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L!J <br /> SECTION 4—APPLICATION APPROVALS u~a <br /> Full Name of Licensee ? x: <br /> BOARD OF COUNTY COMMISSION OF INDIAN RIVER COUNTY, FLORIDA UJ <br /> Business Name(D/B/A) y- <br /> Street Address ` = <br /> 1801 27TH STREET <br /> City County State Zip Code <br /> VERO BEACH INDIAN RIVER COUNTY FL 32960 <br /> i IN Pil Ali 11:1:1 <br /> .,. . <br /> x=-- <br /> R <br /> A. The location complies with zoning requirements for the sale f alco lic beverages or wholesale <br /> tobacco products pursuant to this application for a Series license. <br /> B. This approval includes outside areas which are contiguous to the premises which re to be part of the <br /> premises sought to be licensed and are identified on the sketch?" ❑ Yes No <br /> Signed /<*, Date <br /> Stan Boling, AICP <br /> Title Community Development Director <br /> SALES TAX <br /> TO BE COMPLETED BY THE DEPARTMENT OF REVENUE <br /> The named applicant for a license/permit has complied with the Florida Statutes concerning registration for <br /> Sales and Use Tax. <br /> 1. This is to verify that the current owner as named in this application has filed all returns and that all <br /> outstanding billings and returns appear to have been paid through the period ending <br /> or the liability has been acknowledged and agreed to be paid by the applicant. This verification does not <br /> constitute a certificate as contained in Section 212.10 (1), F.S. (Not applicable if no transfer involved). <br /> 2. Furthermore, the named applicant for an Alcoholic Beverage License has complied with Florida Statutes <br /> concerning registration for Sales and Use Tax, and has paid any applicable taxes due. <br /> Signed Date <br /> Title Department of Revenue Stamp <br /> HEALTH <br /> TO BE COMPLETED BY THE DIVISION OF HOTELS AND RESTAURANTS <br /> OR COUNTY HEALTH AUTHORITY <br /> OR DEPARTMENT OF HEALTH <br /> OR DEPA TMENT OF AGRICULTURE&CONSUMER SERVICES <br /> The above establish t co a requirements of the Florida Sanitary Code. <br /> Signed Date v <br /> E <br /> itle � Agency K10 <br /> Auth.61A-3.020&61A-5.0017,FAC 3 Eff. 7/30/12 <br />