No preview available
HomeMy WebLinkAboutZoning Compliance/Use Permit OFFICE USE ONLY: DATE FILED: PEPMT#: 0 0' Cost: $55.00 PLANNING &DEVELOPMENT SERVICLMISt BUILDING&CODE REGULATIONS DIVI7E "ErV 2300 Virginia AvenueED Ft. Pierce,FL 34982-5652 - - -- 772-462-1553 Fax 772-462-1578 rtment APPLICATION FOR TEMPORARY USE PE �. Y, BUSINESS NAME: CASTLE NAME OF EVENT: Battle of the Bags Cornhole Tournament LOCATION AND ADDRESS OF TEMPORY USE EVENT: � � -oil Sunshine Kitchen,7550 Research Center Road,Fort Pierce,FL 34945 PROPERTY TAX IDENTIFICATION#: DESCRIPTION OF TEMPORARY USE: DATES OF THE EVENT: Saturday, February 22, 2020 APPLICANT'S NAME: CASTLE/Chris Robertson, Executive Director APPLICANT'S STREET ADDRESS: 3525 W. Midway Road CITY: Fort Pierce STATE: FL ZIP CODE: 34981 WILL THE EVENT HAVE A TEMPORARY LIQUOR LICENSE:YES X NO WILL THE EVENT HAVE A TENT(s):YES X NO (up to 900 square feet exempt from fire permit) WILL THE HAVE BANNERS/PENNANTS/FLAGS?YES X /NO (Only 1 per 300 linear feet;32 sq ft max size) I HEREBY ACKNOWLEDGE THAT THE ABOVE INFORMATION IS CORRECT AND AGREE TO CONFORM TO ST.LUCIE COUNTY LAND DEVELOPMENT CODE,SECTIO 2 Chris Robertson s ����---- PRINT APPLICANT'S NAME SIGNATURE OF APPLICANT STATE OF FLORIDA,COUNTY OF AC EDGED B O ME S DAY OF 20�0 BY 6 WHO IS PE OVALLY KNOWN TO ME O S PR U AS IDENTIFICATION. 0 SIGNATURE OF NO TYPE OR PRINT NAME O OTARGY� TITLE: NOTARY LIC COMMISSION NUMBER: F f 0;, SLCPDS 10/19/2015 ""' BRENDA N.MONTGOMERY ., Commission#FF 926672 • = Expires February 10,2020 9*r4wnwTmyFi1etuu�+� ►76i� oW i PERMISSION FROM OWNER OF PROPERTY DATE: AS O R OF THE FOLLOG DESCRIBED PROPERTY,I AUTHORIZE •T Lu C1:e C©J,i?t1 Com) �, 5 TO HOLD A TEMPORARY USE EVENT. PROPER4 TAX IDENTIFICATION ' T LEGAL DESCRIPTION OF PROPERTY: (i )� PROPERTY ADDRESS: 7 50 �eS r�/r 1 Cerr�er g oast OWNER INFORMATION: PROPERTY OWNER'S NAME: C PROPERTY OWNER'S ADDRESS: 23 o o V 16Gri N. o CITY: - O aZ J-� C STATE: ,t 2IP CODE:�. S'1 /,to l� 601�,77-V &CC Is-7 � �-,•,� 0600 C- A-1 A-1 PRINT R'S NAMESIGNA OF OWNER STATE OF FLORIDA,COUNTY OF ACKNOWLEDGED BEFORE ME THIS �� DAY OF .20_220 BY e-eI n A' G +-S WHO IS PERSON Y KNOWN T ME_, OR WHO HAS PRODUCED AS IDENTIFICATION. aj�D14 XA, Z14 SIGNATURE OF ITTARY TYPE OR PRINT N OF NOTARY TITLE: NOTARY PUBLIC COMMISSION NUMBER:- G C n, N7 17 seal ,Nii ,, AUDREY B.HUMPHREY e. .;: MY COMMISSION#GG 3008V EXPIRES:March 6.2023 SLCPDS 10/19/2015 •a ofi°:`' BoftW7hNNotwyPubftWW *d18rs 1 i i - FORM DBPR ABT—60031S REQUIRED TO: •Apply for a temporary permit, not exceeding three days,to sell alcoholic beverages for consumption on premises only;or •Apply for a special sales license,not exceeding three days,for the package sale only of alcoholic beverages. } ! F O APPLICATION FORM DBPR ABT—6003 ❑ Complete Sections 1-6. • Obtain Notarization for Applicant Affidavit in Section 6. ❑ Determine if Section 8-applies to the location of the event and obtain attestation of permanent licensee if applicable. 0 APPROVALS BY OTHER STATE OR LOCAL AGENCIES ❑ Section 3-Sales Tax Certification Obtain approval from the local area office of the Florida Department of Revenue. TEMPORARY PERMIT ❑ Section 4—Zoning Approval Obtain approval from the city or county zoning authority governing the location of the event. 0 APPLICATION FEE ❑ $25.00 Payable To: Div. of Alcoholic Beverages and Tobacco 0 FILE APPLICATION FORM DBPR ABT-6003 ❑ Submit the original, completed application with the required approvals and the application fee at least seven(7)days prior to the first date of the planned event. 0 APPLICATION FORM DBPR ABT—6003 ❑ Complete Sections 1-3 and 7. ❑ Obtain Notarization for Applicant Affidavit in Section 7. 0 APPROVALS BY OTHER STATE OR LOCAL AGENCIES ❑ Section 3-Sales Tax Certification Obtain approval from the local area office of the Florida SPECIAL SALES LICENSE Department of Revenue. 0 APPLICATION FEE ❑ $25.00 Payable To: Div.of Alcoholic Beverages and Tobacco 0 FILE APPLICATION FORM DBPR ABT-6003 Submit the original,completed application with the required approvals and the application fee at least seven(7)days prior to the first date of the planned event. INCORPORATED BY REFERENCE:61A-5.0013,F.A.C. EFFECTIVE 912019 i DBPR ABT—6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE TO PREPARE FORM DBPR ABT—6003: All fields must be completed. If a question on the form is not applicable, insert"NIA." The form must be signed by the applicant prior to filing the application with the Division. TO SUBMIT FORM DBPR ABT—6003: The completed,original application must be submitted, by mail or hand delivery,to a Division District Office serving the location of the licensed premise address at least seven days prior to the first day of the planned event to ensure the permit is issued by the requested event date. District Office contact information is available at:. hftp://www myfloridaii6ense com/DBPR/alcoholic-beverages-and-tobacco/. Florida Law for Temporary Permits Pursuant to section 561.422, Florida Statutes, upon the filing of an application and payment of a fee of $25 per permit,the division may issue a permit authorizing a bona-fide nonprofit civic organization, charitable organization, municipality, or county to sell alcoholic beverages for consumption only on premises for a period not to exceed 3 days,subject to any state law or municipal or county ordinance regulating the time for selling such beverages.Any such civic organization,charitable organization, municipality or county may be issued up to twelve temporary permits per calendar year,except in those counties or cities with special acts governing the number of permits allowed annually. Information regarding the cities and counties with applicable special acts can be found at: httra://www myfloridalicense com/DBPR/alcoholic-beverages-and-tobacco/. Purchases of Alcoholic Beverages and Related Records The permitted bona-fide nonprofit civic organization,charitable organization, municipality, or county may purchase alcoholic beverages from a distributor or vendor licensed under the beverage law. All records of alcoholic beverage purchases and sales must be retained for examination upon request of the Division of Alcoholic Beverages and Tobacco. Sales of Alcoholic Beverages and Related Revenue All alcoholic beverage sales transacted under the authority of the permit must be made by responsible members of the permitted organization,only during the permitted time frame,and only at the permitted location. All net profits from sales of alcoholic beverages collected during the permit period must be retained by the permitted nonprofit civic organization or charitable organization. When a temporary permit is issued to a municipality or county, all net profits derived from sales of alcoholic beverages during the permit period must be donated to a nonprofit civic or charitable organization within 90 days after the event. Changes to the Permitted Event Date(s)or Event Venue If, before the first day of the event date,the permitted event is rescheduled for reasons outside the control of event organizers,the applicant organization must notify the Division within 14 days of the cancellation to be eligible for reissuance of the temporary permit on the rescheduled date(s)at no additional application fee. If the permitted venue becomes unavailable and a new venue is chosen,the city or county zoning authority serving the new event venue must complete a new Section 4 of this application confirming zoning approval. INCORPORATED BY REFERENCE:61A-5.0013,F.A.C. EFFECTIVE 912019 DBPR ABT—6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE .111011M SECTION ADDITIONAL INSTRUCTIONS Registration of Legal Entity or Proof of Nonprofit Status All corporations, domestic or foreign, and limited liability companies seeking a permit are required to be registered with the Florida Secretary of State, Division of Section 1: Corporations, as an active nonprofit. Organizations which are not incorporated must Applicant submit one of the following: a letter outlining the purpose and the goals of the event Information and who will benefit from the event's profits;the organization's national, state,or local charter;the organization's by-laws; 501(c)3 registration, or minutes of meeting. The application will be considered incomplete without this active registration and proof of nonprofit-status. For further information,contact the Department of State at(850)488- 9000 or www.sunbiz.org. Sales Tax Certification Section 3 must be completed by the Florida Department of Revenue confirming that the Section 3: applicant has complied with the Florida Statutes concerning registration for Sales and Sales Tax Use Tax and has agreed to pay any applicable taxes due. Applications must be Certification. submitted within 90 days of DOR approval. The address and other contact information for Department of Revenue area offices can be found at: http://dor.mvflorida.com/dor/taxes/servicecenters.html. Local Zoning Approval Section 4 applies only to applications for a temporary permit, not exceeding three days, Section 4: to sell alcoholic beverages for consumption on premises only. The city or county Local Zoning zoning authority serving the area where the event or special sale will be held must Approval complete this section confirming zoning approval. Applications must be submitted within 180 days of receiving zoning approval. The address and other contact information for area zoning offices can be found at: http://www.mvfloridalicense.com/DBPR/alcoholic-beverages-and-tobacco/. Description Of Premises of Temporary Event(Premises Sketch) Section 5 requires a complete sketch of the premises, drawn in ink or computer generated(letter size), detailing all.permanent walls,doors,windows, counters, and labeling each room and area. Any outside areas where alcoholic beverages will be sold, consumed,or served must also be included in the sketch. Due to the difficulty of. Description Of Section scanning, no blueprints will be accepted. ty Premises of . When the event will be held at a location current) licensed for the sale of alcoholic Temporary beverages, a sketch of the entire premises must be submitted. If the event will not Event make use of the entire licensed premises,the sketch must identify the separate room or enclosure area of the licensed premises where the event will be held. In such circumstances,the attestation in Section 8 of this application must be signed by the current, permanent licensee and must be submitted by the nonprofit civic organization, charitable organization, municipality or count as art of its completed application. Section 6:for Affidavit of Applicant for Temporary Permit Affidavit Section 6, the affidavit of applicant for temporary permit, must be read and signed by Applicant fan officer of the applicant organization in the presence of a notary, with the notary's Temporary Permit seal affixed. Section 8: Attestation By Permanent Licensee For Use Of Licensed Premises As A Attestation By Permitted Temporary Event Permanent When the event will be held at a location currently licensed for the sale of alcoholic License beverages,the attestation in Section 8 of this application must be signed by the Holder current, permanent licensee and must be submitted by the nonprofit civic organization, charitable organization, municipality or county as part of the completed application. INCORPORATED BY REFERENCE:61A-5.0013,F.A.C. EFFECTIVE 9/2019 DBPR ABT—6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE Florida Law for Special Sales Licenses Pursuant to section 561.20(12)(a), Florida Statutes, upon the filing of an application and payment of.a fee of$25 per license,the division may issue a license authorizing the sale of alcoholic beverages in sealed containers only,for a period not to exceed 3 days. This license is issued only for the purpose of authorizing: a sale pursuant to levy and execution; a sale by an insurance company in possession of alcoholic beverages;a.bankruptcy sale; a sale resulting from a license suspension or revocation;a sale of damaged goods by a common carrier; a sale by a bona fide wine collector; or a sale pursuant to Part V of Chapter 679, Florida Statutes. �. s S 5 ... SECTION ADDITIONAL INSTRUCTIONS Registration of Legal Entity Section 1: All corporations, domestic or foreign, general partnerships, limited liability companies, Applicant limited liability partnerships, and limited partnerships seeking a license are required to Information be registered with the Florida Department of State, Division of Corporations. The application will be considered incomplete without this active registration. For further information, contact the Department of State at(850)488-9000 or www.sunbiz.org. Sales Tax Certification Section 3 must be completed by the Florida Department of Revenue confirming that the Section 3: applicant has complied with the Florida Statutes concerning registration for Sales and Sales Tax Use Tax and has agreed to pay any applicable taxes due. Applications must be Certification submitted within 90 days of DOR approval. The address and other contact information for Department of Revenue area offices can be found at: http://dor.mvflorida.com/dor/taxes/servicecenters html. Affidavit of Applicant for Special Sales License Section 7: Section 7, affidavit of applicant for special sales license, must be read and signed by Affidavit of the individual applicant, every partner of a general partnership, every general partner of Applicant for a limited partnership, a managing.member, manager, or officer of a limited liability Special Sales company, a managing member, manager,or officer of a limited liability partnership, or 'License an,officer of a corporate applicant, in the presence.of a notary,with the notary's seal affixed. INCORPORATED BY REFERENCE:61A-5.0013,F.A.C. EFFECTIVE 9/2019 DBPR ABT—6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE ` ❑ Temporary Permit ❑ Special Sales License Full Name of Applicant(s) The permit will be issued in the name of the applicant as provided on the application. A SI-L C Applicant Mailing Address Q , State Zi City County P Code f�/E /rv7- FL `I q 7 Applicant Telephone Number Applicant E-mail Address .7_7Gz- '4165- 6 011 o,3r-RTrs0/1(& Corporation or Other Legal Entity If the applicant is a corporation or other legal entity,enter the name and the document number related to the legal entity as registered with the Florida Department of State Division of Corporations. FEIN Number Florida Department of State Document Number 9 - ��qq7� _751 75 A contact person must be designated below if the applicant prefers to designate a person other than the applicant to receive and reply to Division communications regarding this application. The designated contact person will be permitted to make changes to jthe application paperwork on behalf of the applicant,and the Division will communicate directly with the contact person regarding the application. The applicant will not be copied on communications from the Division to the designated contact. It is the responsibility of the applicant to inform the Division if there is a change of designated contact and/or to the contact information of the designated contact Full Name of Designated Contact CHRIS rsv^-f Designated Contact Mailing Address tom• U• 13ox city county State Zip code F-0 S_T_ r`I E P-C E 13A//f L,_LtC if FL �3{-19 7 7 Designated Contact E-mail Address Designated.Contact Telephone Number l��at�3st� G�s�z�7c. t3� -770- L&5-tQ0r./ -- rLL 04 INCORPORATED BY REFERENCE:61A-5.0013,F.A.C. i DBPR ABT-6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE X IS WINV AW Dates of Active Use for Temporary Permit or Special Sales License Provide the dates of the event or sale when the permit or license will be effective. The dates provided may not exceed three days. Dray 1 Day 2 Day 3 f EI ,QLAAU"'20 Address for Physical Location of Temporary Event or Special Sales Event I -S J0 Rcsem2CH QOl�D City County State Zip Code �70PT PF = c"CIC FL 3,19 yS Is the event location currently licensed for sales of alcoholic beverages under a permanent license issued by the Division? Yes No Q■ If yes,obtain attestation of permanent license holder in Section 8. 04 ¢ { IN Wit. DA , E�bF : E r<, . Full Name of Applicant(s) Florida Department of Revenue Verification of Registration The named applicant(s)for a temporary permit or special sales license has complied with Florida Statutes concerning registration for Sales and Use Tax and has paid or agreed to pay any applicable taxes due. RECEIVED FLORIDA DEPT OF REVENUE Authorized.Agency Signature JAN 31 zuz-u Printed Name _ -1 .r- U Title Date l 3iftORIDA DEPT OF REVED Zc I: TA r COMPLIANCE ENFORM IEN�.. 337 NORTH US HWY 1, SUITE 2075 FT. PIERCE, FL 34950 3 -3 -7 c?, o-7- )13,F.A.C. EFFECTIVE 9/2019 DBPR ABT-6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE } O: g ,TES G ' IS Location of Temporary Event Street Address 15550 .k Cr-e r ROL• City Couln-ty State Zip`Cfoode Local Zoning Approval The location of the temporary event complies with-local ordinances for the temporary sale of alcoholic beverages based on the information supplied by the applicant in this application. l Authorized Agency Signature Printed Name '\ U k%4 C4- Title d v d c I Q S'"' cd Date INCORPORATED BY REFERENCE:61A-5.0013,F.A.C. EFFECTIVE 012019 DBPR ABT—6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE Full Name of Applicants) Name or Title of Temporary Event i4 TTL-Z D F TWE .3 P GS Neatly draw a floor plan of the premises in ink,including:sidewalks and other outside areas which are contiguous to the premises, walls,doors,counters,points of sale of alcoholic beverages,storage areas,restrooms,bar locations,and any other specific areas which are part of the premises where the event will be held. A multi-story building where the entire building is to be licensed must show the details of each floor. S E-e F LLvcvVA-4 INCORPORATED BY REFERENCE: 61A-5.0013,F.A.C. EFFECTIVE W2019 i r 4 . _ v ,F e J" � 4 DBPR ABT–6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE H RAWPkWej Full Name of Applicant(s). "The applicant requesting the permit in the above and foregoing application is a nonprofit civic organization,charitable organization, municipality or county,and the permit,if used,will be used only by the applicant organization on the date(s)requested and at the location stated.By acceptance of this permit,the applicant agrees that,as a nonprofit or civic organization,all net profits from sales of alcoholic beverages during the permitted period will be retained by it,or,as a municipality or county,all net profits from sales of alcoholic beverages during the permit period will be donated to a nonprofit civic or charitable organization within 90 days after the permitted event. As a municipality or county,the applicant attempted to solicit a qualified nonprofit civic or charitable organization to conduct such sales for the permitted event but has been unable to find such a qualifying nonprofit civic or charitable organization in a reasonable and practicable manner and timeframe.The applicant organization has not received more than twelve(12)permits within the calendar year,unless otherwise authorized by law,and the applicant agrees that the location may be inspected and searched, during the time that the permit is issued and business is being conducted without a search warrant by'authorized agents or employees of the Division of Alcoholic Beverages and Tobacco,the Sheriff,Deputies,and Police Officers for purposes of determining compliance with the Florida Beverage Law. I,the undersigned individual,or if a corporation,for itself,its officers and directors,hereby swear oraffirm that I am duly authorized to make the above and foregoing application and,as such,I swear under oath or affirmation under penalty of perjury as provided for in sections 559.791,562.45,and 837.06,Florida Statutes,that the foregoin ipforJr 'eh is true Sn e�ct" Signature of Applicant/Affiant STATE OF ��6r J Q. COUNTY OF S+• L UCk, - T� Sworn to(or affirmed)andsubscribed before me this to day of (A 20 by- I" S o\ .� �-tS0 In (print affiant name). ( ✓)Personally Known ( )Produced Identification Type of Identification Pro u ed BRENDAAH MONTGOMERY Signature of Notary Pub5Z 4ie of FIo 'da ,., Commission#FF 926672, Expires February 10,2020 R r Name of Notary Public–Typedl Printed,ot Stamped (NOTARY SEAL) Commission Expires:_re-by-aa-v!1 /0-, 02.0 DATE ACCEPTED BY DISTRICT OFFICE: INCORPORATED BY REFERENCE:61A-5.0013,F.A.C. EFFECTIVE 912019 DBPR ABT—6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE 1111')llijll'k�' He U Mkk]1111120 fg�lllill E T.111 „S =I- Full Name of Applicant(s) r; S er � So "As the applicant requesting the special sales license in the above and foregoing application,I understand that this license allows package sales in sealed containers for a period of up to three days,and does not permit the sale of alcoholic beverages for consumption on the premises.I agree that the location may be inspected and searched during the hours that the special sale is being conducted without a search warrant by authorized agents or employees of the Division of Alcoholic Beverages and Tobacco, the Sheriff,Deputies,and Police Officers for purposes of determining compliance with the Florida Beverage Law. I,the undersigned individual,or if a corporation,for itself,its officers and directors,hereby swear or affirm that I am duly authorized to make the above and foregoing application and,as such,I swear under oath or affirmation under penalty of perjury as provided for in sections 559.791,562.45,and 837.06,Florida Statutes,that the foregoin ' form is true anec�t."" 'gnature of Applicant/Affiant STATE OF PlY” QQ COUNTYOF 8L. Lue,l -e- - �// Sworn to(or affirmed)and subscribed before me this SCD day of , 20 O by P%'S l�aU�.r�S�r1 (print-affiant name). ( �)Personally Known ( )Produced Identification Type of Identification Produdad Signature of Notary Public— to lorida -��J�' � /✓pan� � Name of Notary Public—Typed, PrWted, or Stark ped (NOTARY SEAL) Commission Expires: 11 LlO �OZ1� E •, BRENDAH.MONTGOMERY Commission#FF926672 *sExpires February 10,2020 ` BmWd71VUTMyFak&ww=aw,%5-iof9 - �..{ _�„.,�a�-'.-.;�o�-.,_, c+...''c'"t:,.�..:...,.,r��':4"�"_�, �:2,...sn.e.a>....,..,S.r;.,.+:t-....?•.+�n.t. ..�;?�`��f`c,.th>•r.,". ,.x;�'r._..x,�< .a.-., ,..,,��.'.dF�=�...a DATE ACCEPTED BY-DISTRICT OFFICE: INCORPORATED BY REFERENCE:61A-5.0013,F.A.C. EFFECTIVE 912019 DBPR ABT—6003 APPLICATION FOR TEMPORARY PERMIT OR SPECIAL SALES LICENSE E IR 17E An attestation is to be obtained from the current,permanent alcoholic beverage license holder when the temporary event of the applicant nonprofit civic organization,charitable organization,municipality,or county is hosted at a location that is permanently licensed by the Division of Alcoholic Beverages&Tobacco for the sale of alcoholic beverages. NOTE:The attestation must have the original signature of the alcoholic beverage license holder(only persons on file with the Division may sign)and must be submitted by the nonprofit civic organization,charitable organization,municipality,or county as part of the application for the Temporary Permit. Full Name of Permanent License Holder at Temporary Event Location Business Name(D/B/A) License Number Series of Permanent License Series Type: Contact Person for Permanent License Holder Contact Person Telephone Number Ext. Contact Person E-mail Address Name of Applicant for Temporary Permit Date(s)of Temporary Event Day 1 Day 2 Day 3 � aaava� _ A temporary permit is being requested for an event to be held on your licensed premises. During the permitted dates and times of the event, no sales or service of alcoholic beverages may be made under your permanent alcoholic beverage license in the area identified for use by the temporary permit applicant in Section 5 of this application. Failure to comply may result in administrative charges being filed against your license. Date Signature of Permanent License Holder at Temporary Event Location Printed Name of Permanent License Holder at Temporary Event Location INCORPORATED BY REFERENCE:61A-5.0013,F.A.C. EFFECTIVE 912019