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Applicant Questionnaire New On Premises Banquet Facility Permit LC 618BF - Michigan

Applicant Questionnaire New On Premises Banquet Facility Permit Form. This is a Michigan form and can be used in General Licensing Liquor Control Commission Statewide .
 Fillable pdf Last Modified 7/29/2011
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Print Form Michigan Department of Licensing and Regulatory Affairs MICHIGAN LIQUOR CONTROL COMMISSION (MLCC) 7150 Harris Drive, P.O. Box 30005 Lansing, Michigan 48909-7505 Commission Use Only BID # __________________ RID # __________________ APPLICANT QUESTIONNAIRE - New On-premises Banquet Facility Permit (Authorized by MCL 436.1522) INSTRUCTIONS: To apply for a new On-premises Banquet Facility Permit complete and return this questionnaire with a $70 inspection fee to the address printed above. _________________________________________________________________________________________ Name of Licensee(s) (Individual, partnership, corporation, limited liability company) _________________________________________________________________________________________ Current Business Address (Street, City, Township, County, Zip Code) Type of License and Number: _________________________________________________________________ Total Gross Receipts of Business:______________________________________________________________ Year Amount Year Amount Total Gross Receipts of Food and Non-alcoholic Beverages: ____________________________________________________________________ Year Amount Year Amount * Please be advised the statute prescribes that you must demonstrate that at least 50% of the gross receipts of your current business is from the sale of food and non-alcoholic beverages prepared for consumption on the premises. _________________________________________________________________________________________ Proposed Address of Banquet Facility (Street, City, Township, County, Zip Code) Do you or Will you have control of this facility? Property document & diagram attached? YES YES NO NO WILL BE AVAILABLE *Please be advised that you must provide a diagram and documentation that demonstrates a preexisting ownership or lease interest in the banquet facility prior to issuance of the permit. Permits Requested for Banquet Facility: ___Dance ___Entertainment ___Outdoor Service ___Sunday Sales ___Topless Activity ____Direct Connection ____Food ____Golf ____ Miscellaneous ________________ List types of scheduled events and functions that will be held at this facility: List the hours of operation at this facility: ________________________________________________________ *Please be advised that a banquet facility shall not have regular meal service and shall not be generally open to the public. _________________________________________________________________________________________ Title Print name of contact person _________________________________________________________________________________________ Telephone Number Mailing address if different from above _________________________________________________________________________________________ Date Signature LC-618BF Rev. 04/11 LARA is an equal opportunity employer/program. Auxiliary aids, services and other reasonable accommodations are available upon request to individuals with disabilities. American LegalNet, Inc. www.FormsWorkFlow.com
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