2. Name of Business*
3. Address of Business*
5. Contact Person*
6. Telephone Number*
8. Today's Date
9. Email Address*
11. Description of Intended Use (including hours of operation)
13. Will liquor be served in the sidewalk cafe area?*

    1. Yes
    2. No
14. Has Liquor Board approved the service of liquor in the sidewalk cafe area?

    1. Yes
    2. No - No date schedule
    3. No - Date scheduled
16. Site plan/seating plan attachment*
    Plan to illustrate intended use of sidewalk, location of entrance doors and fire hydrants for this business and neighboring businesses, location of trees and curb line, and layout of tables, chairs, umbrella overhangs, and perimeter fencing.
18. Copy of liability insurance
    Copy of business' or property owner's liability insurance which shows that the City of Hagerstown has been included as an additional insured for the temporary use of the public right-of-way for the sidewalk cafe use. (This may be submitted following City approval of the application, but prior to issuance of permit by the Engineering Department.)
20. Photographs
    Photographs of intended furniture design for tables, chairs, and perimeter fencing.
22. Printed Name of Applicant*
Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field