manu-rev051217
OFFICE USE ONLY
Date
Original
Amended
56
PREMISES QUESTIONNAIRE
1. Describe the area where the premises is to be located:
Residential
Business
Agricultural
1a. State what the area is zoned for:
(i.e. Residential, Business, Mixed etc.)
2. Premises
a.
Provide a description of the premises to be licensed.
Describe all buildings/structures that will be utilized
in business operations including the number of floors
of each. ( i.e. 2 story free-standing barn on slab
foundation, 2 acre farm with 2 story winery including a
basement, etc.)
b.
Has the building/premises been known by any other address?
Yes
No
If YES. please specify:
c.
Has the premises to be licensed and/or any other floor in the building been
Yes
No
previously licensed or currently licensed to traffic in alcoholic beverages?
d.
What was the prior use of premises to be licensed?
e. Does the proposed location of the business comply with all state and local regulations
and zoning codes?
Yes
No
f. Is there interior access to any other floor(s) that will not be part of the licensed
Yes
No
premises?
If YES, list floor(s) and means of access to each floor(s).
(i.e. stairs, elevator, etc. - must be shown on diagram)
List use of floor(s), (i.e. apartments, offices, etc.)
g.
Does any other person have access to this area?
Yes
No
h.
Where will the alcohol be stored? (Manufacturer with an off site location for storage area may require a warehouse permit.)
i. If applying for a Farm Winery License, Special Farm Winery, or Micro Winery, the premises must be located on a farm. In the
box below, provide a detailed description of the agricultural production that qualifies the premises as a farm.