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DEPARTMENT OF LIQUOR CONTROL COUNTY OF HAWAI‘I
Hilo Lagoon Centre, 101 Aupuni St., Unit 230, Hilo, Hawai‘i 96720 *Phone:(808)961-8218 *Fax:(808)961-8684
E-Mail: cohdlc@co.hawaii.hi.us
STATEMENTS OF OPERATIONS
APPLICANT: dba:
PROPOSED HOURS: TO _____
OPEN HOW MANY DAYS A WEEK: ______________ DAY(S) CLOSED:
TOTAL EMPLOYEES: NO. OF LIQUOR CARD HOLDERS:
(Persons who will take the liquor law examination)
RESTROOMS:
Ifliquor is consumed on premises, must have separate facilities for males and females.
LOCATION OF EMPLOYEE RECORDS:
LOCATION OF FINANCIAL RECORDS:
Provide accountant’s information if you want your “Gross Liquor Sales Report”formsent directly to your
accountantto complete. (Liquor sales report due on or before July 31 and January 31.)
Name:
Address:
RETAIL STORES ONLY: CHECK ITEMS THAT APPLY TO YOU
GAS
HOT FOODS
BENTOS
DELIVERY SERVICE
OFF SITE LIQUOR STORAGE
ON PREMISES CONSUMPTION ONLY: CHECK ITEMS THAT APPLY TO YOU
(Bars, Restaurants, Hotels, Clubs, Vessels – Preparation of all drinks shall be conducted at a service
bar that will permit any interested customer to view the bartender’s operation.)
Food: Kind of Cuisine _____________________________________________
Breakfast/Times ________ Lunch/Times_______Dinner/Times__________
Live Entertainment:SoloistBand DJ Shows/Live performances
Circle days of week: SU M T W TH F SA
In house speaker system Bandwill bring own system
Karaoke Hip Hop/Reggae
Rock Hawaiian
Jazz Other _______________________________
Dancing:
(100’ required and shall not obstruct the normal flow of traffic.)
Checkdays of week: SU M TW TH F SA
Openair facility where noise may emanate
Stage will be provide
Lanai/Deck : If yes,
Do you intend to place speakers on lanai/deck?Yes No
Do you intend to allow entertainment on lanai/deckYes No
Do you intend to allow dancing on lanai/deck? Yes No
By:__________________________________
Hawai'i County is an Equal Opportunity Provider and Employer