Inspection Request for a Liquor License

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Premise Information

* Operation type New construction
Existing

* Business type Food premise
Personal service setting (manicure, hair or barbering, tattoo)
Public pool
Public spa / hot tub

* Premise type Indoor seating
Outdoor patio
Extension
Other

* Location setting Commercial
Residential

* Water supply Municipal
Private well / cistern
Regulated small drinking water system

* Proposed opening date Currently operating
Opening date

* Business name

Corporate name

* Business address

* Business phone number
xxx-xxx-xxxx

* Business email

Owner Information

* Owner name

* Phone number
xxx-xxx-xxxx

* Email address

Mailing address (if different than business address)

Notice of Collection

Any personal information or personal health information submitted will be collected, used, and disclosed, where applicable, by members of Regional staff according to the Municipal Freedom of Information and Protection of Privacy Act or the Personal Health Information Protection Act. Any information you share will only be used for the intended purpose for which it was provided.

For questions or comments about privacy practices, or for more information about the administration of the Municipal Freedom of Information and Protection of Privacy Act in Niagara Region programs, see Freedom of Information and Open Government.

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Inspection Request for a Liquor Licence

Premise Information

Owner Information

Notice of Collection

Public Health