Non Res Block Party - Our Lady of Hungary Parish Festival

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STEP 4. ACKNOWLEDGEMENT In order to qualify for this authority to serve beer and wine, the following guldetlnes must be met: 1. There must be a well defined premises, i.e. building, tent, enclosure, or fenced -in or designated area. 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 a defined separation between the bar area and family area. (Must be on floor plan.) 3. There shall be NO carry -out privileges, NO carry -In privileges and NO spirituous beverages allowed. 4. Each applicant must designate an individual to be responsible for the event and such person shall sign the authority. S. ANY and ALL persons dispensing or accepting payment for alcoholic beverages MUST POSSESS a valid ATC employee permit. 6. The event must meet applicable Indiana State Board of Health requirements, particularly with regard to rastroom facilities. 7. If the event is held in a town park, you must have approval from the town board. 8. Legal Hours of dispensing alcoholic beverages: (Prevailing time) Monday through Saturday — 7 AM to 3 AM the following day Sunday -- 7 AM to 3 AM the following day 9. Applicant must file with the district office at which the event will be held at least five (S) days prior to the event. 10. The authority must be posted in the most conspicuous place at the location of the event. An excise officer or commissioner, for good cause, has the authority to revoke the authority during the event. :STEP 6. COMMUNITY CLEARANCE t. Signature of Shoriff of county, or Chief of Police, or7own Marshall of Jurisdiction where the avant will be hold Bate signed (month, day, year) 2. Signature of the mayor (if the event Is held In Fort Wayne) Rate signed (month, del+, year) Note: Please post your approved request In a conspicuous place where the alcoholic beverages are being dispensed at the location. If for any reason this request is denied, you may be notified either in person or by telephone. I swear or.affirm under penalties of perjury that the information is true an accurate. Slgnjg ra iof parmilloq fray nl gvur sfpna uro a nowle gas flint you have read and V91 obfdo by the lulus and guldaflgas.) Data signed (month, day, year) 13 FOR DISTRICT USE ONLY - District number Rate Issued (month, day, year) Reviewed by Excise Police District Representative ❑ Approved ❑Denied 1. ALL ANTS ARE $50.00 PER DAY. BUSINESS CHECKS OR MONEY ORDERS ARE ACCEPTED MADE OUT TO THE INDIANA ALCOHOL AND TOBACCO COMMISSION. 2. SERVING PAST MIDNIGHT, NO LATER THAN 3 AM, IS ONE DAY, 3. NO RAIN CHECKS ON ANY OF THE ABOVE EVENTS. Page 2 of 2