HomeMy WebLinkAbout20101432.tiffRESOLUTION
RE: APPROVAL OF RENEWAL APPLICATION FOR TAVERN LIQUOR LICENSE FROM
VIPER2, INC., DBA BORDERLINE AND AUTHORIZE CHAIR TO SIGN - EXPIRES
SEPTEMBER 7, 2011
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, Viper2, Inc., dba Borderline, presented to the Board of County Commissioners
of Weld County, Colorado, an application for the renewal of a Tavern 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 $175.00 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 for consumption by the drink on the premises only, outside the corporate limits
of any town or city in the County of Weld at the location described as follows:
68947 Highway 85, Carr, Colorado 80612
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 2010-09 to said applicant to sell malt, vinous and spirituous
liquors for consumption by the drink on the premises only, 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 September 7, 2011, providing that said place where the licensee is
authorized to sell malt, vinous, and spirituous liquors for consumption by the drink on the premises
only, 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.
CA,: SO
2010-1432
LC0047
RENEW LIQUOR LICENSE - BORDERLINE
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 7th day of July, A.D., 2010.
BOARD OF COUNTY COMMISSIONERS
ELD COUNTY COLORADO
ATTEST:
Weld County Clerk to t
BY:
Deputy Clerk to the
AP
County Attorney
Date of signature
gay
Dougla
EXCUSED
Barbara Kirkmeyer, Pro-Tem
r, Char
Sean P/Co
C
illiam F. Garcia
EXCUSED
David E. Long
2010-1432
LC0047
SEPTEMBER 7
THIS LICENSE EXPIRES
ai
H
O
0
J
LT,VINOUS„
TO SELL AT RETAIL
SPECIFY KINDS OF LIQUORS
malt, vinous,
tion on the
The Board of County Commissioners
c O O
a
O
0)
.0
H
IS 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
VIPER 2 INC
BORDERLINE
68947 HIGHWAY 85
CARR CO 80612
BEVERAGE LICENSE
Liability Information
Account Number
County City Indust. Type Liability Date
LICENSE EXPIRES AT MIDNIGHT
42-07852-0000
03 020 722110 C 090805
SEP 07, 2011
Type
Name and Description of License
Fee
2011
2190
TAVERN LIQUOR LICENSE -
MALT, VINOUS, AND
SPIRITUOUS
COUNTY 85 PERCENT OAP FEE
$ 75.00
$ 425.00
TOTALFEE(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.
44-i.oa/a-IL) AUG 1 0 2010
Division Director Executive
$ 500.00
under the provision
and shall be
the expiration
the Department of
Director
DR 8400 (11/09/06) LIQUOR OR 3.2 BEER LICENSE
COLORADO DEPARTMENT OF REVENUE RENEWAL APPLICATION
DENVER, COLORADO 80261
IIuI IIuuIrlrllrrrrLrLJlyd,,I,,.IILrd.Llrr,IIJlrrrl
BORDERLINE
CHAVEZ KIMBERLY
4853 KINGBIRD DR
FIRESTONE CO 80504-3417
This renewal reflects no changes from the last ap-
plication. Complete page 2 and file now!
O 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.
Number
Licens4207852-0000
License
2p1 1
0
Liability Information
03 020 722110 C 090805
Business Location
68947 HIGHWAY 85
CARR CO
Current License Expires
SEP 07, 2010
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 knowle
A o ed6ignatur
D-! 1 -10
4
siness Phone _
iok076D6l
ea/
Sfi T Numbe
7 ? 5L -0)6 )6 C
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.
Local Licensing Authority for 1
i.0 % L 0 7 2010
Weld County Colorado
nature D Rademacher
rx,s�e.C w12 G ✓
Ttle
Chair, Board of Weld
County Commissioners
st •. , ���ii
.9Ffilr—
I
nn "rr) nt?ACN
DR 8400 (11/09/06)
COLORADO DEPARTMENT OF REVENUE
DENVER, COLORADO 80261
LIQUOR OR 3.2 BEER LICENSE
RENEWAL APPLICATION
;yt btxea. kr L.
Make check payable to:ec Colorado tflsml d7 ¢Tamer - te may convert your
check s a one e d y receive banki 2 St %saetJ taut, b.4 it check ount may t be dreturned d.
Its
earlyyour
check
is eectcue dto ns cien.-rt�rlysndwill arttbeteofRev-
If your check is rejected me to insufficient dire or mur funds, the Department aev-
enue may collect the payment amount direct from your banking account electronically.
21
Business Name
BORDERLINE
LICENSE NUMBER (Use for all reference)
42-07852-0000
PERIOD
09-11
TYPE OF LICENSE ISSUED
TAVERN LIQUOR LICENSE -
MALT, VINOUS, AND
SPIRITUOUS
CASH FUND
2320-100(999)
$ 50.00
STATE FEE
2011-750(999)
$ 25.00
COUNTY 85% OAP
2190-100(999)
$ 425.00
SUB -TOTAL $ 500.C
ADD $100.00 TO RENEW RETAIL WAREHOUSE STORAGE PERMIT2210-100(999) $
TOTAL AMOUNT DUE $
2010-1432
LC o09
DR 8401 (02/19109)
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.
Tr me of stab^ s V I t
IWI V dl -lY�
State q t.>) License Number_
`/"JIl O`l'3 3 � U-7 S
eratin
ana er
%Pgr 1 � 1' Z
Ho
s
? $i '- -c/ D
Date f Bi h
2
Do you
Are the
have legal session of the1premofor hich this application
premises owned or rented: Via I YL If rented,
for lic
expiration date
e is made?,2.--
of lease: Co "Z V ICD
es
No
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
Nr o
rj1,2S,Jl�
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
rrNv�N,00
ly I
(1
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 _
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
N„ o
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 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
❑
Yes
,No i
�y-f
IV/J2V.
8.
Sole proprietorships,
Each person
Each person
In lieu of
that (check
Husband -Wife Partnerships or Partners in General Partnerships:
EVIDENCE OF LAWFUL PRESENCE
identified above must complete and sign the following affidavit. Please make additional copies if necessary.
must also provide a copy of their driver's license or state issued identification card.
form DR 4679, the undersigned swears or affirms under penalty of perjury under the laws of the State of Colorado
one):
a United States Citizen
not a United States Citizen but I am a Permanent Resident of the United States
not a United States Citizen but I am lawfully present in the United States pursuant to Federal Law
a foreign national not physically present in the United States
that this sworn statement is required by law because I have applied for a public benefit. I understand that state law
me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit. I further acknowledge
a false, or fraudulent statement or misrepresentation in this sworn affidavit is punishable under the criminal laws of
Revised Statute 18-8-503 and it shall constitute a separate criminal offense each time a public benefit is fraudulently received.
I am
I am
I am
I am
I understand
requires
that making
Colorado
Signatu e
Printed
yame
a
Yom"--'° l,(/I �Cl �V t �
be -A 1
Dat
�'t
MEMORANDUM
TO: JENNY VANEGDOM, CTB
FROM: DAN JOSEPH
ENVIRONMENTAL HEALTH SERVICE
SUBJECT: LIQUOR LICENSE INQUIRY
DATE: JUNE 19, 2010
CC: CINDY SALAZAR; DEBRA ADAMSON
In response to your request, Environmental Health Services has reviewed the Retail Food
Service Establishment file for the Borderline (Viper 2, Inc.) located at 68947 Highway
85, in Carr, 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(a�co.weld.co.us or by phone at 970-304-6415 extension 2206.
Thank you.
Dan Joseph
Environmental Specialist III
Mr
Mac
COLORADO
MEMORANDUM
To: Jenny VanEgdom, Deputy Clerk to the Board June 18, 2010
From: Bethany Salzman, Zoning Compliance Officer, Dept. of Planning Services
Subject: LC0047
Review of the following liquor license renewal by the Department of Planning Services shows the following:
42-07852-0000
Viper2, Inc.
dba Borderline
68947 Highway 85
Carr, CO 80612
Zone District: A (Agricultural)
This use is permitted through an "Amended Use by Special Review" (AmUSR-1096).
Currently there are no active zoning violations on the above mentioned property.
SERVICE, TEAMWORK, INTEGRITY, QUALITY
To: Weld County Board of Commissioners
From: Deputy Lisa Carpenter
Date: June 21, 2010
Re: Viper 2, dba Borderline
Dear Commissioners,
I have researched and found no reported calls for service to the Viper 2/dba;
Borderline, located at 68947 Highway 85, Carr, CO 80612 for the calendar year of 2009
to present day.
I find no grounds for disapproval for the renewal of the liquor license.
Respectfully Submitted,
Deputy Lisa Carpenter
Community Resource Officer
Weld County Sheriffs Office
LIQUOR/BEER RENEWAL REVIEW FORM
Date: June 21, 2010
TO: DEPUTY Lisa Carpenter
FROM: CTB
SUBJECT: Liquor License Check
In accordance with the new procedure for Liquor and/or beer license checks, p lease 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: JUNE 30, 2010
ESTABLISHMENT: VIPER2, INC.
DBA BORDERLINE
68947 HIGHWAY 85
CARR, CO 80612
Current license expires: SEPTEMBER 7, 2010
*******************************************************************
No concerns
4
Deputy ttials
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 Probabl? Cause Hearing
scheduled by the Board of County Commissioners.
(Complete Attached Worksheet)
**********************************************************#************Y**********1**************h**********
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)
Establishment Signature
Establishme
Date
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- SHERIFF'S OFFICE
Community tesaume Office
LIQUOR ENFORGgNIENT WORKSHEET
fy_`.
1950-0`Stfeet
Greeley, Waal) 80631
Voice (970) 356-4015 • Fax (970) 304-6467
Inspection Report
D Incident Report
CR#:
License Trade Name: V • ti
Licensee Name: ,�
Abet 66fcjerl,�
^-Ip�
License # / Tyype;�ITJ GI�o
Date of Report / Incident 4.1) _ I
Address{t? �`� 'i 7 1t g s
Person Contacted: ( t' t. As/.
City, State. Z 4114C2.,. . c z o L fa..
T e t Q--f_O - Ir (4 ,a ` LA,6-3._
es No
State Liquor License Posted
Vv„,Manager
Registered
✓'
State Sales Tax License Posted
✓
License in Control of Premises
✓
County Liquor License Posted
v
Trade Name Property Registered
V
Federal Form 11* Call (800) 398-2822
V
Premises Physical Control Adequate
Food Service License Posted
V
Acceptable Dispensing System
/
Minor Warning Sign Posted
,/
Off Premise Storage Licensed
Meals and Snacks Available
V
Only Permitted Items Sold
L.--..
Cleanliness Adequate
✓
Alcohol From Permitted Source
Books & Invoices Available
-
Discuss Sales of Liquor to Minors
✓
i
Alcohol Beverage Stock Acceptable
/
Discuss Sales to Intoxicated Persons
❑Warning ❑Follow -Up Inspection
Licensee / Representative Signature
Violation:
I Date:
I Time:
Subject:
I DOB:
I Hgt:
I Wgt: I Eyes:
I Hair:
Clothing:
DL 11D#:
State:
Address:
City:
Slate:
zip:
Evidence: Yes NO
HMI Phone #:
Summons #:
Court Date:
Photos: Yes NO
Narrative: 1/3-ta Lou, cpCO C -
'Tz c L'/mil - PS.-cD000
Deputy: L 5 t 01)--cp_s, ,' #: toC O (c_ L Date: to - I
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O Return Receipt Fee
(Endorsement Required)
U.S. Postal Service,..,
CERTIFIED MAILIM RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
Postage
Codified Fee
RJ (Endorsement Required)
ECI
ra
Ul
O
O
Restricted Delivery Fee
Total Postage & Fees
Sent To
m1-mrChuvcz
Postmark
Here
'Throe, Apt. No.; o ,J
orPOBoxPla D 53 kjicrbl r i D f
City, State, ZIP 1
PS Form 3800. June 2002
See Reverse for Instructions
QD l7- lu3a
■ Complete items 1, 2, and 3. Also complete
Rem 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:
1(imbt �� &avez
1.1753 kih5birti. Or.
cyr2s c, u c6u5b1-3t4I
2, Article Number
(Tiansferimm service label)
PS Form 3811, February 2004
C. Date of DelNery
Is delivery address : from item 17 ❑ Yes
If YES, enter delivery address below: O No
3. Service Type
Certified Mall
❑ Registered
❑ insured Mall
❑ Express Mall
❑ Return Receipt for Merchandise
❑ C.O.D.
7005 1820 0003 52214 7969
Domestic Return Receipt
102595O2 -M-1540
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