HomeMy WebLinkAboutForm - Statements of Operations (fillable) 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: If liquor 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” form sent directly to your
accountant to 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: Soloist Band DJ Shows/Live performances
Circle days of week: SU M T W TH F SA
In house speaker system Band will bring own system
Karaoke Hip Hop/Reggae
Rock Hawaiian
Jazz Other _______________________________
Dancing: (100’ required and shall not obstruct the normal flow of traffic.) Check days of week: SU M T W TH F SA
Open air 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/deck Yes No Do you intend to allow dancing on lanai/deck? Yes No
By:__________________________________ Hawai'i County is an Equal Opportunity Provider and Employer