HomeMy WebLinkAbout20110871.tiffRESOLUTION
RE: APPROVAL OF RENEWAL APPLICATION FOR A RETAIL LIQUOR STORE
LICENSE FROM DOROTHY M. ZITEK, DBA HEREFORD PACKAGE LIQUOR, AND
AUTHORIZE CHAIR TO SIGN - EXPIRES JUNE 18, 2012
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 Liquor 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 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 2011-05 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, 2012, 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.
C5'. 5O, (Ippl.
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2011-0871
LC0024-B
RENEW LIQUOR LICENSE - 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 4th day of April, A.D., 2011.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST: �.
Weld County Clerk to t
BY:
Deputy Clerk to the Bo
AP P Paa VED
d "ty Attorney
Date of signature:
RM:
Barbara Kirkmeyer, chair
Sean P.P. C6n y, Pro-Tem
F. arcia
C
David . Long
ougla(s Rademache
2011-0871
LC0024-B
L�Crre.M.M.M.M.MW.Cre_Mr13
Incense Fee 13750
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T, VINOUS, AND SPIRITUOUS LIQUOR
TO SELL AT RETAIL
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authorized this 4th day of April, 2011
The Board of County Commissioners
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THIS LICENSE MUST BE POSTED IN PUBLIC VIEW
DR 8402
(10129/07)
DEPARTMENT
ALCOHOLIC
STATE OF COLORADO
OF REVENUE
Liquor Enforcement Division
1881 Pierce Street, Suite 108
Lakewood, Colorado 80214
ZITEK DOROTHY N
HEREFORD PACKAGE
LIQUOR
39520 WCR 136
HEREFORD CO 80732
BEVERAGE LICENSE
Liability Information
Account Number
County City Indust. Type Liability Date
LICENSE EXPIRES AT MIDNIGHT
24-77634-0000
03. 206 445310 I 061998
JUN 18, 2012
Type
Name and Description of License
Fee
1941
2190
RETAIL LIQUOR STORE
LICENSE - MALT, VINOUS,
AND SPIRITUOUS
COUNTY 85 PERCENT OAP FEE
$ 100.00
$ 212.50
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.
APR 2 0 20111
6K7 / J RLE if
Division Director Executive
$ 312.50
under the provision
and shalt be
the expiration
the Department of
IZALLA,
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
a This renewal reflects no changes from the last ap-
plication. Complete page 2 and file now!
I-1 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 2u 77634-0000
4
Llcensep
1941
Liability Information
03 206 445310 I 061998
Business Location
39520 WCR 136
HEREFORD CO
Current License Expires
JUN 18, 2011
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.
,AutAorized Signature
�� h7 . )
Date
Sa—aJ /b/2V-'is—O4.24O
Business Phone
Title C
�rTJ
Sale�sf Tax �NfuLmber
l O ° ao
REPORT AND APPROVAL OF CITY OR COUNTY LICENSING AUTHOR
The foregoing application has been examined and the premises, business conducted and character of the applicant are satisfactory, and we
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. --_ --�
Local Licensing Authority for \)
Welfi County, Colorado 4.
f•
Date m
011
Signature Y/`%
Barba K er t /
Title Chair, Board of Weld sy -
County Commissioners 5 ) r
DE NOT DETACH
DR 8400 (11/09/06) LIQUOR OR 3.2 BEER LICENSE
COLORADO DEPARTMENT OF REVENUE RENEWAL APPLICATION
DENVER, COLORADO 80261
er
Make check payable to
check to a one time electr
early as the same day receive
If your check is rejected due to insu cien or uncollected funds, the Department of Rev-
enue may collect the payment amount directly from your banking account electronically.
=--rpj the esar-ci •�
epagrr1i i of e.The state may convert your
tJl(r ns9eti�n �Y r bank account may be debited as
Jfsanvened, your check will not be returned.
21
Business Name
HEREFORD PACKAGE
LICENSE NUMBER (Use for all reference)
24-77634-0000
PERIOD
06-12
TYPE OF LICENSE ISSUED
RETAIL LIQUOR STORE
LICENSE - MALT, VINOUS,
AND SPIRITUOUS
CASH FUND
2320-100(999)
$ 50.00
STATE FEE
1941-750(999)
$ 50.00
COUNTY 85% OAP
2190-100(999)
$ 212.50
SUB -TOTAL $ 312.50
ADD $100.00 TO RENEW RETAIL WAREHOUSE STORAGE PERMIT2210-100(999) $ •
TOTAL AMOUNT DUE $-
2011-0871
Leto ay B
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 L.
Ae-,���oxd Pik,XV )1)5i Li 0 R
State License Number
2/ 97 ���o�
Aerating Manager HoYe Address
.s> it'z / 3`%310 EA). e, , Rd 13/o Li,AE5e/?d re,
Date of Birth
7-:
Do you/ ve legal ss ssion of the premises for which this application for license is made?
Are the premises owned or rented: If rented, expiration date of lease:
Yes No
w
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 No
r�
Ell
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 No
� ►l
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
✓�
7(
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
100/0 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
7
Yes No
8. Solo proprietorships, Husband -Wife Partnerships or Partners
EVIDENCE OF
Each person identified above must complete and sign the following
Each person must also provide a copy of their driver's license
In lieu of form DR 4679, the undersigned swears or affirms
that (check one):
® I am a United States Citizen
I am not a United States Citizen but I am a Permanent Resident
in General Partnerships:
LAWFUL PRESENCE
affidavit. Please make additional copies if necessary.
or state issued identification card.
under penalty of perjury under the laws of the State of Colorado
of the United States
in the United States pursuant to Federal Law
States
I have applied for a public benefit. I understand that state law
States prior to receipt of this public benefit. I further acknowledge
in this sworn affidavit is punishable under the criminal laws of
criminal offense each time a public benefit is fraudulently received.
• I am not a United States Citizen but I am lawfully present
I am a foreign national not physically present in the United
I understand that this sworn statement is required by law because
requires me to provide proof that I am lawfully present in the United
that making a false, or fraudulent statement or misrepresentation
Colorado Revised Statute 18-8-503 and it shall constitute a separate
Signature
1Ua-e---. ht .....Z.;:g J
Printed name
.Doiecit 6 u A4 7;c167?
Date
1-.2S-- )i
RIC
COLORADO
MEMORANDUM
To: Christie Peters, Deputy Clerk to the Board March 7, 2011
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
Dorothy M. Zitek
dba Hereford Package Liquor
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, INTEGRITY, QUALITY
COLORADO
MEMORANDUM
TO: CHRISTIE PETERS, CTB
FROM: DAN JOSEPH
ENVIRONMENTAL HEALTH SERVICE
SUBJECT: LIQUOR LICENSE INQUIRY
DATE: MARCH 11, 2011
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
LIQUOR/BEER RENEWAL REVIEW FORM
Date: March 3, 2011
TO: {DEPUTY} zu1/4.6,e rr erce...
FROM: CTB
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: March 18, 2011
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, 2011
********************************************************************************************************
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` l.t �Q r/ lam at Extension . , of the date and time of the
Board of Comr)r(issioner's renewal hearing. N�
9Th -3'1lo-33 6
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)
ORe
K 90 4151"1 !Lt 71 -74
Establishment Owner, Please Print
Establis' m: nt ig
Date
LaMo cut.,
eputy's 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.
WELD COUNTY SHERIFFS OFFICE
Community Resource Office
LIQUOR ENFDRC£,MENT WORKSHEET
1950 O'Street
Greeley, Colorado 80631
Voice (970) 356-4015. Fax (970) 304-6467
0
Inspection Report
Incident Report
CR#:
iiceae TsaOe tlsne:
'61bA IA -4 i f.C.j(d or (ac - l.;
Licensee Name: Odf b-
tat
License f / Type. J
ap 0 0-1 A --(-)(6r
i.
Date of Report I Incident.
ii
C,Ot \lZ
Address: a6d6
Person contacted:10t (
'T
I
'1tCdy,
State,.wed. a,b--.Oz,
7 `
...-
Telephone:: °170 '
5._
b
State Liquor License Posted
)(
Manager Registered
w
av
nn_
,TC
State Sales Tax License Posted
�l
License in Control of Premises
X
County Liquor License Posted
Trade Name Properly Registered
Federal Form 11 `Call (800) 398-2822
Premises Physical Control Adequate
x
Food Service License Posted
}(
Acceptable Dispensing System
Minor Warning Sign Posted
Off Premise Storage Licensed
X
Meals and Snacks Available
X
Only Permitted Items Sold
Cleanliness Adequate
Alcohol From Permitted Source
Books & Invoices Available
X
Discuss Sales of Liquor to Minors
_
Alcohol Beverage Stock Acceptable
Discuss Sales to Intoxicated Persons
❑Warning OFollow-Up inspection
Date
Violation:
( Date: l Time:
Sutyect:
1 DOB
I Hgt:
I Wgt: 1 Eyes Hair:
Clothing:DL
11D#:
State:
Address:
City:
Stale:
Zfl:
Evidence: Yes
NO
HtW Phone
Summons #
Court Date:
iwtcs: Yes
NO
Narrative: Oil --1.7(Q. -boob
CIA),hN. t , -L10 0)
Deputwq,L _
#: L 3'17 Date: 3 _3
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RECEIPT DATE 43/02-0// "O 85778
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ADDRESS 361520 X3(0
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MONEY
ORDER
RECEIPT
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ADDRESS
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U.S. Postal ServiceTM
CERTIFIED MAILTr., RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
Postage
Certified Fee
Return Receipt Fee
(Endorsement Required)
Restricted Delivery Fee
(Endorsement Required)
Total Postage & Fees
Postmark
Here
micro, do 'kk
-atreat, Apt. No.; �
or PO Box No. 3 (—1 aQ
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CI State, ZIPt4 �!
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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:
Btxtcord Yaa4- avid Grit(
1-4z.YcQord PGCa(twjc Liquor
C�o Ooro�l �i k
3°\5ao wCR 1 3l
\AtreS-trd Co Sel 3 a
different from Item 1 O Yes
If YES, enter delivery address below: In No
3. Service Type
® Certified Mall
o Registered
❑ Insured Mall
2. Article Number
(rransfer from service label)
PS Form 3811, February 2004 Domestic Return Receipt
❑ Express Mail
❑ Return Receipt for Merchandise
❑ C.O.D.
7005 1820 0003 5224 8263
102505-02-M-1540
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