§ A129-2. Application form.

Any applicant seeking an inter-municipal transfer or economic development license shall fill out the Township's application form which shall be available at the Township and shall contain a request for the following information:

A. 

Applicant name; address; telephone number; fax number and e-mail address.

B. 

Proposed location of the license to be transferred.

C. 

The name of the establishment sought to be licensed.

D. 

Type of license proposed to be transferred.

E. 

Other locations owned or operated by the applicant which currently hold liquor licenses including name, address and license number of these establishments.

F. 

Whether applicant has ever been cited with Liquor Law violations.

G. 

Name, address and distance from proposed licensed premises of:

(1) 

Nearest licensed establishment.

(2) 

Nearest school.

(3) 

Nearest park.

(4) 

Nearest church.

(5) 

Nearest private recreation or amusement facility.

H. 

List of existing licenses in Lawrence Township which are inactive, in safekeeping and/or for sale including name, address and telephone number of contact person for each.

I. 

Certification by the applicant that the information contained in the application is true and correct; that the presentation of false information shall subject the applicant to possible arrest, fines and imprisonment; and acknowledgement that submission of false information may constitute grounds for revocation of the liquor license.