DR 8506 (8/99) COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION DENVER CO 80261 303-205-2300 COLORADO LIMITED WINERY WINE FESTIVAL PERMIT APPLICATION 21 Initial Festival Application - $25.00 Annual Fee Subsequent Festival Application DO NOT WRITE IN THIS SPACE 1. Name of Applicant exactly as it appears on your current Limited Winery License: Applicant License No: 2. Trade Name of Applicant: Business Telephone: 3. Business Address of Applicant: State Sales Tax No: City County State ZIP Code 4. Mailing Address (Number and Street) City or Town State ZIP Code 5. Festival Location: Festival Dates (Limit 3 days) 6. Rights to Premises Granted By: Attach a copy of Premises Use Authorization Letter or Lease 7. Notification to Local Licensing Authority Local Licensing Authority Name: Date Application Copy provided to Local Licensing Authority: NOTICE TO LOCAL LICENSING AUTHORITY THIS APPLICATION FOR A WINE FESTIVAL PERMIT WILL BE GRANTED TO THE ABOVE NAMED APPLICANT UNLESS ANY OF THE BELOW LISTED CONDITIONS APPLY. IF ANY OF THESE CONDITIONS APPLY PLEASE CONTACT THE STATE LICENSING AUTHORITY IMMEDIATELY. THE APPLICANT HAS NOT PROVIDED YOU WITH AT LEAST 10 BUSINESS DAYS NOTICE OF THE PROPOSED FESTIVAL PAST WINE FESTIVALS HAVE HAD A HISTORY OF VIOLATION OF THE COLORADO LIQUOR CODE IF GRANTED THIS PERMIT WOULD RESULT IN VIOLATIONS OF THE COLORADO LIQUOR CODE OR THE LAWS OF THE LOCAL GOVERNMENT DR 8506 (08/99) COLORADO LIMITED WINERY WINE FESTIVAL PERMIT APPLICATION DO NOT WRITE IN THIS SPACE - FOR DEPARTMENT OF REVENUE USE ONLY DATE LICENSE ISSUED LICENSE ACCOUNT NUMBER 2365-100 (999) TOTAL FROM PERIOD TO 00 American LegalNet, Inc. www.FormsWorkflow.com 8. During this wine festival wines will be sold by the participating wineries: Check all that apply In open containers for on-premises consumption In sealed containers for off-premises consumption 9. Diagram and control of FESTIVAL PREMISES Attach a diagram of proposed premises Attach a copy of premises control plan outlining how premises will be controlled to insure compliance with liquor code provisions including restricting sales to minors and intoxicated persons and insuring that festival participants cannot leave the premises with open containers of alcohol beverages. 10. LIST OF PARTICIPATING WINERIES WINERY NAME LICENSE # PERSON RESPONSIBLE PHONE# OATH OF APPLICANT I declare under penalty of perjury in the second degree that this application and all attachments are true, correct, and complete to the best of my knowledge. I also knowledge that it is my responsibility and the responsibility of my agents and employees to comply with the provisions of the Colorado Liquor or Beer Code which affect my license or permit. Authorized Signature Title Date American LegalNet, Inc. www.FormsWorkflow.com