Restaurant Caterer'S Permit - Alaska Alcoholic Beverage Control Board printable pdf download

RESTAURANT

State of Alaska

Permit No. __________________

CATERER’S

Alcoholic Beverage Control Board

PERMIT

550 W. 7

Avenue, Suite 540

Anchorage, Alaska 99501

Application Fee: $50.00

Phone: 269-0350

Fee Paid __________________

NOTICE TO APPLICANT: After approval by the appropriate law enforcement authority, send the completed form along with the

$50.00 fee to the Alcoholic Beverage Control Board. When the permit has been approved, it will be returned for posting at the event.

Name of Licensee(s)

Restaurant or Eating Place

License No.

Contact Person & Phone No.

Doing Business As

Location of Premises

Licensee’s FAX Number

Mailing Address (Street or P.O. Box, City, State and Zip Code)

The restaurant or eating place licensee named above hereby makes application under Alcoholic Beverage Control Board regulation 15

AAC 104.680 for permission to cater the event and temporary premises described below.

Event

Event To Be Held at:

(Name and location of premise to be licensed)

Purpose

Date of Event

Time of Event

I/We certify this written notice is submitted as required under 15 AAC 104.680 AND WILL BE RETURNED TO THE BOARD

WITHIN 48 HOURS AFTER THE EVENT HAS ENDED. Any person observed to be giving or selling alcoholic beverages to a

person under the age of 21 or a drunken person may be cited under AS 04 .16.030, AS 04.16.040, AS 04.16.050, AS 04.16.051, AS

04.16.052 or AS 04.16.060.

SIGNATURE OF

LICENSEE(S):

____________________________________________________________________________________________

Approved

Disapproved

By: __________________________________Date______________________

Law enforcement agency with jurisdiction over site

Reason Disapproved: _________________________________________________________________________________________

___________________________________________________________________________________________________________

This permit is only for the event on the date and at the location requested. This permit authorizes the licensee to sell or dispense beer

or wine before and during service of food provided by the licensee at a designated location for a banquet or dinner event held off the

licensee’s licensed premises. The licensee(s) is hereby notified that any violation of any Alcoholic Beverage Control Board law or

regulation will be charged against the licensee(s). This permit will be issued unless a protest is noted by the appropriate police

authority, or if the Board finds that it would not be in the best interest of the public.

Restaurant Designation

Approved for the licensees designation permit No. __________________

___________________________

_________________

Approved

Disapproved

by:

Date

Alcoholic Beverage Control Board

Reason Disapproved: ________________________________________________________________________

Menu /Food Service

Instructions: Draw a detailed plan of the premises where the event will be held in the space below; show all entrances and exits,

and all fixtures such as counters, bars, coolers, stages, etc. Include the dimensions of the Premises. Outline in red

the areas where alcoholic beverages will be sold, served and consumed.

Rev. 12/26/00

Restaurant Caterer'S Permit - Alaska Alcoholic Beverage Control Board

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