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Annual Outdoor Dining Permit Application

2. Annual Outdoor Dining Permit Application
   Community Development Department - Building Division 1st Floor - 5127 Oakton St. Skokie, IL 60077 Phone: 847/933-8223 Fax: 847/933-8230
3. 
5. Business Applicant Information
7. Business Name:
8. Business Telephone:
10. Business Street Address:
11. Business Fax:
13. 1. Skokie, IL 60076
    2. Skokie, IL 60077

    1. Evanston, IL 60203
    2. Chicago, IL 60645
14. Emergency Telephone:
16. Business Owner/Manager:
17. Email:
19. Use:

    1. Bar or drinking place

    1. Carryout restaurant (up to 5 seats)

    1. Limited service restaurant

    1. Full service restaurant
21. Signature of applicant or authorized officer/agent confirming that all information on this application is accurate and correct, he or she has read and understands the attached Outdoor Dining Regulations Handout and understands that any violation of the Outdoor Dining Regulations may result in citations, fines and or revocation of the Outdoor Dining Permit.
23. 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.

    1. I agree.
25. Electronic Signature*
26. Date:
30. Property Owner Information
32. Name of Property Owner:
33. Telephone (daytime):
35. Authorized Officer or Agent:
36. Telephone (evening):
38. Address:
39. Fax:
41. City/State/Zip:
42. Email:
44. Signature of owner or authorized officer/agent consenting to tenant’s application for an outdoor dining permit.
46. 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.

    1. I agree.
48. Electronic Signature*
49. Date:
53. Outdoor Dining Information
55. Zoning Classification:

    1. NX
    2. TX
    3. CX

    1. B1
    2. B2
    3. B3

    1. B4
    2. B6
    3. M1
57. Number of Tables:
58. Number of Chairs:
59. Proposed Hours of Operation for Existing Business:
61. Proposed Hours of Operation for Outdoor Dining:
62. Location:

    1. Private Property

    1. Public Way
66. Submittal Requirements:

    1. Plat of Survey (Must not be more than 2 years old from submittal date)
    2. Site Plan: Must indicate the proposed location of the outdoor dining area, number of tables and chairs, distance from property lines and curb lines, type of barriers (fencing, landscaping etc.)
    3. Furniture Information: Must indicate the style and material of all furniture
    4. Refuse Disposal Information: Must indicate how refuse will be disposed for the outdoor dining area
    5. Use of Public Way for Outdoor Dining Agreement & fee (only for outdoor dining located on public right-of-way)
    6. Annual Outdoor Dining Application fee
68. Please upload all requirements here:
72. Fee Schedule
74. Private Property only - $200
75. Public right-of-way only - $400
76. Both private and public right-of-way $500
78. This is an annual permit fee. Each year you will automatically receive a bill for the Outdoor Dining Permit that will be included with your Certificate of Occupancy renewal notice and bill.
    Payments may be mailed or delivered to the Building Division - 5127 Oakton St. Skokie, IL 60077
82. Please review the outdoor dining regulations on pages 3 & 4 of the below document.
    Outdoor Dining Regulations
Leave This Blank:


86. 1. Receive an email copy of this form.
87. Email address

    This field is not part of the form submission.

88. Submit Submit and Print

* indicates a required field