HomeMy WebLinkAbout20120744.tiffRESOLUTION
RE: APPROVAL OF RENEWAL APPLICATION FOR 3.2 PERCENT BEER RETAIL
LICENSE ISSUED TO CIRCLE K STORES, INC., DBA CIRCLE K STORE #2709846
AND AUTHORIZE CHAIR TO SIGN - EXPIRES MAY 29, 2013
WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
WHEREAS, Circle K Stores, Inc., dba Circle K Store #2709846, presented to the Board
of County Commissioners of Weld County, Colorado, an application for the renewal of a 3.2
Percent Beer Retail License for the sale of fermented malt beverages, containing not more than
3.2 percent of alcohol by weight, in sealed containers not for consumption at the place where
sold, and
WHEREAS, pursuant to Exhibit 5-H of the Weld County Code, said applicant has paid
the sum of $107.50 to the County of Weld for the renewal of the existing license, and
WHEREAS, said applicant has exhibited a State License for the sale of fermented malt
beverages containing not more than 3.2 percent of alcohol by weight in sealed containers not
for consumption at the place where sold, outside the corporate limits of any town or city in the
County of Weld at the location described as follows:
10963 West 1-25 Access Road, Longmont, Colorado 80501
NOW, THEREFORE, BE IT RESOLVED that the Board of County Commissioners of
Weld County, Colorado, having examined said application and the other qualifications of the
applicant, does hereby grant License Number 2012-06 for applicant to sell fermented malt
beverages, containing not more than 3.2 percent of alcohol by weight, in sealed containers not
for consumption at the place where sold, only at retail at said location; and the Board does
hereby authorize and direct the issuance of said license by the Chair of the Board of County
Commissioners, attested to by the Clerk to the Board of Weld County, Colorado, which license
shall be in effect until May 29, 2013, providing that said place where the licensee is authorized
to sell fermented malt beverages containing not more than 3.2 percent of alcohol by weight, in
sealed containers not for consumption at the place where sold, shall be conducted in strict
conformity to all of the laws of the State of Colorado and the rules and regulations relating
thereto, heretofore passed by the Board of County Commissioners of Weld County, Colorado,
and any violations thereof shall be cause for revocation of the license.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said application.
2012-0744
Cc_ so, Opp?.
4-1°I-ID-
LC0013
RENEW 3.2 PERCENT BEER RETAIL LICENSE - CIRCLE K STORE #2709846
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 19th day of March, A.D., 2012.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST:
Weld County Clerk to the Board
BY:
Deputy C
k to the Board
APPROVED AS TO FO
ounty Attorney
Date of signature: Li/S/-/A'
Sean P
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2012-0744
LC0013
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License Fee $107.50
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THIS LICENSE MUST BE POSTED IN PUBLIC VIEW
DR 8402
(10/29/07)
DEPARTMENT
ALCOHOLIC
STATE OF COLORADO
OF REVENUE
Liquor Enforcement Division
1881 Pierce Street, Suite 108
Lakewood, Colorado 80214
CIRCLE K STORES INC
CIRCLE K STORE
#2709846
10963 W 1-25 ACCESS RD
LONGMONT CO 80504
BEVERAGE LICENSE
Liability Information
Account Number
County City Indust. Type Liability Date
LICENSE EXPIRES AT MIDNIGHT
21-65089-0120
03 206 445120 C 053007
MAY 29, 2013
Type
Name and Description of license
Fee
2125
2190
3.2 PERCENT BEER RETAIL
LICENSE (OFF PREMISES)
COUNTY 85 PERCENT OAP FEE
$ 75.00
$ 42.50
TOTAL FEE(S)
This license is issued subject to the laws of the State of Colorado and especially
of Title 12, Articles 46 or 47, CRS 1973, as amended. This license is nontransferable
conspicuously posted in the place above described. This license is only valid through
date shown above. Questions concerning this license should be addressed to
Revenue, Liquor Enforcement Division, 1375 Sherman Street, Denver, CO 80261.
In testimony whereof, I have hereunto set my hand.
�
Division Director Executive
$ 117.50
under the provision
and shall be
the expiration
the Department of
ceutive Director
DR 8400 (11/09/06) LIQUOR OR 3.2 BEER LICENSE
COLORADO DEPARTMENT OF REVENUE RENEWAL APPLICATION
DENVER, COLORADO 80261
IIuJdJJl111rIIr111II111hIrII111I11III111I.I11I.Irrlrll.1
CIRCLE K STORE #2709846
SHELLEY HUFF
3001 GATEWAY DRIVE STE 130
IRVING TX 75063-2640
This renewal reflects no changes from the last ap-
plication. Complete page 2 and file now!
n Yes there are changes from the last application.
If applicant is a Corporation or Limited Liability com-
pany, use DR 8177 and send in with this renewal.
Any other changes of ownership require a transfer
of ownership. See your Local Licensing Authority
immediately.
License Number
21-65089-0120
License Type
2125
Liability Information
03 206 445120 C 053007
Business Location
10963 W 1-25 ACCESS
LONGMONT CO
Current License Expires
MAY 29, 2012
DEPARTMENTAL USE ONLY
Total Amount Due
Total Paid
$
Date
Wholesaler, manufacturer, importer, and public transportation
system license renewals do not need Local Licensing Author-
ity approval and must be returned directly to the Colorado De-
paMmont of Revenue at lonet Qn days prior to tho Current li
cense expiration date.
This application for renewal must be returned to your O TY. OR
COUNTY Licensing Authority at least 45. days prior to the expira-
tion date of your current license. Failureto do so may result in
your license not being renewed. Include both pages of this renewal
and payment..
OATH OF APPLICANT
I declare under penalty of perjury in the second degree that this application and all attachments are true, correct, and complete to the
best of my knowledge.
Authorized Signature
YCut
r—
Date
I-)-2013-
Business
DIErfa-C
Phone
Title U(SnI)f,
bYrt*-v2,1anct-cin 4 kfrixanA
Sales Tax Number
Al(05o8^
REPORT AND APPROVAL OF CITY OR COUNTY LICENSING AUTHORITY
The foregoing application has been examined and the premises, business conducted and character of the applicant are satisfactory, and w
do hereby report that such license, if granted, will comply with the provisions of Title 12, Articles 46 and 47, C.R.S.
THEREFORE THIS APPLICATION IS APPROVED. i
Local Licensing Authority for y t,; Ii
Weld County, Colorado ,-
Date
MAR 012
Signature Sean 'P. Conwa
Title Chair, Board of W d
County' Commissioners
4st
:
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D
DON TAC
1bC1By
DR 8400 (11/09/06)
COLORADO DEPARTMENT OF REVENUE
DENVER, COLORADO 80261
LIQUOR OR 3.2 BEER LICENSE
RENEWAL APPLICATION
Make check payab. to Cpbredn Pe{ per:dr evenueThe State may convert your
check to a one time ele ✓MchNdfgy'�iis.�'. n. Your bank account may be debited as
early as the same day received4y4ba = f converted, your check will not be returned.
If your check is rejected due to insufficient or uncollected funds, the Department of Rev-
enue may collect the payment amount directty from your banking account electronically.
21
Business Name
CIRCLE K STORE
LICENSE NUMBER (Use for all reference)
21-65089-0120
PERIOD
05-13
TYPE OF LICENSE ISSUED
3.2 PERCENT BEER RETAIL
LICENSE (OFF PREMISES)
CASH FUND
2330-100(999)
$ 50.00
STATE FEE
2125-750(999)
$ 25.00
COUNTY 85% OAP
2190-100(999)
$ 42.50
$ 117.E
2012-0744
Le -0O13
DR 8401 (02/19/09)
COLORADO DEPARTMENT OF REVENUE
LIQUOR ENFORCEMENT DIVISION
1881 PIERCE
LAKEWOOD. CO 80261
(303) 205-2300
ATTACHMENT TO LIQUOR OR
3.2 BEER LICENSE RENEWAL APPLICATION
This page must be completed and attached to your signed renewal application form.
Failure to include this page with the application may result in your license not being renewed.
Trade Name of Establishment /� v i + /
ul K `�Y ,
State License Number
Al-c,s198°1-orao
1. Operating Manager
G ilie Cf
Home Address .
1 e ao iii, a. for+Co1k's)e-O 8052
Date pf Birth
_._.
Y -e No
i i
2.
Do ou have legal possession of the premise for which this application for license is made?
Are the premises owned or rented: Owe_- If rented, expiration date of lease:
_
3.
Has there been any change in financial interest (new notes, loans, owners, etc.) since the last annual application? If yes, explain in
detail and attach a listing of all liquor businesses in which these new lenders or owners, (other than licensed financial institutions) are
materially interested.
Yes Soa
4.
Since the date of filing of the last annual application, has the applicant, or any of its agents, owners, managers, principals, or lenders
(other than licensed financial institutions), been convicted of a crime? If yes, attach a detailed explanation.
Yes No
/..]
5.
Since the date of filing of the last annual application, has the applicant, or any of its agents, owners, managers, principals, or lenders
(other than licensed financial institutions), been denied an alcoholic beverage license, had an alcoholic beverage license suspended or
revoked, or had interest in any entity that had an alcoholic beverage license denied, suspended or revoked? If yes, attach a detailed
explanation.
Yes
6.
Does the applicant, or any of its agents, owners. managers, principals, or lenders (other than licensed financial institutions), have a
direct or indirect interest in any other Colorado liquor license (include loans to or from any licensee, or interest in a loan to any
licensee)? If yes, attach a detailed explanation.
Yes PNo
7.
Corporation or Limited Liability Company (LLC) or Partnership applicants must answer these questions.
Since the date of filing of the last annual license application:
(a) Are there, or have there been: any officers or directors; or managing members; or general partners added to or deleted from
applicant for renewal of a 3.2 beer or liquor license?
(b) Are there or have there been: any stockholders with 10% or more of the issued stock of the Corporation; or any members with
or more membership interest in the LLC; or any partners with 10% or more interest in the partnership added to or deleted
from the applicant for renewal of a 3.2 beer or liquor license?
(c) If Yes to (a) or (b), complete and attach Form DR 8177: Corporation, Limited Liability Company or Partnership Report of Changes,
and all supporting documentation, and fees your Local Licensing Authority immediately.
Yes No
Yes A10%
8.
Sole proprietorships, Husband -Wife Partnerships or Partners in General Partnerships:
EVIDENCE OF LAWFUL PRESENCE
Each person identified above must complete and sign the following affidavit. Please make ad tional copies if necessary.
Each person must also provide a copy of their driver's license or state issued identification card.
In lieu of form DR 4679, the undersigned swears or affirms under penalty of perjury under the laws of the State of Colorado
that (check one):
I am a United States Citizen
I am not a United States Citizen but I am a Permanent Resident of the United States
I am not a United States Citizen but I am lawfully present in the United States pursuant to Federal Law
I am a foreign national not physically present in the United States
1 understand that this sworn statement is required by law because I have applied for a public benefit. I understand that state law
requires me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit. I further acknowledge
that making a false, or fraudulent statement or misrepresentation in this sworn affidavit is punishable under the criminal laws of
Colorado Revised Statute 18-8-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received.
Signature
tAdk--
Printed name
Altai ti -1114-
Date
lib -12.
-
i
LIQUOR/BEER RENEWAL REVIEW FORM
Date: February 23, 2012
TO: Lisa Carpenter and Jeremy Frey
FROM: CTB — Tonya Disney
SUBJECT: Liquor License Check
In accordance with the procedure for Liquor and/or beer license checks, please review all
records on the following establishment for any associated reports during the last year and return
your report to the Weld County Clerk to the Board's Office within two weeks. Your report will
be used by the Board of County Commissioners in considering the renewal of the license.
PLEASE RESPOND NO LATER THAN: March 9, 2012
ESTABLISHMENT: CIRCLE K STORES, INC.
DBA CIRCLE K STORE #2709846
109631-25 ACCESS ROAD WEST
LONGMONT, CO 80504
Current license expires: May 29, 2012
*******************************************************************************************************
No concerns
Deputy's Initials
The Sheriffs Office had a concern and the deputy has mutually
worked with the licensee to correct the concern.
(Complete Attached Worksheet)
Unresolved concerns exist requiring a Probable Cause Hearing
scheduled by the Board of County Commissioners.
(Complete Attached Worksheet)
********************************************************************************************************
Please notify at Extension
Board of Commissioner's Transfer of Ownership hearing.
of the date and time of the
Liquor/Beer License Worksheet
The following concerns are noted:
4
The Licensee and the Sheriffs Office have collectively agreed to implement the following to
correct concerns noted above: (A time line and corrective action should be listed for each
concern)
c5ess Ica 101 e u\c�C
he Establisr tent Owner�Please Print
O 2 l�
Date
Deputy Signature
Use another sheet of paper or attach separate proposal to this packet if needed.
Attach copies of all reports associated with this establishment for the last year.
Both the Deputy and the Owner of the establishment will be required to attend the Liquor
Hearing to testify to the above agreement.
To: Weld County Board of Commissioners
From: Deputy Jeremy Frey
Date: February, 24 2012
RE: Circle K Store #270946
Dear Commissioners,
I have researched and found 2 reported call for service to the Circle K Store #2709846
located at 10963 I 25 Access Road Longmont CO, 80504 for the Calendar year of 2011 to
present day. The calls were for theft at the business.
I find no grounds for disapproval for the renewal of the liquor license.
Respectfully Submitted,
Deputy Jeremy Frey
Community Resource Officer
Weld County Sheriff's Office
1950 "O" Street
Greeley, CO 80631
WELD
COUNTY 'SFIERLFi` 9Ei OFFICE
CommunitylResource Office
Lit LIDR ENFDRGEI.11'ENT WORKSHEET
1950(i'Sfreot
Greeley, Colorado 80631
Voice (970) 356-4015 • Fax (970) 304-6467
inspection Report
0 Incident Report CF :
uarlu Trade Name GAL IC ,4 .7% Q c g j , licensee Name:
License #1 Type: ? z Dale of Report, lacident: O 4) 3 1 a
t Peron Conlacled: ,r
q�3 s n/'��S Access �FOcc�11"� 5t5+SrCr
Adiws:
City, State, Tip: ( o..:M C 0 . Ps764-f Telephone If. 3pj . 42 7 g °C3
Y_�lo NfA Yes NIA
'
State Liquor License Posted Manager Registered
license in Control of Premises
State Sales Tax License Posted
County Liquor License Posted
Federal Form -11 ' Call (800) 398-2822
Food .Service License Posted
Alcohol Beverage Stock Acceptable
❑Warning DFollow-Up inspection
Violation:
Subject
Cbtting:
Addess:
HAW Plan ll:
Narrative: Act. Ou •. a \ - (S08 l -C l aO
rade Name Property Registered
Premises Physical Control Adequate ' /
Acceptable Dispensing System
Off Premise Storage Licensed
Only Permitted Items Sold
Alcohol From Permitted Source
Discuss Sales of Liquor to Minors
DSalado n 'dated Persons
az 7 a.
Date
Summons if:
DL/ IDW State:
Depu .
#: 1 l $ZI) Date: O 3 i
fat4wil
COLORADO
MEMORANDUM
To: Tonya Disney, Clerk to the Board
From: Bethany Salzman, Zoning Compliance Officer II
Date: March 2, 2012
Subject: Liquor License Referral ((LC0013))
Review of the following liquor license renewal by the Department of Planning Services shows the following:
21-65089-0120
Circle K Stores, Inc.
Dba: Circle K Store # 2709846
10963 1-25 Access Road
Longmont, CO 80504
Mailing Address:
Circle K Store #2709846
Shelley Huff
3001 Gateway Drive Ste 130
Irving, TX 75063-2640
Zone District: C-3
This use is allowed through the zone district and the Site Plan Review (SPR-241) Permit.
No violations are occurring on the property at this time.
SERVICE, TEAMWORK, INTEGRITY, QUALITY
Liquor License Renewal
Building Department Comments
Department of Planning Services
1555 N 17th Ave
Greeley, CO 80631
(970) 353-6100
ESTABLISHMENT: CIRCLE K STORES, INC.
DBA CIRCLE K STORE #2709846
10963 1-25 ACCESS ROAD WEST
LONGMONT, CO 80504
Dear Sir/Madam,
The Weld County Building Department has reviewed the history and investigated any complaints or
violations that accompany the parcel the establishment resides on. The findings are as followed:
There currently is an open permit on the parcel for the remodel of the convenience store. They are
installing a new gas pump station with a canopy and a tenant finish of a Subway food store in part of the
main building. Permits have not yet been pulled for the Subway finish as of today. The building
Department has been contacted by the representative for the Subway and expect a permit to the pulled
in the very near future. We have no concerns with the request.
For further information or comments please contact the Weld County Building Department.
Sincerely,
Plans Examiner and Building Inspector
970-353-6100 x-3532
Memorandum
TO: Tonya Disney
FROM: Dan Joseph
SUBJECT: Liquor license inquiry
DATE: March 9, 2012
CC: Cindy Salazar; Debra Adamson
In response to your request, Environmental Health Services has reviewed the Retail Food Service
Establishment file for Circle K Store #2709846, located at 10963 West I-25 Access Road, in
Longmont, Colorado. At this time, there are no problems or concerns regarding this
establishment.
Should you have any questions regarding this matter, please contact me via e-mail at
djoseph@co.weld.co.us or by phone at 970-304-6415 extension 2206.
Thank you.
Dan Joseph
Environmental Specialist III
Tonya Disney
From:
Sent:
To:
Cc:
Subject:
Hi Tonya,
Janet Carter
Friday, February 24, 2012 9:42 AM
Tonya Disney; Bethany Salzman; Dan Joseph; Jeremy Frey; Jonathan Gesick; Lisa
Carpenter; Roy Rudisill
Brad Yatabe; David Clarke; Deb Adamson; Margie Martinez; Sara Evans
RE: Liquor Renewal - Circle K Store #2709846
This is an existing facility and Public Works doesn't have any comments at this time.
Janet L Carter
Traffic Engineer
Weld County Public Works Dept.
P.O. Box 758, Greeley, CO 80632
Tele-970.356.4000 ext 3726
Fax -970.304.6497
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
From: Tonya Disney
Sent: Thursday, February 23, 2012 8:48 AM
To: Bethany Salzman; Dan Joseph; Janet Carter; Jeremy Frey; Jonathan Gesick; Lisa Carpenter; Roy Rudisill
Cc: Brad Yatabe; David Clarke; Deb Adamson; Margie Martinez; Sara Evans; Tonya Disney
Subject: Liquor Renewal - Circle K Store #2709846
The following applicant has submitted a request for renewal of its 3.2 Percent Beer Retail License, LC0013. Please
provide any comments you may have before Friday, March 9, 2012. A .pdf copy of the application materials is
attached.
License Number:
21-65089-0120
Applicant:
Circle K Store Inc
Circle K Store #2709846
C/O Shelley Huff
10963 West I-25 Access
Longmont CO
Current License Expires:
May 29, 2012
Thank you,
Tanya Disney
Clerk to the Board
1150 0 streetIPO Box 758IGreeley, Colorado 80632
Phone: 970-336-7215 x 5226
Confidentiality Notice: This electronic transmission and any attached documents or other writings are intended only for
the person or entity to which it is addressed and may contain information that is privileged, confidential or otherwise
protected from disclosure. If you have received this communication in error, please immediately notify sender by return
e-mail and destroy the communication. Any disclosure, copying, distribution or the taking of any action concerning the
contents of this communication or any attachments by anyone other than the named recipient is strictly prohibited.
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THIS IS WATERMARKED PAPER - DO NOT ACCEPT WITHOUT VERIFYING WATERMARK - HOLD TO LIGHT TO VERIFY WATERMARK
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U.S. Postal Service,.
CERTIFIED MAILTM RECEIPT.
(Domestic Mail Only; No Insurance Coverage Provided)
Postage
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O Certified Fee
O Return Receipt Fee
(Endorsement Required)
Restricted Delivery Fee
(Endorsement Required)
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Street, Apt. No.; .r'
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PS Form 3800. June 2002
See Reverse for Instructions
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• Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
• Print your name and address on the reverse
so that we can return the card to you.
• Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
&AAAr 5to-t.a. c f r c.
roc, C,nW W.SA.).-,zs#DID`ISMlr
1O1.23 I '5 iACCQ.55 Rot We "
r`G\rllc-(TV U- a1,5CD 1 _c,ycjl
B. R-.=lved by (Printed Name)
❑ Agent
❑ Addressee
G., rate of Delivery
cao
D. Is delivery address different from hem 17 O Yes
If YES, enter delivery address below: O No
3. Service Type
a Certified Mail
❑ Registered
❑ Insured Mail
❑ Express Mail
❑ Return Receipt for Merchandise
❑ C.O.D.
4. Restricted Delivery) (Extra Fee)
O Yes
2. Article Number
(Transfer from service label)
PS Form 3811, February 2004
7004 2890 0003 5709 8723
Domestic Return Receipt
102595-02-M-1540
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