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Provisional License Beverage Retail License Application

  1. Provisional licenses are for establishments that have filed a liquor license application with the Clerk's Office, however, would like a temporary license to be issued while waiting for Council approval.

    In order to be issued, the applicant must: 

    File the application and meet ALL the criteria in one of the options. 

    Pass Inspections (Call 920-448-3300 to schedule). 

    Have an approval recommendation  by the Green Bay Police Department (Clerk's Office will confirm).

    For New Applicants: Met with the Police Department for review of the license stipulation.

    If your provisional license is approved, you may come to the Clerk's Office to pay and pickup your provisional license. 

  2. Pursuant to Green Bay Municipal Code section 4.5 and as indicated on the provisional retail license application filed along with this explanation form, I am applying for a provisional retail license to permit me to engage in the applied-for activity on the grounds that (select one):
  3. Option 1: I have submitted an original alcohol beverage retail license application, which remains pending, and all of the following apply:
  4. Option 2: I have submitted a renewal alcohol beverage license application, and all of the following apply:
  5. Option 3: Regular Application
  6. The information on this form is true and correct to the best of my knowledge. I understand that any false statement on this form or any attachments constitutes grounds for revocation of any provisional retail license issued and/or denial of my regular license application.
  7. Electronic Signature Agreement
    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.
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