STATE OF WISCONSIN
Town of ________
________ County
Whereas, ________ ________, of the Town of ________, ________ County, Wisconsin, has applied to the town board for a license to sell at [retail or wholesale] beverages containing less than one-half of one percent of alcohol by volume to be consumed [on or off] the premises where sold on the following described premises within the town: [describe premises];
It is ordered as follows:
1. That the application for the license applied for be granted, upon payment of the following license fee: $________;
2. That the town clerk sign and deliver the license to each license applicant, upon producing to the clerk a receipt, showing the payment to the town treasurer of the license fee required under this order.
Dated this ______ day of ________, 20__.
[Signatures of town board]
Attest: [Signature of town clerk]
