Connecticut > Statewide > Department Of Consumer Protection > Liquor Control Division
Application For Additional Consumer Bar(s) CPLP-03 - Connecticut
| Application For Additional Consumer Bar(s) Form. This is a Connecticut form and can be used in Liquor Control Division Department Of Consumer Protection Statewide . |
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CPLP-03 Rev 1/04 FOR OFFICIAL USE ONLY STATE OF CONNECTICUT DEPARTMENT OF CONSUMER PROTECTION LIQUOR CONTROL DIVISION Telephone: (860) 713-6210 Fax: (860) 713-7235 Web Site: www.ct.gov/dcp APPLICATION FOR ADDITIONAL CONSUMER BAR(S) Instructions: Complete this application and submit with a check or money order made payable to "Treasurer, State of CT" for the total number of consumer bar(s) for which you are requesting approval at $150.00 each. èReturn your completed application and appropriate fee to: Department of Consumer Protection, License Services Division, 165 Capitol Ave, Hartford, CT 06106 Permittee Name: (First, Last) Name of Business: Business Street Address: (Location of Business) City: Backer's Name: Business Telephone Number (with area code) Number of Additional Consumer Bar(s) Requested @ $150.00 each: State: Zip code: Liquor Permit Number: NOTE: · This application must be accompanied by an 8.5 x 11 inch sketch of the entire premises, showing the location(s) of the additional consumer bar(s) for which you are requesting approval. You must also submit a photograph(s) of these proposed location(s) I have attached a sketch and photograph(s), as described above, related to the additional consumer bar(s) for which I am requesting approval: Yes No Signature of duly authorized representative: Date: American LegalNet, Inc. www.FormsWorkflow.com
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