The Alaska 02 007 form is essential for anyone seeking to operate a Teen Nightclub or Cultural Performance Venue within the Municipality of Anchorage. Managed by the Office of the Municipal Clerk, this document outlines the necessary steps and requirements for securing a permit under Title 10 of the Anchorage Municipal Code. Applicants are instructed to provide detailed information, including both personal and business details, alongside their compliance plans for safety, crowd control, curfew laws, and parking. This comprehensive approach ensures that the operation of such venues meets the specific legal and community standards set forth in the code. Additionally, the form addresses the need for proof of insurance, procedures in case of emergencies, and adherence to capacity limits to ensure the safety and well-being of patrons. For venues to align with local regulations, they must also showcase their strategies to verify the age of patrons and comply with residential proximity rules, among other stipulations. With these requirements clearly laid out, the form serves as both a guideline for prospective venue operators and a tool for municipal oversight.
| Question | Answer |
|---|---|
| Form Name | Alaska Form 02 007 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names |
MUNICIPALITy OF ANCHORAGE |
|
|
OFFICE OF THE MUNICIPAL CLERk |
|
|
P.O. Box 196650 (632 W. 6th Ave., Ste 250) |
||
Anchorage, Alaska |
TEEN NIGHTCLUB/CULTURAL |
|
|
||
PLEASE PRINT OR TYPE INFORMATION |
PERFORMANCE VENUE |
|
PERMIT APPLICATION |
||
|
||
For Office Use Only
License No.________________
Date Issued________________
Application Date: __________________(LICENSES ARE NOT TRANSFERABLE)
I, __________________________________, hereby make application for a □ TEEN NIGHTCLUB □ CULTURAL PERFORMANCE VENUE PERMIT in
accordance with Title 10 of the Anchorage Municipal Code for the 20________, 20________ license years.
Applicant’s Name: ________________________________________________________________________ (Phone)__________________
Applicant’s Mailing Address: ________________________________________________________________ (ZIP) ____________________
Applicant’s Street Address: _________________________________________________________________ (ZIP) ____________________
Business Name: _________________________________________________________________________ (Phone)__________________
Business Mailing Address:__________________________________________________________________ (ZIP) ____________________
Business Street Address: __________________________________________________________________ (ZIP) ____________________
Have you ever had any license or permit revoked or suspended? □ YES □ NO If yes, give details including date(s), place(s) and reasons (attach additional pages as needed) ________________
______________________________________________________________________________________________________________________________________________________________
List the true name, residence address, daytime telephone number, and date of birth of each person directly engaged or employed in the management or operation of the business.
NAME |
TITLE |
RESIDENCE ADDRESS |
PHONE # |
BIRTHDATE |
________________________________ |
__________________________ |
__________________________________________________________ |
______________________ _____________ |
|
________________________________ |
__________________________ |
__________________________________________________________ |
______________________ _____________ |
|
________________________________ |
__________________________ |
__________________________________________________________ |
______________________ _____________ |
|
OWNER/LANDLORD NAME ______________________________________________________________________________________________________________________________________
OWNER/LANDLORD ADDRESS___________________________________________________________________________________________________________________________________
If a partnership, list the true name, principal occupation, residence address, birth date and daytime telephone number of each partner and number of shares owned or controlled by each.
NAME |
OCCUPATION |
RESIDENCE ADDRESS |
PHONE # |
BIRTHDATE |
SHARES |
______________________________ |
_________________________ |
____________________________________________________ |
_____________________ |
_____________ ________ |
|
______________________________ |
_________________________ |
____________________________________________________ |
_____________________ |
_____________ ________ |
|
______________________________ |
_________________________ |
____________________________________________________ |
_____________________ |
_____________ ________ |
|
The premises which is the subject of this application is in compliance with the Anchorage Municipal Code. Further I agree to comply with all laws, including, but not limited to, the noise control regulations in the conduct and operation of the TEEN NIGHTCLUB OR CULTURAL PERFORMANCE VENUE.
State of Alaska Business License No.____________________________ Date Issued_______________ Expiration Date__________________
(please attach a copy)
IF BUSINESS ENTITY, PLEASE COMPLETE:
State of Alaska |
) |
|
) ss: |
Third Judicial District |
) |
__________________________________________, being duly sworn, deposes and says that he/she is the individual making the foregoing application
and authorized agent for this business that the answers to the questions and other statements contained in this application are true and complete to his/her knowledge.
Subscribed and Sworn to before me this _____ day of_______________, 20_______. |
________________________________________ |
|
Signature of Applicant |
|
_______________________________________ |
|
Notary Public |
|
My commission expires: ____________________ |
|
|
FOR OFFICE USE ONLy |
|
I.D. Furnished and Number
Fee Paid: $
Cash
Check No.
Receipt No.
TEEN NIGHTCLUB/CULTURAL PERFORMANCE VENUE PERMIT APPLICATION
STATEMENT OF PROCEDURES FOR CROWD PROTECTION , TRAFFIC CONTROL AND CURFEW LAW COMPLIANCE
Business Name and Address: ___________________________________________________________________________________________
____________________________________________________________________________________________________________________
1.How will you identify when occupancy/capacity limits have been met? _________________________________________________________
____________________________________________________________________________________________________________________
2.How will entry be restricted when the premise is at capacity? _________________________________________________________________
____________________________________________________________________________________________________________________
3.What are your emergency evacuation plans? Who will be responsible for clearing the nightclub in case of emergency? ___________________
____________________________________________________________________________________________________________________
4 Identify the means to control or evict persons who pose a threat or hazard to others on the premises.__________________________________
____________________________________________________________________________________________________________________
5.What procedure is used to summon Police or Fire to an emergency or altercation? ________________________________________________
____________________________________________________________________________________________________________________
6.Describe procedures for admission. Where is the line located and what method will be used to prevent blocking of the sidewalk? ___________
____________________________________________________________________________________________________________________
7.Describe procedures for ensuring compliance with the Municipality’s curfew ordinance. ____________________________________________
____________________________________________________________________________________________________________________
STATEMENT OF PARKING PLAN AND DISTANCE FROM RESIDENTIAL BUILDINGS
1.How do you plan to provide parking for patrons? How many parking spaces will be provided? ________________________ Please attach a dia- gram.
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
____________________________________________________________________
2.What is the distance from the location of the proposed TEEN NIGHTCLUB/CULTURAL PERFORMANCE VENUE to the nearest residential dwell- ing? __________________________Please attach a certification from the Department of Community Planning and Development that the location of
the proposed TEEN NIGHTCLUB/CULTURAL PERFORMANCE VENUE is more than 150 feet from the nearest residential dwelling. (An applicant is exempt from this requirement only if the TEEN NIGHTCLUB/CULTURAL PERFORMANCE VENUE had already been operating as of August 1, 1996.)
TO BE COMPLETED By TEEN NIGHTCLUB APPLICANTS ONLy
STATEMENT ON AGE RESTRICTIONS AND CONTROLS
1.How will you verify age of prospective patrons? How will you prevent prospective patrons under 14 or 21 or older from entering unless they fit in the ordinance’s exceptions?
2.How will you prevent entrance of persons for whom a parent or legal guardian has requested such limitation?
TO BE COMPLETED By CULTURAL PERFORMANCE VENUE APPLICANTS ONLy
EVIDENCE OF QUALIFICATION FOR CULTURAL PERFORMANCE VENUE PERMITS
State all evidence that shows the applicant can qualify for a permit as a cultural performance venue under AMC 10.55.005 B.
ATTACH ADDITIONAL SHEETS AS NEEDED
Applicant Signature ___________________________________________________________________________________ Title_______________________________________________________
Applicant Printed Name________________________________________________________________________________ Date ______________________________________________________