Filing Letter to Board in Response to M Bennett Email with Exhibits 12 02 2024

PLEASE TYPE OR PRINTALL INFORI\4ATION STATE ASSIGNED LICENSE NUMBER 4.1 rS THE NEAREST ENTRANCE OF THE PLACE TO BE LICENSED WTTHIN 200 FEET OF THE NEAREST ENTRANCE OF ANY CHURCH OR SCHOOL? _Yes _]Zl No IFTHEANSWER IS'YES,'IS A WAIVER SIGNED BY THE APPROPRIATE OFFICIAL ATTACHED TO THIS APPLICATION? USE ANY VEHICLES FOR THE TRANSPORT OR DELIVERY OF 4.2 DOES THE APPLICANT -No TOYes -Yes INTEND ALCOHOLIC BEVERAGES? J1- NO (A TRANSIT INSIGNIA IS NECESSARY BEFORE ALCOHOLIC BEVERAGES T]|AY BE TRANSPORTED.) 4,3 HAS THE APPLICANT FILED -AN ANNUAL SPECIAL TAX REGISTRATION AND RETURN FORi/, (TTB F 5630 5) \MTH THTEDERAL ALCOHOL aND TOBACCO TAX AND TRADE BUREAU? Yes 7 ./ No o rra,'oora r,aao- l- l - SALE oF ALcoHoLlc BEVERAGES BE coNDUcrED oN THE 4.4 wLL ANy BUSTNEss orHER THAMHE PREMISES TO BE LICENSED? No -lYes IF THEANSWER IS 'YES,' INDICATE THE NATURE OF THE BUSTNESS - AND ffiOWLL CONDUCT IT BY RESPONDING TO THE FOLLOWNG OUESTIONS: /.,,,,-,,, Restaurant aApphcant , ,/. --1 Applicant Olher other Other -APPlicant Other N.J. Lottery -Other -ApPlicant -Amusements Grocery or Delicatessen -Applicant Other Other (specify) -Olher -APplicant OPERATETHE OTHER BUSINESS ON THE LICENSED 4,5 IF- SOITEONE OTHER THAN THEAPPLICANTWLL -Applicant ANSWER THIS QUESTION, IF THERE IS IUORE THAN ONE TNDIVIDUAL OR COMPANY, tzlcaten"g Hotel/l\rotel PREMISES. ATTACH A SEPARATE PAGE LISTING THE REQUESTEO INFORI/iATION FOR EACH OPERATOR, Business to be operated Name of company/individual (Lasl Name, First Name or Corporate Name) Street Address Number Municipality zip Streel Name State NJ Sales Tax Cedffcate of Authority No.