, connected with, or concerning the issuance, use or existence of the permit. SIGNATURE OF APPLICANT DATE OF APPLICATION FOR OFFICE USE ONLY Permit fee paid - $25 (check # or cash) Receipt Date received: Date of approval: License # Issued: Deposit fee - $100 (check # or cash): (Required if using City property) Condition of location (verified w/Parks) – Date/verified by: Deposit return date: Manner of return/returned by: ---PAGE BREAK--- STAFF COMMENTS & APPROVALS CITY ADMINISTRATOR ADMINISTRATIVE SERVICES DIRECTOR CITY CLERK CHIEF OF POLICE PUBLIC WORKS DIRECTOR COMMUNITY DEVELOPMENT/PLANNING DIRECTOR