NORTH CAROLINA ALCOHOLIC BEVERAGE CONTROL COMMISSION 4307 Mail Service Center Raleigh, NC 27699-4307 (919)779-0700 FAX: (919)662-3583 LOCAL GOVERNMENT OPINION for ALCOHOLIC BEVERAGE PERMITS   APPLICANT SHOULD COMPLETE THIS SECTION ONLY Applicant’s Name______________________________________________________ Corporate or LLC Name (if applicable)_______________________________________________________ Trade Name of Business ________________________________________________ Former Trade Name (if any)_______________________________________________ Business Address ______________________________________________________ City/State ____________________________________________________________ Date of Birth _________________________________________________________ NC Driver’s License # __________________________________________________ Last 4 of Social Security # _______________________________________________ TYPE OF ABC PERMIT(S) BEING APPLIED FOR: _______________________________________________________ On Premise Indicate Type (if any) _______________________________________________________ Off Premise Indicate Type (if any) REMAINDER OF FORM FOR OFFICIAL USE ONLY Date Form 001 Mailed or Delivered ___________________________________________ Designated Official’s Name _________________________________________________ Title ____________________________________________________________________ City/County ______________________________________________________________ Address _________________________________________________________________ Contact Telephone # _______________________________________________________ NOTICE: The Alcoholic Beverage Control Commission shall give notice of a permit application to the Governing body of a city or county prior to issuing a retail ABC permit. Designated Officials are expected to process this form within 15 days of receipt. The applicant will be required to provide proof of mandatory compliance with all applicable building and fire codes. The Inspection/Zoning Compliance form (Form 002) is for this purpose and will be completed by the appropriate local agencies. FACTORS IN ISSUING A PERMIT: Pursuant to N.C.G.S. 18B-901(c), before issuing a permit, the ABC Commission shall be satisfied the applicant is a suitable person and that the location is a suitable place. American LegalNet, Inc. www.FormsWorkflow.com PLEASE INDICATE YOUR ANSWER TO THE FOLLOWING: Do you approve of the applicant and location for the ABC permit? YES ____ Applicant ________ Location ________ NO ____ Applicant _______ Location _______ Disapprovals: Pursuant to N.C.G.S. 18B-901 (b), to be considered by the ABC Commission, the objections shall state the facts upon which it is based. If you have indicated disapproval by answering “NO”, please explain your reason(s) based on the factors outlined in N.C.G.S. 18B-901(c) on the attached page. Use extra sheets if additional space is required and attach all records and/or documents used to arrive at your decision. The mere indication of “NO” without an explanation is an insufficient basis for rejection and cannot be considered by the Commission. ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________ Signature of Designated Official Date _______________________________________________________ Title of Designated Official State of North Carolina ____________________________ County ________________________________________________Being duly sworn says that the contents of the foregoing Local Government Opinion are true to his/her own knowledge, except as to matters stated on information and belief, and as to those matter(s) he/she believes them to be true. Sworn to and subscribed before me this: __________________________________________ Day Month Year __________________________________________ (Notary Public’s Signature) NC ABC 001 Local Government Opinion Form 001 Rev 11/2007 American LegalNet, Inc. www.FormsWorkflow.com