..---------------..,,~-----------------------------.--.--.---

P.O. Box 1325Pine Lake, GA 30072404.292-4250 Officewww.pinelakega.com

City of Pine Lake

Special EventTemporary Alcohol Permit

Application

Business Organization Details

Name of Business/Organization:

Physical Business/Organization Address:.,

Mailing Address:

Name of Contact Person:

Email: ------------------------------------- Telephone: _

Cell #: _

Details

Name of Event:

Location of the Event (Physical Address):

Date of Event: From To _

Note: The Special EventlTemporary Alcohol Permit shall be issued only to an individual person,the business owner/sponsor of the event. In this case, business owner/sponsor means theperson responsible for planning, producing, and conducting the special event. If a group,organization, association, or other entity is sponsoring the special event, a designated agentshall be named for purposes of the permit, and that individual shall be solely and fullyresponsible for compliance with all provisions of the Special Event Temporary Alcohol Permit.

P.O. Box 1325Pine Lake, GA 30072404.292-4250 Officewww.pinelakega.com

City of Pine Lake

I hereby agree that as a condition to the issuance of a Special Event Temporary Alcohol Permit,the business owner/sponsor of the Event shall indemnify and hold the City harmless fromclaims, demand or cause of action which may arise from activities associated with the event.

I hereby solemnly swear, subject to criminal penalties for false swearing that the statements andanswers made by me to the foregoing question in this application for a Special Event TemporaryAlcohol Permit are true and no false or fraudulent statement or answer is made herein toprocure the granting of such permit.

Signature of ApplicantSworn to and subscribed before methis _ day of ,2014

Notary Public

STAFF USE ONLY

Permit#: Date Received:

Processed B Permit Fees:

Approved/Denied B Expiration Date:

Denied Date:Ap roval Date:

_ ..... __ .._--------_._----------------

P.O. Box 1325Pine Lake, GA 30072404.292-4250 Officewww.pinelakega.com

City of Pine Lake

Sec. 10-46. Temporary Permit

Temporary permit for bona-fide non-profit, tax-exempt civic organization. Uponthe filing of an application as required by City Clerk and payment of the appropriate fee by abona-fide non-profit, tax-exempt civic organization, the City Clerk may issue a permitauthorizing the organization to sell or serve alcoholic beverages for consumption only on thepremises for a period not to exceed two days, subject to provisions of this chapter regulatingthe time for selling such beverages.

a) No more than four permits may be issued to an organization in anyone calendar yearpursuant to this paragraph.

b) Permits issued pursuant to this paragraph shall be valid only for the place specified inthe permit. No permit may be issued unless the sale of distilled spirits, wine, or maltbeverages is lawful in the place for which the permit is issued. The zoning restrictionsand distance restrictions contained in Section 10-29 shall apply.

c) Proof of such non-profit, tax-exempt status, such as a determination form the InternalRevenue Service that the organization is exempt under Section 501-C of the InternalRevenue Code must be provided.

Sec. 10-47. Special Event or Function

In addition to the general occupational tax certificate requirements of this Code, the followingsection shall apply to the licensing and operation of all establishments selling alcoholicbeverages for consumption off-premises in connection with an authorized special event orfunction and should any section of this article conflict with other provisions in this chapterthen this section shall control.

a) Any alcohol vendor who possesses a valid license from the City of Pine Lake oranother city or county in Georgia and possesses a valid license from the state ofGeorgia to sell malt beverages, wine, or distilled spirits by the drink and for by thepackage at a fixed location within the city may be issued an event permit authorizingsuch sales off-premises and in connection with an authorized special event or function.

b) A licensed alcoholic beverage vender may only sell that which is authorized by hisfheralcohol beverage license. For example, if the alcoholic beverage vendor possesses a

---------

valid license to sell malt beverages, he/she may only sell malt beverages at theauthorized special event or function.

c) An alcoholic beverage caterer shall submit an application for an off-premises eventpermit to the city clerk. The license may be applied for at the same time as thealcoholic beverages license(s).

d) Exclusive of the license required herein, each alcoholic beverage vendor wishing tosell or distribute spirits, malt beverages, or wine at an authorized special event orfunction within the city must also apply for an event permit. The application for theevent permit shall include the name of the caterer; the date, address, time and nameof the event; and the t of alcoholic beverages to be transported from the licensee'sprimary location to the location of the authorized catered event or function.

e) The event permit fee shall be $50.00 per event for those located outside the City ofPine Lake; the event permit fee shall be waived for those vendors inside the City ofPine Lake. ,~

f) The original event permit shall be kept in the vehicle transporting the alcoholicbeverages to the special event or function, and shall be available for inspection at thespecial event or function during the duration of such event of function.

g) It is unlawful for any person to engage in, carry on or conduct the sale ordistribution of alcoholic beverages off-premises and in connection with a specialevent or function without first having obtained a permit as provided herein.

-End-