HomeMy WebLinkAboutNITRO STATION BEER & WINE LICENSE APPCUSTOMER SUPPORT
REXBURG SERVICES
America's Family Community
35 North 151 East (PO Box 280) Phone: 208-359-3020 x2101
Rexburg, Idaho 83440 Fax: 208-359-3022
www.rexburg.org deborahl@rexburg.org
APPENDIX B - APPLICATION FOR RETAILER'S LICENSE TO SELL:
BEER ONLY
WINE ONLY
1p BEER AND WINE
I (or we) the undersigned, make application for a license to sell beer and/or wine, as a retailer within
the City of Rexburg, Idaho, and for the purpose represent:
The name of the business is:
Al 1 f-rd S kI
i c n
L Z- e
Address of business:
2. -% at U
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JE
Business to be conducted thereon by the
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Address of applicant: f o 5d c 3,13- Q e-ocb�► . 1'_ t� �Cdo
Phone: C, 4 4 Email: W a n a q e tom► e M f- e y'1
Length of residence in the State of Idaho: SO
I am applying for a beer and/or wine license to sell: 'W (on premises); (off premises)
Ordinance 1128.•
OA- Off premise) where the applicant applies for a license to sell as a retailer, only bottled or canned beer
and urine, none of which is consumed, or to be consumed, on the premises where sold, the license fee
shall be ,$50.00 for beer and ,$50.00 for wine per year until such fee is amended by resolution
of the Council.
B. (On premise) where the applicant applies for a license to sell beer and/or wine as a retailer for consumption
on premises:
1. Draft beer and bottled or canned beer only, the amount of the license fee shall be ,$200.00
peryear, or if
2. Bottled, boxed or canned wine only, the amount of the license fee shall be $200. 00peryear.
Note: The licenseyear be October 1 "and ends September 30`h. The fee will be prorated to (50%) for a halfyear
with applications after March 31 S1
.
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If applicant is a partnership, names, contact information and places of residence of each
partner:
Full Name:
Address:
Full Name:
Address:
City: State: City: State:
Zip: Zip:
Phone: Phone:
Email:
Email:
If applicant is a corporation or association, the date and place of incorporation or
organization, the location of its principal place of business in Idaho and the names and
places of residence of its officers, directors or members of its governing board.
Date & Place of Incorporation or organization:
Principal Place of Business in Idaho:
Names of Officers:
Name and residence of person who manages or will manage the business of selling beer at retail:
Manager Phone:
This is to certify:
Manager Email:
(a) That applicant: k i �, �- P " M c-tN is the bona fide owner of the business
which will be engaged in the sale of beer at retail and with respect to which license is sought;
(b) That the condition of the place or building wherein it is proposed to sell beer at
retail conforms to all laws and regulations of the state of Idaho and to the
ordinances of the county and municipality applicable thereto relating to public health
and safety and to the zoning ordinances of the municipality applicable thereto:
(c) That the individual applicant, or each partner of a partnership applicant, is a
citizen of the United States; or, with respect to a corporation or association, that
is qualified to do business with the state of Idaho and that the person who is or will
be the manager of the corporation's or association's business of selling beer at
retail is a citizen; further, that such individual applicant, at least one (1) of the
partners of the partnership applicant, and said manager of the corporation or
association applicant, shall have been a bona fide resident of the state of Idaho for
at least thirty (30) days prior to the date of application;
(d) That the applicant, if an individual, is not less than nineteen (19) years of age;
(e) That within three (3) years immediately preceding the date of filing the
application, the applicant has not been convicted of the violation of any law of the
State of Idaho, any other state, or of the United State, regulating, governing or,
prohibiting the sale, manufacture, transportation or possession of alcoholic beverages
or intoxicating liquors, or within said time, suffered the forfeiture of a bond for
failure to appear in answer to charges of any such violation;
(f) That within five (5) years immediately preceding the date of filing the
application, the applicant has not been convicted of any felony or paid any fine or
completed any sentence of confinement therefore within said time;
(g) That within three (3) years next, preceding the date of filing the application,
the applicant has not had any license provided for herein, or any license or permit
issued to the applicant pursuant to the law of this state or any other state, or of
the United States, to sell, manufacture, transport or possess beer, revoked.
That I will observe all requirements of the City of Rexburg relating to the hours of closing and will
not sell or dispense beer in violation of any such ordinance.
I FURTHER DECLARE that I have read the foregoing application, that I understand the same
and agree to all statements therein contained.
Signature:
Office Use On
Registration No.Lf 9
CC Approval Date q
Revised: June 26, 2024
Date: `t - 7 - Z 5—
Deborah Lovejoy, City Clerk
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