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Home My WebLink About20100995.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, 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, 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 80504 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 2010-01 to said 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, 2011, 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. CC so, App(. 2010-0995 -1-15-10 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 12th day of May, A.D., 2010. ATTEST: Weld County Clerk to th BY: APP Deputy Cler!o the Boa BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO her, Chair EXCUSED Barbara Kirkmeyer, Pro-Tem Sean Will ounty Attorney EXCUSED David E. Long Date of signature: 03/4719/0 2010-0995 LC0013 ONLY 3.2% BEER SOLD HERE C N W.\ lk • "Jr Anti ca Ore a7 dear of, earapit fr/fe Vii''' •,Y,w... f rrotrat irks_ .1. • ,d3 fp Y "'he, the v •f � �'�z.��,r x&=�rjNe#41(1 � it t�,� \\•F�y. %bin" a IV 'itl '\\�te aYattr:•• /ref .,y it \ rht. ea. •• 3k .1g.:1'4.$s rt11. ti k�. 7/Vin. ••i°�j;A}� 7.1d �Asi:O. j X1,3. s „>f ft tir��. /A\,_ ‘tZt�'�i�7 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, 2011 Type Name and Desatptbn of License Fee 2125 2190 3.2 PERCENT BEER RETAIL LICENSE (OFF PREMISES) COUNTY 85 PERCENT OAP FEE $ 75.00 $ 42.50 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. �(Q �'// JUN 2 4 2010 ( ICv �(z IC/ K KA Division Director Executive $ 117.50 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 1 IIuJrLhlhnJh,,,II,,,hhlL„L III,.J,I„IJ„IJ„I 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! El 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, 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 knowledge. Authorized Signature Date 3s al0 1 r Business Phone 972-815 Vt e, k ‘ Tile Licensing presen v Sales Tax Number 2(—t2c5`A---Q \"2 O 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, anc the of Title 12, Articles 46 do hereby report that such license, if granted, will comply with provisions THEREFORE THIS APPLICATION IS APPROVED. Local Licensing Authority for Weld County, Colorado ; .''1r�11i��w/�i10 Signature jea,---- Title Chair, Board of Weldaa in •! Douvlas ad an r County Commissioners .t .l7/! [$b$OETA DO NOT Arm DO NOT DFTAGH c Ux. MO e LIQUOR OR 3.2 BEER LICENSE Make check payable to: Colorado De'farment-*Ree*rnwe.1'he State may convert your check to a one time electronic banking transaction Your bank account may bedebiled as n RENEWAL APPLICATION early as the same day received byt estate. it converted, your check will not be returned. L lf your check is rejected due to insufficient or uncollected funds, the Department of Rev- enue may collect the payment amount direct y from your banking account electronically. DR 8400 (11/09/06) COLORADO DEPARTMENT OF REVENUE DENVER, COLORADO 80261 Business Name CIRCLE K STORE LICENSE NUMBER (Use for all reference) 21-65089-0120 PERIOD 05-11 TYPE OF LICENSE ISSUED CASH FUND STATE FEE 3.2 PERCENT BEER RETAIL COUNTY 85% 0f LICENSE (OFF PREMISES) 2330-100(999) 2125-750(999) 2190-100(99! $ 50.00 $ 25.00 $ 42.50 $ 117 2010-0995 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 YC1-C, V 2:1 OqS--1 0 State License Number 21 - l0 `D O1Zfl - O l 2D 1. Ope/�ling Ma agar \ �1 ,V11 ne\ Home Address _ 11Di e oo1 net- fDY-t CLA(1 n5 ttlO524 Date of Birth 2. Do you have legal possession of th arremiis�ess for rhich this ap lion for license is made? Are the premises owned or rented: \ ,Y\ 1 tet�foIf rented, expiration date of lease: Y 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 Nq 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 k:No. � Lam( 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 IVY 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 JJa ❑ \/i 7`�• Yes N ❑ IY . 8. Soie proprietorships, Husband -Wile Pa. as ships or rartners in General Partnerships: EVIDENCE OF LAWFUL PRESENCE N /1 - 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): I am a United States Citizen E 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. Signature \ 1.e.iG \I \ 1 y Printed name Shelley Huff Date -3/3D11( (+t\w 1111De. COLORADO MEMORANDUM TO: JENNY VANEGDOM, CTB FROM: DAN JOSEPH ENVIRONMENTAL HEALTH SERVICE SUBJECT: LIQUOR LICENSE INQUIRY DATE: APRIL 19, 2010 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 dioseph@co.weld.co.us or by phone at 970-304-6415 extension 2206. Thank you. Dan Joseph Environmental Specialist III M EMORANDUM \ To: Jenny VanEgdom, Clerk to the Board IiIDeFrom: Bethany Salzman, Zoning Compliance Officer II COLORADO Date: April 15, 2010 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 West Longmont, CO 80504 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/BEER RENEWAL REVIEW FORM Date: May 7, 2010 TO: {DEPUTY} FROM: CTB 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: APRIL 28, 2010 ESTABLISHMENT: CIRCLE K STORES, INC. DBA CIRCLE K STORE #2709846 10963 1-25 ACCESS ROAD WEST LONGMONT, CO 80504 Current license expires: May 29, 2010 ******************************************************************************************************* No concerns LA...) L. -Lt. 6puty'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 m m Tr rU ru U) Postage U.S. 'ostal Service.h, CERTIFIED MAIL,,, RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) m O Certified Fee O O Return Receipt Fee (Endorsement Required) Restricted Delivery Fee N (Endorsement Required) C r1 Total Postage & Fees Postmark Here irtit k 5+ores In L.` 4_ 46 Gr--�I-I e --a70. �8 treat, Apt. No.; t A or PO Box No. 10903 Lv 1 )5 k -I c(55 Rd tOPlstare,nP+a j 305_04 05 0 / n � ` ■ 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 mallpieoe, or on the front if space permits. 1. Article Addressed to: C1rt\2 V.. JA-ons int- reit, k Sore a D1 DGl if�4 ii< lc 113 U. T a5 Access i2J Lit)v- hrlok,-1- go bli A. Signature X B. R ed by (Printed/game) .. 0 Age. ❑ Aden to of Dell\ D. Is delivery address different from item 1 ❑ Yes If YES, enter delivery address below 0 No 3. Service Type C3 Certified Mall 0 Registered 0 Insured Mall ❑ Express Mall 0 Return Receipt for Merchandise ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) 2. Article Number (transfer from service Isae1) PS Form 3811, February 2004 7005 1820 0003 5224 7938 Domestic Return Receipt 102595-02-M-1540 Hello