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2. 
3. City of Middleton - Sidewalk Café Permit Application

   License Period:  April 15 - April 14

5. License Type*

   1. New

   1. Renewal
7. Check One*

   1. Individual
   2. Partnership
   3. Corporation/Nonprofit organization
   4. Limited Liability Company
9. Business Name*
11. Contact Person*
12. Contact Phone*
14. Names and Address of all Officers:
16. President Name
17. President Address
19. Vice-President Name
20. Vice-President Address
22. Secretary Name
23. Secretary Address
25. Treasurer Name
26. Treasurer Address
28. Premise Information
30. Address1*
32. Scale Drawing of Site*

    A scale drawing of site, including the location of all trees, poles, benches, grates, and other amenities or obstructions, and the exact type, size and location of the proposed furniture, fences, and other vending equipment. 

33. Liability Insurance*

    Proof of adequate liability insurance naming the City as additional insured. The minimum amount of insurance is $500,000.00 

35. Review and Approval

    All applicants and requests are subject to:

    • Plan Commission design review
    • Approval of the License and Ordinance Committee and the Common Council
    • Restrictions as outlined in Middleton City Ordinance 7.09(5) & 7.09(6)
37. Payment Method*

    1. Online
    2. Mailing Check

    Once you hit submit, you will be directed to the credit card processing page.  You may also mail a check to our office at 7426 Hubbard Avenue, Middleton, WI  53562.

41. Under penalty of law, the applicant states that each of the above questions have been truthfully answered to the best of the knowledge of the signers. Signers agree to operate this business according to law and that the rights and responsibilities conferred by the permit, if granted, will not be assigned to another. (Individual applicants and each member of a partnership applicant must sign; corporate officer(s) must sign.) I attest that the above information is true and correct and that any false or incomplete information may result in denial of my application.
43. By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.
44. Initial here*
46. Please type name as shown on application above*
47. Date*
    Date
Leave This Blank:


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

    This field is not part of the form submission.

51. Submit

* indicates a required field