2. 
4. Name of Business
6. Contact Person
8. Address of Business
10. Telephone Number
11. Email
13. Are you (please select one):

    1. Property Owner
    2. Property Occupant
15. Per Section 26-54 of the Wheaton City Code, all applicants must submit the following: (Upload documents or deliver to Wheaton City Hall: 303 W. Wesley Street)
17. Dimensioned Drawing
    Dimensioned drawing showing the sidewalk adjacent to the business, any street lights, signs, planters, trees, tree grates, the curb, on-street parking of any other public appurtenances, and the proposed location of any chairs. The drawing must detail the distance between the proposed table and chairs and the curb.
19. Upload Dimensioned Drawing Here
21. Certificate of Insurance
    Certificate of insurance naming the City of Wheaton as an additional insured for the term of the permit and addressing the service of alcohol, if applicable. Said certificate shall include a liability policy of not less than $2,000,000 per occurrence.
23. Upload Certificate of Insurance Here
25. Number of Tables
    Fee of $50.00 per table
26. Total Fee Enclosed
28. Idemnification Statement
    I (type name below) representing (type business name below), as its (type title below) agree to hold harmless and indemnify the City, its directors, officers, employees and agents, from and against any and all liabilities, losses, claims, demands, damages, fines, penalties, costs, and expenses, including, but not limited to, reasonable attorney's fees and costs of litigation, and all causes of action of any kind or character resulting from my use of the public sidewalk as a cafe. I certify that I have read and understand the rules of Section 26-54, Sidewalk Cafe permits.
30. Name
31. Title
33. Business Name
34. Date
36.  

    1. I understand that checking this box constitutes a legal signature confirming the statements made above.
38. OFFICIAL USE
    Date application received ____/____/____ by: _______________________________________
40. Included in application: (__) Dimensioned Drawing (__) Certificate of Insurance (__) Fee per Table
42. Inspection of public improvements completed on ____/____/____ by: _________________________________
44. Application: (__) Approved (__) Denied- License issued on ____/____/____ by: ______________________________
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit Submit and Print

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