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If you DO NOT currently hold an annual Carbondale liquor license, please complete the entire application.
If you are a current City of Carbondale liquor license holder, please skip to Section 2 Event Details.
Primary Contact / Event Manager Information
Secondary Contact Information (if applicable)
Attach proof of property owner's permission below
Include the number and location of restroom facilities, trash cans, fencing, seating, etc.
The undersigned does hereby swear (or affirm) that the manager/agent in whose name this affidavit is made will not violate any of the ordinances of the City of Carbondale or the laws of the State of Illinois or the United States of America, in the conduct of the place of business described herein, and that the statements contained in the application are true and correct to the best of his/her knowledge and belief and he/she understands that violation of any ordinances or laws shall constitute grounds for suspension or revocation of the license. I also acknowledge that this completed application and information contained in the files pertaining to this application is public record, except that information considered to be private information as defined under the Illinois Freedom of Information Act, and authorize its distribution and release.
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
The certificate must indicate that coverage extends to the location of the event.
If licensee holds an annual license
Download PDF here
Required if the applicant does not hold an annual liquor license or if the applicant has not previously held temporary liquor licenses issued by the City
* indicates a required field