VICTUALER’S PERMIT APPLICATION

OWNER NAME______________________________________________________

OWNER ADDRESS___________________________________________________

HOME TELEPHONE NUMBER_________________________________________

BUSINESS TELEPHONE NUMBER_____________________________________

NAME OF BUSINESS________________________________________________

BUSINESS ADDRESS________________________________________________

TYPE OF MERCHANDISE SOLD_______________________________________

PLEASE CHECK OFF WHERE YOU WOULD LIKE YOUR LICENSE SENT TO:

OWNER’S ADDRESS __________

BUSINESS ADDRESS __________

DAYS AND HOURS OF OPERATION__________________________________

HAVE YOU HAD A VICTUALER’S PERMIT BEFORE? ___________________

Return proper fee to Town Clerk, 8 School Rd., Windham, ME. 04062

Victualer without on-site consumption of liquor, $25.00

Including street vendors

Victualer with on-site consumption of liquor $55.00

Non-Profit Organization $1.00

Notice to Applicant

Please take notice that if the Municipal Officers grant the attached license, you must still comply with all the requirements of the provisions of the Town’s Land Use Ordinance, Health Code and all other municipal ordinances, codes and regulations. It is your responsibility to investigate the applicability of these requirements to your propose use.

______________ _________________________________

Date Applicant, Acknowledgement of Receipt

TOWN CLERK

8 SCHOOL ROAD

WINDHAM, ME. 04062

892-1900