Alcohol Distance Appeal Application Form December 2012
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1Request to the City Council M& C# _____________________
ALCOHOL DISTANCE APPEAL APPLICATION
(Please Print or Type)
Name of Establishment ________________________________________ Location ____________________________________________________
Legal Description __________________________________________________________
Block/Ab __________
Lot/Tr _________________
Owner of Establishment _______________________________________ Owner Signature _____________________________________________
Owner Address ________________________________________________________ City ___________________________ Zip ______________
nd
Owner Phone No _____________________ 2
Ph No _____________________ Email ______________________________________________
Name of School or Church < 300 ft / 1000 ft from the establishment _______________________________________________________________
Yes□ No□
Has the School, Church, etc. been contacted or do you know of any opposition to this request?
□
□
Is Alcohol Consumption:
or
Type of TABC License(s) ____________________________________________
ON PREMISE
OFF PREMISE
□
□
Type of Business_____________________________ Setback Measurement / Distance Requested __________ Is building leased? Yes
No
Building Owner / Lessor name ________________________________________ Lessor Signature_______________________________________
Lessor Address _____________________________________________________ City _______________________________ Zip _____________
nd
Lessors Phone No. _____________________ 2
Ph No ______________________ Email ____________________________________________
Applicant Name (if other than Owner) _______________________________________________________________________________________
Applicant Address ______________________________________________________ City ____________________________ Zip _____________
nd
Applicant Phone No. _____________________ 2
Ph No ______________________ Email ___________________________________________
ALCOHOL DISTANCE APPEAL PROCESS & REQUIREMENTS:
Building Inspector, Ken McGowen (817-392-7834), (Rejection Letter and Measurements required PRIOR TO SUBMITTING).
Processing time is approximately 4 weeks and the request will be heard at the appropriate City Council Hearing. Hearings are held
at City Hall on Tuesdays and the applicant is required to be present.
Summery of hardship and/or reason for requesting a DISTANCE APPEAL is recommended.
Staff to provide Early Notifications to surrounding HOA’s, Schools, etc., within a ¼ mile buffer of subject property.
Staff will notify all property owners, neighbors, within a 300’ buffer of subject property
(You may contact Council Members prior to the hearing to see if they approve or have received opposition for your case at
)
** At the hearing, “Speaker Request forms” must be completed and turned in to the staff desk upon addressing the City Council.
Beginning April 1, 2011, the speaker request form must be turned in fifteen (15) minutes prior to the start of the meeting, and
to register to speak before the meeting you may call 817-392-6150, fax 817-392-6196 or )**
Application Fee
Received
Date
Hearing Date
Case #
Code 124
$350.00
By: ___________
___________
________________
AA13-________
City of Fort Worth, Texas, Municipal Building, 1000 Throckmorton Street, Fort Worth, TX, 76102
Planning Department
817-392-8826 * 817-392-2561 * 817-392-8026
12-10-12
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Parent category: Legal