OREGON LIQUOR CONTROL COMMISSION BUSINESS INFORMATION Please Print or Type Applicant Name:_________________________________________ Phone:_____ _________________ Trade Name (dba):__________________________________________________________________ Business Location Address:___________________________________________________________ City:________________________________________________ ZIP Code:____________________ DAYS AND HOURS OF OPERATION Business Hours: Outdoor Area Hours: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Sunday Monday Tuesday Wednesday Thursday Friday Saturday ________ to ________ ________ to ________ ________ to ________ ________ to ________ ________ to ________ ________ to ________ ________ to ________ Seasonal Variations: Yes No The outdoor area is used for: Food service ________ to ________ ________ to ________ ________ to ________ ________ to ________ ________ to ________ ________ to ________ ________ to ________ Hours: ________to ________ Alcohol service Hours: ________to ________ Enclosed, how ________________________ _ The exterior area is adequately viewed and/or supervised by Service Permittees. _____________________ (Investigator’s Initials) If yes, explain:_____________________________________ _________________________________________________________________________________ ENTERTAINMENT Check all that apply: Live Music Karaoke Recorded Music Coin-operated Games DJ Music Video Lottery Machines Dancing Social Gaming Nude Entertainers DAYS & HOURS OF LIVE OR DJ MUSIC Pool Tables Sunday Monday Tuesday Wednesday Thursday Friday Saturday ________ ________ ________ ________ ________ ________ ________ to ________ to ________ to ________ to ________ to ________ to ________ to ________ Other: __________________ SEATING COUNT OLCC USE ONLY Restaurant: ________ Outdoor: ________ Lounge: ________ Other (explain): __________________________ Investigator Initials:_______________________ Banquet: ________ Total Seating: ________ Date:__________________________________ Investigator Verified Seating:____(Y) ____(N) I understand if my answers are not true and complete, the OLCC may deny my license application. Applicant Signature:___________________________________ Date:_______________________ 1-800-452-OLCC (6522) www.oregon.gov/olcc (rev. 12/07) American LegalNet, Inc. www.FormsWorkflow.com