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7,AMENDIM ENS' <br /> RR <br /> -Changg .............. ....... <br /> _pf,13remises Information <br /> Aiteration of Premises-(must fill out attached financial information form) <br /> .. ............. <br /> F SS PREMIE <br /> I-'-............................................... _""­"_"_"""'................................................................ ......................................_­".................... .. ................ <br /> Pleasesummarize the details of the alterations and highlight any specific changes from the last-approved premises. <br /> .................... ...................... ........ <br /> ............ ...............—­­.......................................­"...................... <br /> PROPQ�E,U,E5CRIPTION OF PREMISES­-—--------- "I'll".............._'"_.......... 111..............—1 <br /> Please provide a complete description of the proposed premises,including the number of floors,number of rooms on each floor,any <br /> outdoor areas to be included in the licensed area,and total square footage.You must also submit a floor plan. <br /> 7� <br /> L ...... ..................................................... .......................... .. ........... <br /> 11............................... .............................. <br /> Total Sq.Footage Seating Capacity Occupancy Number <br /> Number of Entrances Number of Exits Number of Floors <br /> ...........I I <br /> ..................__j L__"'�........... ................. ............................ ............. .......... .................... <br /> ggi , (rnt,.,tst fill out attached financial information form) <br /> ------- <br /> B. HA GE LOCATION <br /> Last-Approved Street Address <br /> ..................................................................................... ——----- <br /> Proposed Street Address <br /> ............. ...................... ...................­�.................... ....................... <br /> .......... ................. .......... <br /> ............1�1............. <br /> DCR .................... <br /> ES , lffibWdF—PREMISES ......................... <br /> ........................... ....... <br /> Please provide a complete description of the premises to be licensed,including the number of floors,number of rooms on each floor,any <br /> �outdoor areas to be included in the licensed area,and total square footage.You must also submit a floor plan. <br /> ................... .............. ...... ....................... .. ........................ .......... <br /> ............-—-——------------------ <br /> Total Sq.Footage Seating Capacity Occupancy Number <br /> ................ <br /> .................. <br /> Number of Entrances Number of Exits Number of Floors <br /> ...................... . ........ <br /> RO—C................C.................U......PANCY OF PREMISES-""' ...................................... <br /> ............ <br /> Please complete all fields in this section. Please provide proof of legal occupancy of the premises.(E.g.Deed,lease,letter of intent) <br /> Please indicate by what means the applicant has to occupy the premises <br /> .................................................................................................................... -—------------------.................. <br /> Landlord Name <br /> .................. ................................... .......... ................... ........ . <br /> Landlord Phone Landlord Email <br /> ......................... ............................................. .......... .........._­­,"""""',............................... <br /> Landlord Address <br /> ......... ............ ................ <br /> Lease Beginning Date E Rent per Month <br /> ........................... ................... ....... <br /> Lease Ending Date Rent per Year <br /> Will the Landlord receive revenue based on percentage of alcohol sales? ( Yes C No <br /> a 10 <br /> .......... .................. .............................. ....... ......................................... ——--------- ........................ <br />