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HomeMy WebLinkAbout20121176RESOLUTION RE: APPROVAL OF RENEWAL APPLICATION FOR RETAIL LIQUOR STORE LICENSE FROM DOROTHY NI. ZITEK, DBA HEREFORD PACKAGE LIQUOR AND AUTHORIZE CHAIR TO SIGN - EXPIRES JUNE 18, 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, Dorothy M. Zitek, dba Hereford Package Liquor, presented to the Board of County Commissioners of Weld County, Colorado, an application for the renewal of a Retail Liquor Store License, for the sale of malt, vinous and spirituous liquors, and WHEREAS, pursuant to Exhibit 5-H of the Weld County Code, said applicant has paid the sum of $137.50 to the County of Weld for the renewal of the existing license, and WHEREAS, said applicant has exhibited a State Liquor Store License for the sale of malt, vinous and spirituous liquors in sealed containers not for consumption at place where sold, outside the corporate limits of any town or city in the County of Weld at the location described as follows: 39520 County Road 136 Hereford, Colorado 80732 WHEREAS, the Licensee shall host "responsible vendor" training every six (6) months as agreeable to the Colorado Department of Revenue Liquor Enforcement Division, and this training shall be open to other area licensees. Each employee shall be "responsible vendor" trained, and the Licensee shall provide documentary evidence that each employee has been "responsible vendor" trained to the Weld County Sheriff's Office within thirty (30) days of the first available "responsible vendor" class after hiring. Evidence of such shall be included in the referral report submitted by the Sheriff's Office at the time of annual renewal. 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 2012-10 to said applicant to sell malt, vinous and spirituous liquors in sealed containers not for consumption at 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 June 18, 2013, providing that said place where the licensee is authorized to sell malt, vinous, and spirituous liquors in sealed containers not for consumption at 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. tu' so, nppl. 2012-1176 LC0024B RENEW LIQUOR STORELICENSE - HEREFORD PACKAGE LIQUOR PAGE 2 BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said application. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 7th day of May, A.D., 2012. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: -5 — Weld County Clerk to the Board BY: Deputy CI Date of signature: & 19 / Sean P. Ii� ay, Chair Dou.las Radema her 2012-1176 LC00246 1 -- , ,L rr.i...\.)).Cr 0 C.,K • 9-4 Ct l� .d H ono 1 CCI ti) 8.4 C w Cfc V U 1 Q77S 714 a) 4-44 E C� 1 r O U O C) O cn c� U cn U cc 0 Pic' V O V ct b �` •� y� 1 r Ct c� i� Y.--% b ct Cf' 4 0O ,n O : \�- 1 4 c _ V V cu w x V O O O cu c 1 N _ czs o �' ^ �1 iii of N� cei ^ w o L � � cat cucn 3-4 •.--I co 0O O H �� CJ�JGJ�JFJ'J'�C1'�GJ�cJ�FJ�JFJ'J'�_JCJ�GJ�FJ��'-C7'-GJ�J ��� THIS LICENSE EXPIRES JUNE 18, 2013 w H O TO BE POSTED IN A CONSPICUOUS PLACE. THIS LICENSE MUST BE POSTED IN PUBLIC VIEW DR 8402 (11/23/11) S A O CO ORADO D PAR M N O R V NU Liquor Enforcement Division 1881 Pierce Street, Suite 108 Lakewood, Colorado 80214 ZITEK DOROTHY M HEREFORD PACKAGE LIQUOR 39520 WCR 136 HEREFORD CO 80732 A CO 0 B V RAG C NS Liability Information Account Number County City Indust. Type Liability Date LICENSE EXPIRES AT MIDNIGHT 24-77634-0000 03 206 445310 I 061998 JUN 18, 2013 Type Name and Description of License Fee .1941 RETAIL LIQUOR STORE $ 100.00 LICENSE - MALT, VINOUS, AND SPIRITUOUS 2190 COUNTY 85 PERCENT OAP FEE $ 212.50 TOTAL FEE(S) $ 312 . 50 This license is issued subject to the laws:: •ote: o C.olrado and especially under the provision of Title 12, Articles 46 or 47, CRS 19: . amended �"1' s:�License is nontransferable and shall be conspicuously posted in the place above es ibed::: hfs license is only valid through the expiration date shown above. Questions concerning t it uld Abe addressed to the Department of Revenue, Liquor Enforcement Division, 1375 Si: • . . .......... ..- •• .. ar ...... . :Stree ............... ............. .......... ..... ........... r etf:•0 .. ........ .. ..... ........... .......... 80261. . ...„........:::.:.:.:.:.,.........•......„:::::...:::.:.::. ........................„............. ............ ...................................................... ...... In testimony whereof, I have hereunto set. 073m444,-14,t,A.` JUN 06 201; si,„64,,,a-Atetc Division Director Executive Director DR 8400 (11/09/06) LIQUOR OR 3.2 BEER LICENSE COLORADO DEPARTMENT OF REVENUE RENEWAL APPLICATION DENVER, COLORADO 80261 ZITEK DOROTHY M HEREFORD PACKAGE LIQUOR PO BOX 45 HEREFORD CO 80732 ❑ This renewal reflects no changes from the last ap- plication. Complete page 2 and file now! ❑ 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. LicensNumber 24-77634-0000 License p 1941 Liability Information 03 206 445310 I 061998 Business Location 39520 WCR 136 HEREFORD CO Current License Expires JUN 18, 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- partment of Revenue at least 30 days prior to the current li- cense expiration date. This application for renewal must be returned to your CITY OR COUNTY Licensing Authority at least 45 days prior to the expira- tion date of your current license. Failure to 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. ,,z2.67#7,46; orized Signature p )17±iTitle Date '{.,/3 /z Business Phone pav 3s z1/o /-L4IMe... Sales Tax Number 24"'94,31/ 0000 REPORT AND APPROVAL OF CITY OR COUNTY LICENSING AUTHORITY The foregoing application has been examined and the premises, business conducted an f the applicant are satisfactory, and we do hereby report that such license, if granted, will comply with the provisions of Title 1 •il °s 6 , C.R.S. THEREFORE THIS APPLICATION IS APPROVED. Local Licensing Authority for - Weld County, Colorado y 4`;•E Date 2012 Signature �—T (D Title Chair, Board of it County Commissioners/- s. � DEfACF' Sean P. Conway accr TAri;l DC)NOT DETACH . - - t.� rk to the DENVER, ....,-- Business SUB -TOTAL $ 312. ADD $100.00 TO RENEW RETAIL WAREHOUSE STORAGE PERMIT2210-100(999) $ • TOTAL AMOUNT DUE $ 2012-1176 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 C 11 671 E cil Rd PAGE'/S<f LiyeiO/z State License Number 1. Operating Manager i% PotefAy 4l Z,°/f 1 Home Address °ys.)0 LeAE,Rd /3‘ N6Rf50Rd, C,”, BnOdz Date of Birth --,,,:,-, 2. Do yili have legal possession of the premises for which this application Are the premises owned or rented: ........... If rented, for license is made? expiration date of lease: Yes No X 3, Has there been any change in financial interest (new notes, loans, owners, etc.) since the last annual application? If yes, explain in Yes No detail and attach a listing of all liquor businesses in which these new lenders or owners, (other than licensed materially interested. financial institutions) are v �6 4. Since the date of filing of the last annual application, has the applicant, or any of its agents, owners, managers. (other than licensed financial institutions), been convicted of a crime? If yes, attach a detailed explanation.EN principals. or lenders 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 Yes No revoked, or had interest in any entity that had an alcoholic beverage license denied, suspended or revoked? If yes, attach a detailed explanation. AA 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 No igl 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 10% or more membership interest in the LLC; or any partners with 10% or more interest in the partnership added to or deletedXI 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 riAr Yes No 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 additional 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): (r�4 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 I 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. Si nature Printed name Date � � boasFhK,M-,2Viia(< N r3 iz Apr 25 12 0.1:47p mark zitek 970-895-2216 p.1 CEASE AGREEMENT I, Mark W. Zitek, on this date lease to k Dorothy M. Zit is for May 26, 2011 WCR 136 a , hereby extend a Hereford, Colorado g portion of my building at 39520 store. This lease 0732 for use as a foot traffic and calls out that it is for package liquor will have its own package liquor only, no has always entrance. This business is, and continue under been, called Hereford Package such business name. e Liquor and will s for as long as Dorothy The term for this lease is her package liquor business. Z�tek wishes to utilize the space for Agreed to by: _ Doroth'/I. Zi , Hereford Package Liquor } l N. 1 J � I.. -969-0.L6 �e}iz pew dzv:k,o JdV O O 'O CO O U ° cti m o ° • � U o d Y m N N ° O N UaO O -o o ° N Co U o 0 m aD co Fig, O O • L r U g o p Y m N N N O N HOW PAID CASH CHECK 13.1 I 63 MONEY ORDER RECEIPT DATE q - I - / RECEIVED FROM Hen corgi 'Podia e L1 tAUr ADDRESS LID oV 86393 KAI ithaau d k FOR LC -0,7) 4 > HOW PAID CASH CHECK3 31a 50 MONEY ORDER a loo $ a.cjo e. it liquor U Ctn5R 7Rksttwoi 4 fTV\TL i -'n BY -,1- • RECEIPT DATE Li-ii-tca NO, 86394 RECEIVED FROM iki0corcl. (\IA aI 2. Uotkier ADDRESS C.lo Qor&Ayw\ ic\c OflItla�rul,�,d ll�a, - A,rt l "'I tar $ I?er,� a9 FOR LC. °D9 -1 e R-C�G L C'' en 141 BY ciA • To: Weld County Board of Commissioners From: Deputy Lisa Carpenter Date: February 6, 2012 RE: Dorothy M. Zitek/ DBA Hereford Package Liquor Dear Commissioners, I have researched and found no reported calls for service to the Hereford Package Liquor, located at 39520 Weld County Road 136, Hereford, CO 80732 for the Calendar year of 2011 to present day. I find no grounds for disapproval for the renewal of the liquor license. Respectfully Submitt eputy Lisa Carpenter Community Resource Officer Weld County Sheriffs Office 1950 "O" Street Greeley, CO 80631 LIQUOR/BEER RENEWAL REVIEW FORM Date: March 3, 2011 TO: Lisa Carpenter and/or Jeremy Frey FROM: CTB — Tonya Disney SUBJECT: Liquor License Check In accordance with the new 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 renewal of the liquor and/or beer license. PLEASE RESPOND NO LATER THAN: February 14, 2012 ESTABLISHMENT: DOROTHY M. ZITEK DBA HEREFORD PACKAGE LIQUOR 39520 WELD COUNTY ROAD 136 P.O. BOX 45 HEREFORD, CO 80732 Current license expires: JUNE 18, 2012 No concerns //1),; 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 renewal hearing. of the date and time of the Liquor/Beer License Worksheet The following concerns are noted: 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) Estaiatishmertt-OwnerrPlease Print Establishment Signature Date ePnature r72</ Cu/SK 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. WELD COUNTY SHERIFF'S OFFICE Community Resource Office LIQUOR ENFORCEMENT WORKSHEET • 1950 O'Street Greeley, Colorado 80631 Voice (970) 356-4015 • Fax (970) 304-6467 inspection Report Incident Report CR#: i crrwe Made t+ame.. O f ,� � Licensee Namer/ `4 / /j..0 ,7�l tai-: `~ License/!Type. , i{� ] c.C�.c 1 t✓t, C Date of Report !Incident: _ 7--/J - Address: S _ c",./. rS & `'C Person Contacted: /1 jai k 7, lei_ ``„J/) City. State. Zip: :e_ it., rci t- t- • 5,;./.6-,7.3..1... Telephoto t •,;iii Yes No NIA Yes No NIA State Liquor License Posted ,1 Manager Registered `---i State Sales Tax License Posted LLicense in Control of Premises ✓` County Liquor License Posted ,/ Trade Name Properly Registered 1. -- Federal Form 11 ' Call (800) 398-2822 ,/ Prernises Physical Control Adequate ✓ Food Service License Posted ✓ Acceptable Dispensing System Minor Warning Sign Posted n;/' Off Premise Storage Licensed --Only 1. -- Meals and Snacks Available v" Permitted Items Sold Cleanliness Adequate ✓i Alcohol From Permitted Source I ,..- Books & Invoices Available '� Discuss Sales of Liquor to Minors .-- Alcohol Beverage Stock Acceptable ✓ Discuss Sales to Intoxicated Persons [1Warning LFollow-Up Inspection Licensee preaentati re S gnature �� 0 t VNatborl: Date: Time: Subject: Hat. Wgt: Eyes: I Hair: Clothing: Address City: State: DL I ID# Stale: HAY Phone Summons Court Date: Evidence: Yes NO Photos: Yes NO Narrative:. -2 V- /7Z 3 j Deputy: - y`/ ./l#:iA-%0 ( -5 .e Date: - /;_ Tonya Disney From: Sent: To: Subject: Janet Carter Tuesday, April 17, 2012 2:43 PM Tonya Disney RE: Liquor License Renewal - Hereford Package Liquor do Dorothy Zitek This is an existing facility. Public Works does not 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: Tuesday, April 17, 2012 1:45 PM 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 License Renewal - Hereford Package Liquor c/o Dorothy Zitek The following applicant has submitted a request for renewal of its Retail Liquor License, LC0024B. Please provide any comments you may have before May 1, 2012. A .pdf copy of the application materials is attached. License Number: 24-77634-0000 Applicant: Hereford Package Liquor c/o Dorothy M. Zitek Current License Expires: June 18, 2012 Thank you, Tonya Disney Memorandum TO: Tonya Disney FROM: Dan Joseph SUBJECT: Liquor license inquiry DATE: 4/19/12 CC: Cindy Salazar; Debra Adamson In response to your request, Environmental Health Services has reviewed the Retail Food Service Establishment file for Hereford Packaged Liquor, located at 39520 WCR 136, in Hereford, Colorado. While the Department doesn't currently inspect this facility (it is not regulated by the Department) we are involved with the food facility located immediately adjacent to it. The liquor store prepares ice that is to be sold at the food facility. The ice is produced with an approved water system. Based on this, the Department is recommending for approval of their liquor license. 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 TY MEMORANDUM To: Tonya Disney, Deputy Clerk to the Board April 20, 2012 From: Bethany Salzman, Zoning Compliance Officer, Dept. of Planning Services Subject: LC0024-B Review of the following liquor license renewal by the Department of Planning Services shows the following: 24-77634-0000 Hereford Package Liquor c/o Dorothy M Zitek 39520 WCR 136 PO Box 45 Hereford, CO 80732 Zone District: Agricultural This use existed prior to zoning and is permitted as a "Nonconforming Use" (NCU-336). No violations are occurring on the property at this time. SERVICE, TEAMWORK, INTEGRI'!Y, QUALITY Tonya Disney From: Sent: To: Subject: Roy Rudisill Friday, April 27, 2012 4:40 PM Tonya Disney; Jonathan Gesick RE: Liquor License Renewal - Hereford Package Liquor c/o Dorothy Zitek No Concerns for this on from me. Director Roy Rudisill Weld County Office of Emergency Management 1150 O St. Greeley Co. 80632 970-304-6540 Office 970-381-0417 Cell 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: Friday, April 27, 2012 4:23 PM To: Roy Rudisill; Jonathan Gesick Subject: FW: Liquor License Renewal - Hereford Package Liquor c/o Dorothy Zitek Just a reminder that I would like to have your referrals by May 1, 2012. Thank you, Tonya Disney Clerk to the Board 1150 O Street I PO Box 758 Greeley, Colorado 80632 Phone: 970-336-7215 x 5226 1 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: Tuesday, April 17, 2012 1:45 PM 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 License Renewal - Hereford Package Liquor c/o Dorothy Zitek The following applicant has submitted a request for renewal of its Retail Liquor License, LCOO24B. Please provide any comments you may have before May 1, 2012. A .pdf copy of the application materials is attached. License Number: 24-77634-0000 Applicant: Hereford Package Liquor c/o Dorothy M. Zitek Current License Expires: June 18, 2012 Thank you, Tonya Disney Clerk to the Board 1150 O Street PO Box 758 Greeley, 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. 2 Tonya Disney From: Sent: To: Subject: Jonathan Gesick Monday, April 30, 2012 7:36 AM Tonya Disney RE: Liquor License Renewal - Hereford Package Liquor do Dorothy Zitek The building Department has no concerns.Thanks Jonathan D Gesick Plans Examiner/Building lnpsector Building Department 1555 N 17th Ave Greeley, CO 80631 tel: (970)353-6100 Ext. 3532 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: Tuesday, April 17, 2012 1:45 PM 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 License Renewal - Hereford Package Liquor c/o Dorothy Zitek The following applicant has submitted a request for renewal of its Retail Liquor License, LC0024B. Please provide any comments you may have before May 1, 2012. A .pdf copy of the application materials is attached. License Number: 24-77634-0000 Applicant: Hereford Package Liquor c/o Dorothy M. Zitek Current License Expires: June 18, 2012 Thank you, Tonya Disney 1 Clerk to the Board 1150 O 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. 2 Fedbc. USAirbill ICUCA.I.UII I I.ODU.UUfeULX I.ODU.403.�SOy Express Trdfx acking T, Number 8715 2808 1689 1 From mama pm, end pram bet 5-8-12 Senders FedEx Date Account Number S NDi l � ''1253-'-194'8'-3 -. 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Byeang Patiury agree. x terserlge coMNms on the beck dilly Arbil and mea cameFedEaSenina OuW,inclWFiglama that Raybail rym'Partn yn4¢Jlm4ipk FedErPsINRO IN USA •sas 553 r 5 a s DOROTHY ZITEK DBA HERFORD PACKAGE LIQUORS PH. 970-895-2338 39525 WELD CR. 136 HERFORD, CO 80732 Pay To The Order Of 76-162-1041 1172 20 '- Fec POINTS WEST COMMUNITY BANK TELEBANK1-800-361751U 906c0 HRS.) O2O42 U.S. Postal Servicemi CERTIFIED MAILTM RECEIPT. (Domestic Mail Only; No Insurance Coverage Provided) Postage Certified Fee Return Receipt Fee (Endorsement Required) Restricted Delivery Fee (Endorsement Required) Total Postage 8 Fees Postmark Here Sent To � "A / l WLb}h Zi k QI&I/e.rrlue_l -A lief Zito or Street, Apt. N or PO Box No. 3 cj5&b C.e /J...11 City, State, ZIP+4 �C A/ere fort=6O ■ 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. pro}hvt zI k O�W %ert ord o. e U (Uor 'Y15O CIJZ 13u 0001. 1 � 0-isbeck Cx svi3 2. Article Number (Transfer from service label) D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: O No 1. Article Addressed to: 3. Service Type '=atertlfled Mail ❑ Registered ❑ Insured Mail ❑ Express Mail ❑ Return Receipt for Merchandise o C.O.D. 4. Restricted Delivery? (Extra Fee) 7004 2890 0003 5709 8761 ❑ Yes PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 Hello