Full Text
City of Star P.O. Box 130 Star, Idaho 83669 P: [PHONE REDACTED] [EMAIL REDACTED] Application for Beer, Wine, Liquor License Form #210 Rev 04-2025 Page 1 of 4 APPLICATION FOR BEER, WINE, LIQUOR LICENSE ☐ New License ☐ Renewal ☐ Transfer Applicant: Business Name: Business Mailing Address (if different from business address): Business Phone: Other Phone: Email Address: Owner Full Name: • I AM OR WILL BE: ☐Sole Owner ☐Partner ☐Officer ☐Director ☐Stockholder ☐Business Manager • Owner date of birth: Owner driver’s License State: On-Site Manager Name (if different from owner) • I AM OR WILL BE: : ☐Sole Owner ☐Partner ☐Officer ☐Director ☐Stockholder ☐Business Manager Building Owner LICENSE TYPE: FEES (PER YEAR): FEE: Beer consumed on premises $200.00 Beer consumed off premises $50.00 Wine consumed on premises $200.00 Wine consumed off premises $50.00 Liquor $562.50 Total Fee Due ---PAGE BREAK--- City of Star P.O. Box 130 Star, Idaho 83669 P: [PHONE REDACTED] [EMAIL REDACTED] Application for Beer, Wine, Liquor License Form #210 Rev 04-2025 Page 2 of 4 A complete application includes: Applicant Description Staff Completed and signed Liquor License Application Payment in Full Copy of any lease agreement if premises to be used are not owned by the applicant(s), partners, or members Articles of Incorporation and Bylaws Copy of State of Idaho Alcohol Beverage License Copy of Ada County Alcohol Beverage License Copy of approval letter from the Star Fire Department Proof of Insurance OFFICERS AND/OR DIRECTORS: (attach (attach (attach (use reverse side if necessary) Please answer the following questions: 1. Are the premises to be licensed located within 300 feet to the entrance from any public school, church, or other place of worship? ☐ No ☐ Yes 2. Are the premises to be licensed located within a neighborhood predominantly residential? ☐ No ☐ Yes 3. Do you now have any direct or indirect interest in any other business licensed for the sale of alcoholic beverages? ☐ No ☐ Yes If yes, please list other businesses licensed for the sale of alcoholic beverages: 4. Have you, as an individual, or partner, or while an officer, director or stockholder or a corporation application or licensee ever had an alcoholic beverage license denied, suspended, or revoked by any jurisdiction granting such license, including the state of Idaho and Ada or Canyon County? ☐ No ☐ Yes If yes, explain each event fully: ---PAGE BREAK--- City of Star P.O. Box 130 Star, Idaho 83669 P: [PHONE REDACTED] [EMAIL REDACTED] Application for Beer, Wine, Liquor License Form #210 Rev 04-2025 Page 3 of 4 5. Have you, any partner, or the manager of the premises (within the past three years) been convicted of a violation of any laws governing or prohibiting the sale of alcoholic beverages or intoxicating liquor? (If any of these events has occurred, this question must be answered “YES” regardless of subsequent court action resulting in dismissal or expungement.) ☐ No ☐ Yes If yes, please explain each event fully: Date of conviction: Place of conviction: Date of conviction: Place of conviction: 6. Have you, any partner, or the manager of the premises (within the past three years) been convicted of a violation of driving under the influence of alcoholic beverages or other intoxicating substances and/or hasn’t paid the fine or completed the sentence or parole/probation for such an offense? (If any of these events has occurred, this question must be answered “YES” regardless of subsequent court action resulting in dismissal or expungement.) ☐ No ☐ Yes If yes, please explain each event fully: Date of conviction: Place of conviction: Date of conviction: Place of conviction: 7. Have you, any partner or the manager of the premises, been convicted or received a withheld judgement for any crime relating to possession of a controlled substance? (If any of these events has occurred, this question must be answered “YES” regardless of subsequent court action resulting in dismissal or expungement.) ☐ No ☐ Yes If yes, please explain each event fully: Date of conviction: Place of conviction: Date of conviction: Place of conviction: 8. Do you, any partner or the manager of the premises, allow conduct to occur on the premises which is defined as a moral nuisance by state law or City of Star ordinance? ☐ No ☐ Yes If yes, please 9. Do you, any partner or manager of the premises, manage or operate the premises in a way to be a nuisance to surrounding businesses by reason of the conduct of employees or clientele constituting lewd, violent or disorderly behavior? ☐ No ☐ Yes If yes, please ---PAGE BREAK--- City of Star P.O. Box 130 Star, Idaho 83669 P: [PHONE REDACTED] [EMAIL REDACTED] Application for Beer, Wine, Liquor License Form #210 Rev 04-2025 Page 4 of 4 I have read all of the above and declare under penalty of perjury that each and every statement made is true, correct and complete. Applicant Signature SUBSCRIBED AND SWORN BEFORE ME this day of NOTARY PUBLIC in and for the State of Idaho Residing: Commission Expires: Date Application Received: Date License Issued: Fee Paid: Star License No: Application Complete: