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Restaurant Operation Plan LIC0114 - Arizona

Restaurant Operation Plan Form. This is a Arizona form and can be used in Liquor Licenses And Control Statewide .
 Fillable pdf Last Modified 1/11/2010
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Arizona Department of Liquor Licenses and Control 800 W Washington 5th Floor Phoenix, AZ, 85007-2934 (602) 542-5141 RESTAURANT OPERATION PLAN DLLC USE ONLY LICENSE # ____________________________________________ 1. 2. Name of restaurant (Please print): ____________________________________________________ List by Make, Model, and Capacity of your: (If you attached a legible copy of your equipment list, only provide the following items:) Grill Oven Freezer Refrigerator Sink Dish Washing Facilities Food Preparation Counter (Dimensions) Other 3. 4. Attach a copy of your full menu including prices (examples: Breakfast, Lunch, Dinner, and Nonalcoholic beverages). List the seating capacity for: a. Restaurant dining area of your premises: (Do not include patio seating) b. Bar area of your premises: c. Total dining and bar seating capacity of your premises: [ [+ [= ] ] ] 5. What Type of dinnerware and utensils are utilized within your restaurant? Reusable Disposable Both 6. Does your restaurant have a bar area that is distinct and separate from the dining area? (If yes, what percentage of the public floor space does this area cover?) __________% What percentage of your public premises is used primarily for restaurant dining? (Do not include kitchen, bar, hi-top tables, or game area.) ____________% YES No 7. 8/11/2015 Page 1 of 2 Individuals requiring ADA accommodations call (602) 542-9027. American LegalNet, Inc. 8. Does your restaurant contain any games, televisions, or any other entertainment? YES No (If yes, specify what types and how many (examples: 4-TV's, 2-Pool Tables, 1-Video Game, etc.) 9. Do you have live entertainment or dancing? YES No (If yes, what type and how often (example: DJ-2 x a week, Karaoke-2 x a month, Live Band-1 x a month, etc.) 10. Use space below to list how many employees for each position to fully staff your business. Position Cooks Bartenders Hostesses Managers Servers Other ( Other ( Other ( ) ) ) How many I, _______________________________________________, hereby declare that I am the APPLICANT filing this application. I have read this application and the contents and all statements true, correct and complete. X_______________________________________________ (Signature of APPLICANT) (Print full name) NOTARY State of __________________County of ____________________________ The foregoing instrument was acknowledged before me this ________ day of ___________________________ Day Month Year My Commission Expires on: ___________________ Date _______________________________________________ Signature of Notary Public 8/11/2015 Page 2 of 2 Individuals requiring ADA accommodations call (602) 542-9027. American LegalNet, Inc.
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