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0 <br />STEP4. ACKNOWLEDGMENT <br />In order to quality for [his authority to serve beer and wine, the following guidelines must be met: <br />1. There must be a well defined premises, Le. building, tent, enclosure, or fenced -in or designated area. <br />2. You must have a defined floor plan or diagram. This Is to be drawn on Page 1, Step 3 of this application. If minors are to be present, you must have <br />a defined separation between the bar area and family area. (Must be on floor plan.) <br />3. There shall be NO carry -out privileges. NO ca -in privileges and NO spirituous beverages allowed. <br />4. Each ap n must designate an individual to be responsible for the event and such person shall sign the authority. <br />5. ANY and ALL persons dispensing or accepting payment for alcoholic beverages MUST POSSESS a valid ATC employee permit. <br />6. The event must most applicable Indiana State Board of Health requirements, particularly with regard to restroom facilities. <br />7. If the event is held In a town park, you must have approval from the town board. <br />8. Legal Hours of dispensing alcoholic beverages: (Prevailing time) <br />Monday through Saturday — 7 AM to 3 AM the following day <br />Sunday — 7 AM to 3 AM the following day <br />9. Applicant must file with the district office at which the event will be held at least five (5) days prior to the event. <br />10. The authofky must be posted in the most conspicuous place at the location of the event. An excise officer or commissioner, for good cause, has the <br />authority to revoke the authority during the event. <br />STEP 5. COMMUNITY CLEARANCE <br />1. Sign a r of S of cou r hle <br />f Police. of Town Marshall of jurisdiction where the event will be held <br />Date signed (month, day, ar) <br />2. Signatureofthe mayor (1 a event Is hold In Fort Wayne) <br />Date signed (month, day, year) <br />Note: <br />Please post your approved request in a conspicuous place where the alcoholic beverages are being dispensed at the location. <br />If for any reason this request is denied, you may be notified either in person or by telephone. <br />I swear or affirm under penalfies of perjury that the information is [rue and accurate. <br />SI lure of to iit" / age Yours lore ecanowWVfr that you have read and w91 able by the rules and guldeanes.) <br />Date signed (month, day, year) <br />2)20123 <br />3 <br />v <br />FOR DISTRICT:USE ONLY <br />District number % Date towed /month, day, yes:) <br />Reviewed by Excise Poi a lslncl esentative <br />Approved El Denied <br />v <br />