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The undersigned, requests a "Special Events Liquor License Permit" for the purpose of hosting a special event to be held at the location listed. This request is made pursuant to Ordinance Number 3112 of the City of Litchfield, Montgomery County, Illinois. The details of the request for a "Special Events Liquor License Permit" are as follows:
Information of civic, service, charitable or other not-for-profit organization, current liquor license holder or any person who qualifies for Permit for a special event liquor license, including, but not limited to, wedding parties, employer customer relation events or at openings and the like.
Name
Phone Number
Address
City
State
Zip Code
Full name of responsible person for this permit
Date of Birth
Date of Birth
Full name of responsible person for this permit
Date of Birth
Date of Birth
Date and Time Requested for Special Event
Date and Time Requested for Special Event Start Date
Date and Time Requested for Special Event Start Time
—
Date and Time Requested for Special Event End Date
Date and Time Requested for Special Event End Time
Location Where Special Event Will Be Held
Purpose of Special Event
Number of Special Events Held Within 1 Year Period
Applicant has read Ordinance Number 3112 and will follow instructions?
1. Yes
2. No
Ordinance 3112
Name
Permit Fee
Price
Quantity
Shipping Cost
Name
Security Deposit
Price
Quantity
Shipping Cost
Taxable
Taxable
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