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1 CITY OF JEROME ALCOHOL BEVERAGE CATERING PERMIT NO. ALCOHOL BEVERAGE LICENSEE FEE $ (Corporation, partnership or individual listed on the state license) ADDRESS CITY COUNTY TELEPHONE NO. OF LICENSEE TELEPHONE NO. OF SPONSOR STATE OF IDAHO LIQUOR BEER WINE BY THE DRINK LICENSE # YEAR Estimated number of attendees: PERMIT TO BE USED , HOURS M to M LOCATION Address where alcohol is to be served, and if public building, rooms in which it is to be served DESCRIPTION OF EVENT Festival or Convention, Dance, charity event, family event (wedding, birthday, etc.) SPONSORED BY Name of organization, group or individuals This sponsored event will be open to the named organization, group or persons and guests for a period of days, not to exceed five consecutive days for a festival or convention or two consecutive days for a party etc. at a fee of twenty dollars ($20.00) per day. Signature of Alcohol Beverage Licensee Unless licensee is disqualified, approval of this permit does certify that the licensee is entitled to hold and use this Idaho Alcohol Beverage Catering Permit at the above designated premises, subject to provisions of Title 23-934(a) and Idaho Code APPROVED DENIED DATE APPROVED: CITY CLERK OR DESIGNEE Original to the licensee Copies to the City Clerk, Chief of Police, Fire Chief, and Director of Idaho ABC