CITY OF NORTHPORT, ALABAMA
3500 McFarland Boulevard
Phone (205)339-7000
P.O. Box 569
Fax (205)333-3005
Northport, AL 35476
APPLICATION FOR BEER, WINE, AND LIQUOR LICENSE
Application Type:
New
Name Change (TRANSFERS NOT ALLOWED)
Legal Business Name ____________________________________________________________________
Trade Name (DBA) if different from above ___________________________________________________
Form of Ownership
Sole Proprietorship
Partnership
Corporation
LLC
Other (Specify) ____________________________________________________
Physical Address ________________________________________________________________________
(Street)
(City)
(State)
(Zip)
Mailing Address ________________________________________________________________________
(Street)
(City)
(State)
(Zip)
Telephone _____________________________________________________________________________
(Business)
(Fax)
(E-Mail)
List the Owner(s), Partners or Officers (Attach separate sheet if necessary)
Name
Residence Address
SSN
Title
Home Phone
Name and phone number for contact person ___________________________(______)________________
Brief description of business activity in Northport______________________________________________
Business located in _____ or out _____ of Northport City limits Date to open in Northport___________
If business has physical location in Northport, list name of manager _______________________________
State Sales or Use Tax Number____________________________ Federal ID Number ________________
CHECK ALCOHOLIC BEVERAGE ( ) BEER ON PREMISES ( ) BEER OFF PREMISES
( ) WHOLESALE BEER ( ) WINE ON PREMISES
( ) WINE OFF PREMISES
( ) WHOLESALE WINE ( ) LIQUOR ON PREMISE ( ) LIQUOR OFF PREMISES ( ) LOUNGE