Full Text
Pickens County Beer & Wine Board 1266 East Church Street, Suite 136 Jasper, GA 30143 [PHONE REDACTED] ALCOHOL SPECIAL EVENT LICENSE $100 fee must be paid at time of submittal NOTE: Applicant or representative needs to attend Beer & Wine Board meeting to review this application. Organization/Business/Individual Name: Type of Entity: ☐ Non-Profit (Please Include a copy of 501(c)(3)) ☐ For-Profit Organization ☐ Business ☐ Private Event Mailing Address: Type of Event/Description: Location and parking plan: Provide documentation that applicant has access to property (deed, lease, sublease, agreement, etc.) Date of Event: Event Start Time: Event End Time: Products to Be Poured/Served/Sold: ☐ Beer ☐ Wine ☐ Distilled Spirits Name of Person Responsible for the Event: Address: Contact Number: Alternate Number: Does the Special Event location comply with the distance requirements from a church or school per Section 6-44 of the Pickens County Code of Ordinances (600 ft from front of structure/area to church or school? ☐ YES ☐ NO I hereby certify that I have read and examined this application and know the same to be true and correct. As an authorized representative of the above organization, I agree to release, indemnify and hold harmless Pickens County from any liability for personal injury or property damage sustained by any person in connection with the activities for which this permit is issued. The applicant agrees to comply with all federal, state and local laws, rules and regulations. Applicant’s Name: (Print) Applicant’s Signature: Date: Date of review by Pickens County Beer & Wine Board: ☐APPROVED ☐DENIED