HomeMy WebLinkAbout20101717RESOLUTION
RE: APPROVAL OF RENEWAL APPLICATION FOR HOTEL AND RESTAURANT LIQUOR
LICENSE FROM JENSEN ENTERTAINMENT, LLC, DBA T-BONES RESTAURANT AND
LOUNGE AND AUTHORIZE CHAIR TO SIGN - EXPIRES JULY 17, 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, Jensen Entertainment, LLC, dba T -Bones Restaurant and Lounge, presented to
the Board of County Commissioners of Weld County, Colorado, an application for the renewal of a
Hotel and Restaurant 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:
3815 Highway 119, Longmont, Colorado 80504
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 Clerk to the Board within thirty (30) days of the first available
"responsible vendor" class after hiring.
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 2010-11 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 July 17, 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.
'l,C A opt , SO 2010-1717
3t.o - t e LC0014
RENEW LIQUOR LICENSE - T-BONES RESTAURANT AND LOUNGE
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded, adopted by
the following vote on the 28th day of July, A.D., 2010.
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, COLORADO
ATTEST:
Weld County Clerk to the
cy 7
BY: ,
Deputy Clerk to the Board
APP
unty Attorney
Date of signature:
M:
Radema.r'er, Qhair
rbara Kirkmeyer•,,Pro-Tem
Sean P. Conway
• I
F. Gar
cv„ 1
DavidJE. Long
e l�
2010-1717
LC0014
r4
O
N
or
THIS LICENSE EXPIRES
NSE 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
JENSEN ENTERTAINMENT
LLC
T-BONES RESTAURANT
AND LOUNGE
3815 HWY 119
LONGMONT CO 80504
BEVERAGE LICENSE
Liability Information
Account Number
County City Indust. Type Liability Date
LICENSE EXPIRES AT MIDNIGHT
42-57083-0000
03 206 722110 B 071808
JUL 17, 2011
Type
Name and Description of License
Fee
1971
2190
HOTEL AND RESTAURANT
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.
(4462- k! )1c)
AUG 1 6 2@10
Division Director Executive
$ 500.00
under the provision
and shall be
the expiration
the Department of
aleA,
Director
DR 8404 (05/07/09) Page 1
COLORADO DEPARTMENT OF REVENUE
LIQUOR ENFORCEMENT DIVISION
DENVER CO 80261
---Arkn1Ewsitik- 21
COLORADO LIQUOR
RETAIL LICENSE APPLICATION
❑ NEW UCENSE O TRANSFER OF OWNERSHIP _X LICENSE RENEWAL
• ALL ANSWERS MUST BE PRINTED IN BLACK INK OR TYPEWRITTEN
• APPUCANT MUST CHECK THE APPROPRIATE BOX(ES)
• LOCAL UCENSE FEE $
• APPUCANT SHOULD OBTAIN A COPY OF THE COLORADO LIQUOR AND BEER CODE(Call 303-370-2165)
1. Applicant is applying as a
❑ Corporation
❑ Partnership (includes Limited Liability and Husband and Wife Partnerships)
DEPARTMENT USE ONLY
❑ Individual
Limited Liability Company
Association or Other
2. qpI Applicant If an LLC, name of LLC; if partnership, at least 2 partner's names; if corporation, name of corporation
tcv\S1.ot- Enrfaunmr.n± LLC_
2a. Trade Name of Estab�li ment (DBA)
range s /Cestau.rluul- Lis2r
3. Address of Premises (specify exact location of premises)
3Y)5 1/%
City
r�
l'2 I.LOv.1
County\
State Sales Tax No.
3'° 5�(?83-oo2O
State
C3
State
Cep
Fein Number
83- 0C7I ( 84, 5
Business Telephone
,3i(3-67g-9/Dim
ZIP Code
4. Mailing'Address (Number and Street)
381 + OY 117
5. If the premises currently have a liquor or beer license, you MUST an er the following questions:
Present Trade Name of Establishment (DBA)
Tim tetufac1J`a>
LIAR SECTION A
2300 ❑ Application Fee for New License $1,025.00
2302 ❑ Application Fee for New License -
w/Concurrent Review $1,125 00
2310 ❑ Application Fee for Transfer $1,025.00
ZIP Code
spy
Present State License No.
Ufa -57 -00O9
NONREFUNDABLE AP ICATION FEES
Present Class of License
19 /
Present Expir tion Date
LIAR SECTION 8 (CONT.) LIQUOR LICENSE FEES
1985 ❑ Resort Complex License (City) $500.00
1986 ❑ Resort Complex License (County) $500.00
1988 ❑ Add Related Facility to Resort Complex... $ 75.00 X Total
1990 ❑ Club License (City) $308.75
1991 ❑ Club License (County) $308.75
2010 ❑ Tavern License (City) $500.00
2011 El Tavern License (County) $500.00
2012 ❑ Manager Registration - Tavern $ 75.00
2020 ❑ Arts License (City) $308.75
2021 ❑ Arts License (County) $308.75
2030 ❑ Racetrack License (City) $500.00
2031 ❑ Racetrack License (County) $500.00
2040 ❑ Optional Premises License (City) $500.00
2041 ❑ Optional Premises License (County) $500.00
2045 ❑ Vintners Restaurant License (City) $750.00
2046 ❑ Vintners Restaurant License (County) $750.00
2220 ❑ Add Optional Premises to H & R $100.00 X Total
2370 ❑ Master File Location Fee $ 25.00 X Total
2375 ❑ Master File Background $250.00 X Total
LIAB SECTION B LIQUOR LICENSE FEES
1905 ❑ Retail Gaming Tavern License (City) $500.00
1906 ❑ Retail Gaming Tavern License (County) $500.00
1940 ❑ Retail Liquor Store License (City) $227.50
1941 ❑ Retail Liquor Store License (County) $312.50
1950 ❑ Liquor Licensed Drugstore (City) $227.50
1951 ❑ Liquor Licensed Drugstore (County) $312.50
1960 ❑ Beer and Wine License (City) $351.25
1961 ❑ Beer and Wine License (County) $436.25
1970 ❑ Hotel and Restaurant License (City) $500.00
1971Q Hotel and Restaurant License (County) $500.00
1975 ❑ Brew Pub License (City) $750.00
1976 ❑ Brew Pub License (County) $750.00
1980 ❑ Hotel and Restaurant License w/opt premises (City)$500.00
1981 ❑ Hotel and Restaurant License w/opt premises (County) $500.00
1983 ❑ Manager Registration - H & R $ 75.00
DO NOT WRITE IN THIS SPACE - FOR DEPARTMENT OF REVENUE USE ONLY
LIABILITY INFORMATION
County
City
Industry Type
License Account Number
Liability Date
License Issued Through
(Expiration Date)
FROM
TO
State
-750 (999)
City
2180-100 (999)
County
2190.100(999)
Managers Reg
-750 (999)
TOTAL
cash Fund New Wawa
2300-100
(999)
Cash Fund Transfer uca,.
2310-100
(999)
2010-1717
1-CO0/4/
City or Town
,1�rat-
DR 8404 (05/07/09) Page 2
APPLICATION DOCUMENTS
CHECKLIST AND WORKSHEET
Instructions: This check list should be utilized to assist applicants with filing all required documents for licensure. All documents must
be properly signed and correspond with the name of the applicant exactly. All documents must be typed or legibly printed. Upon final State
approval the license will be mailed to the local licensing authority. Application fees are nonrefundable.
ITEMS SUBMITTED, PLEASE CHECK ALL APPROPRIATE BOXES COMPLETED OR DOCUMENTS SUBMITTED
I.
APPLICANT INFORMATION
H A. Applicant/Licensee identified.
❑ B. State sales tax license number listed or applied for at time of application.
■ C. License type or other transaction identified.
❑ D. Return originals to local authority.
❑ E. Additional information may be required by the local licensing authority.
II.
DIAGRAM OF THE PREMISES
E A. No larger than 8 1/2" X 11".
❑ B. Dimensions included (doesn't have to be to scale). Exterior areas should show control (fences, walls, etc.).
❑ C. Separate diagram for each floor (if multiple levels).
❑ D. Kitchen - identified if Hotel and Restaurant.
Ill.
PROOF OF PROPERTY POSSESSION
[_j A. Deed in name of the Applicant ONLY (or)
B. Lease in the name of the Applicant ONLY.
i C. Lease Assignment in the name of the Applicant (ONLY) with proper consent from the Landlord and acceptance by the Applicant.
D. Other Agreement if not deed or lease.
IV.
BACKGROUND INFORMATION AND FINANCIAL DOCUMENTS
• A. Individual History Record(s) (Form DR 8404-I).
• B. Fingerprints taken and submitted to local authority. (State authority for master file applicants.)
■ C. Purchase agreement, stock transfer agreement, and or authorization to transfer license.
■ D. List of all notes and loans.
V.
CORPORATE APPLICANT INFORMATION (If Applicable)
❑ A. Certificate of Incorporation (and/or)
B. Certificate of Good Standing if incorporated more than 2 years ago.
• C. Certificate of Authorization if foreign corporation.
[! D List of officers, directors and stockholders of parent corporation (designate 1 person as "principal officer").
VI.
PARTNERSHIP APPLICANT INFORMATION (If Applicable)
Li A. Partnership Agreement (general or limited). Not needed if husband and wife.
VII.
LIMITED LIABILITY COMPANY APPLICANT INFORMATION (If Applicable)
■ A. Copy of articles of organization (date stamped by Colorado Secretary of State's Office).
• B. Copy of operating agreement.
C Certificate of Authority (if foreign company).
VIII. MANAGER REGISTRATION FOR HOTEL AND RESTAURANT, TAVERN LICENSES WHEN INCLUDED WITH THIS
APPLICATION
H A. S75.00 fee.
[ I B. Individual History Record (DR 8404-I).
DR 6404 (05/07/09) Page 3
6. Is the applicant (including any of the partners, it a partnership; members or manager if a limited liability company; or officers, stock-
holders or directors if a corporation) or manager under the age of twenty-one years?
Yes No .
•
CS
7. Has the applicant (including any of the partners, if a partnership; members or manager if a limited liability company; or officers,
stockholders or directors if a corporation) or manager ever (in Colorado or any other state);
(a) been denied an alcohol beverage license?
(b) had an alcohol beverage license suspended or revoked?
(c) had interest in another entity that had an alcohol beverage license suspended or revoked?
If you answered yes to 7a, b or c, explain in detail on a separate sheet.
■ IN
❑ 1V
❑
8. Has a liquor license application (same license class), that was located within 500 feet of the proposed premises, been denied within
preceding two years? If "yes," explain in detail.
the
■ CZ
9. Are the premises to be licensed within 500 feet of any public or private school that meets compulsory education requirements of
Colorado law, or the principal campus of any college, university or seminary?
■ IR
10. Has a liquor or beer license ever been issued to the applicant (including any of the partners, if a partnership; members or manager
limited liability company; or officers, stockholders or directors it a corporation)? If yes, identity the name of the business and list any
current or former financial interest in said business including any loans to or from a licensee.
if a
■
11.
a.
Attach
entrances,
to
Does the Applicant, as listed on line 2 of this application,
arrangement?
in
of
have legal possession of the premises by virtue of ownership, lease or other
124
■
• Ownership X Lease • Other (Explain
Detail)
expiration, EXACTLY as they appear on the lease:
If leased, list name of landlord and tenant, and date
Landlord
J & £,Lte✓,o [ 'r c5
Tenant �[
Je,� L---4-11-0 ✓ C �te.pttvvvwl� 1-1..,____ L
Expires
I-1— aV f
a diagram and outline or designate the area to be licensed (including dimensions) which shows the bars, brewery, walls, partitions,
exits and what each room shall be utilized for in this business. This diagram should be no larger than 8 1/2" X 11". (Doesn't have
be to scale)
12. Who, besides the owners listed in this application (including persons, firms, partnerships, corporations, limited liability companies),
wilt loan or give money, inventory, furniture or equipment to or for use in this business; or who will receive money from this business.
Attach a separate sheet if necessary.
NAME
DATE OF BIRTH
FEIN OR SSN
INTEREST
Attach copies of all notes and security instruments, and any written agreement, or details of any oral agreement, by which
any person (including partnerships, corporations, limited liability companies, etc.) will share in the profit or gross proceeds of
this establishment, and any agreement relating to the business which is contingent or conditional in any way by volume,
profit, sales, giving of advice or consultation.
t3. Optional Premises or Hotel and Restaurant Licenses with Optional Premises
Has a local ordinance or resolution authorizing optional premises been adopted?
Number of separate Optional Premises areas requested. (See License Fee Chart)
Yes No
• •
14. Liquor Licensed Drug Store applicants, answer the following:
(a) Does the applicant for a Liquor Licensed Drug Store have a license issued by the Colorado Board of
Pharmacy? COPY MUST BE ATTACHED.
Yes No
❑ •
15.
Club Liquor License applicants answer the following
(a) Is the applicant organization operated
not for pecuniary gain?
(b) Is the applicant organization a regularly
operated solely for the object of a patriotic
(c) How long has the club been incorporated?
(Three years required)
and attach:
solely for a national, social, fraternal, patriotic, political or athletic purpose and
chartered branch, lodge or chapter of a national organization which is
or fraternal organization or society, but not for pecuniary gain?
(d) Has applicant occupied an establishment for three years
that was operated solely for the reasons stated above?
Yes No
e
•❑
■ •
• ❑
16. Brew -Pub License or Vintner Restaurant Applicants answer the following:
(a) Has the applicant received or applied for a Federal Permit?
(Copy of permit or application must be attached)
Yes No
O ■
17a. Name of Manager (for all on -premises applicants)
application for a Hotel, Restaurant or Tavern License,
17b. Does this manager act as the manager of, or have
licensed establishment in the State of Colorado? If
(If this is
an
(DR 8404-I).
Date of Birth
the manager must also submit an Individual History Record
a financial interest in, any other liquor
yes, provide name, type of license and account number.
Yes No
■ ■
18. Tax Distraint Information. Does the applicant or any other person listed on this application and including its partners, officers,
directors, stockholders, members (LLC) or managing members (LLC) and any other persons with a 10% or greater financial interest
in the applicant currently have an outstanding tax distraint issued to them by the Colorado Department of Revenue?
If yes, provide an explanation and include copies of any payment agreements.
Yes No
• X
DR 8404 (05/07/09) Page 4
19. If applicant is a corporation, partnership, association or limited liability company, applicant must list ALL OFFICERS. DIRECTORS,
GENERAL PARTNERS, AND MANAGING MEMBERS. In addition applicant must list any stockholders. partners. or members with OWNER-
SHIP OF 10% OR MORE IN THE APPLICANT. ALL PERSONS LISTED BELOW must also attach form DR 8404-I (individual History record),
and submit finger print cards to their local licensing authority.
NAME
HOME ADDRESS, CITY & STATE
DOB
POSITION
%OWNED'
�ny--�f,� ieir�
Qac'5 .De -Ater Di-•
Lo.-tj) LG,,,j, CO gCY5�, I
/`'/�
'lei e�-
��:
Dc::
b� nta Ile ).les
l 17 /rte utto P J e -,4
,le-�' , C-) I
/7 ii/ir
5i) 7
if total ownership percentage disclosed here does not total 100% applicant must check this box
Applicant affirms that no individual other than these disclosed herein, owns 10% or more of the applicant
Additional Documents to be submitted by type of entity
❑ CORPORATION ❑ Cert. of Incorp. ❑ Cert. of Good Standing (if more than 2 yrs. old) ❑ Cert. of Auth. (if a foreign corp.)
❑ PARTNERSHIP ❑ Partnership Agreement (General or Limited) ❑ Husband and Wife partnership (no written agreement)
X LIMITED LIABILITY COMPANY U Articles of Organization U Cert. of Authority (if foreign company) ❑ Operating Agrmt.
❑ ASSOCIATION OR OTHER Attach copy of agreements creating association or relationship between the parties
Registered Agent (if applicable) Address for Service
I
I declare under penalty of perjury in the second
to the best of my knowledge. I also acknowledge
to comply with the provisions of the Colorado
Authorized nature
��J — -
/
OATH OF APPLICANT
degree that this application and all attachments are true, correct, and complete
that it is my responsibility and the responsibility of my agents and employees
Liquor or Beer Code which affect my license.
' Title
(A' O c.J7l-e'r
D�/i
f A)
EPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY (CITY/COUNTY)
Date application flied with local authority ; Date of local authority hearing (for new license applicants; cannot be less
I than 30 days from date of application 12-47-311 (1)) C.R.S.
THE LOCAL LICENSING AUTHORITY
That each person required to file DR
H Been fingerprinted
HEREBY AFFIRMS:
8404-I (Individual History Record) has:
including NCIC/CCIC check for outstanding warrants
or intends to conduct, an inspection of the proposed premises to
code provisions affecting their class of license
Date
ensure that the applicant is in
Yes No
❑ III
❑ ❑
ii Been subject to background investigation,
That the local authority has conducted,
compliance with, and aware of. liquor
(Check One)
U Date of inspection or Anticipated
Li Upon approval of state licensing
❑ ■
authority.
The foregoing application has been examined; and the premises, business to be conducted, and character of the applicant are satisfactory.
We do report that such license, if granted, will meet the reasonable requirements of the neighborhood and the desires of the adult inhabitants,
and will comply with the provisions of Title 12, Article 46 or 47, C.R.S. THEREFORE, THIS APPLICATION IS APPROVED.
Local Licensing Authority for
Weld County, Colorado
Telephone Number
970-356-4000 x 4225
TOWN, CITY
V] COUNTY
t
nature ti 11 : ! _
-/.. of County Commissioners
Date
JUL 2 8 2010
.natur: t) yy �
, i�4 ;,.9 .
o the Board
Date JUL 2 8 2010
y: /(�6n-11-d- , � ut r rk to the Board
DR 8401 (02119/09)
COLORADO DEPARTMENT OF REVENUE
LICd1OR 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 Nine of Establishment �f C ( ,L
l.._ one �� / `C'_ �tCY cu e-
1 Operatln a:Ter
State License Number
/Ti
Date of Birth
Yes
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
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
❑ U'
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
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
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.
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):
{ I am a United States Citizen
Y❑" 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
Yes
Yes
No
❑ X
Signature
Printed name
Date
7/6/,�
OFFICE OF THE SECRETARY OF STATE
OF THE STATE OF COLORADO
CERTIFICATE
I, Mike Coffman, as the Secretary of State of the State of Colorado, hereby certify that,
according to the records of this office,
Jensen Entertainment, LLC
is a
Limited Liability Company
formed or registered on 09/25/2007 under the law of Colorado, has complied with all applicable
requirements of this office, and is in good standing with this office. This entity has been
assigned entity identification number 20071438463 •
This certificate reflects facts established or disclosed by documents delivered to this office on
paper through 10/24/2007 that have been posted, and by documents delivered to this office
electronically through 10/29/2007 (a7 15:56:45 •
I have affixed hereto the Great Seal of the State of Colorado and duly generated, executed,
authenticated, issued, delivered and communicated this official certificate at Denver, Colorado
on 10/29/2007 @ 15:56:45 Pursuant to and in accordance with applicable law. This certificate is
assigned Confirmation Number 6921522 •
k
Secretary of State of the State of Colorado
sass*ss****ssss s s s ss ss ss s ss ss sss ********End of Certificates ssssssss ssss s** srsssssss ass ss** sss ss sss
Notice: A certificate issued electronically from the Colorado Secretary of State's Web site is fully and immediately valid and effective. However,
as an option, the issuance and validity of a certificate obtained electronically may be established by visiting the Certificate Confirmation Page of
the Secretary of State's Web site. ow; I till/,.1T.‘. ‘..Iti ) y- n , ;lt' entering the certificate's confirmation number
displayed on the certificate, and following the instructions displayed. Confirming the issuance of a certificate is merely optional and is not
necessary to the valid and effective issuance of a certificate. For more information. visit our Web site. 'r n ,,.n , in click Business
Center and select "Frequently Asked Questions."
CERT_GS_D Revised 01/022007
a:rm
1111De
COLORADO
MEMORANDUM
TO: JENNY VANEGDOM, CTB
FROM: DAN JOSEPH
ENVIRONMENTAL HEALTH SERVICE
SUBJECT: LIQUOR LICENSE INQUIRY
DATE: JULY 14, 2010
CC: CINDY SALAZAR; DEBRA ADAMSON
In response to your request, Environmental Health Services has reviewed the Retail Food
Service Establishment file for T -Bones Restaurant and Lounge, located at 3815 HWY
119, 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(adco.weld.co.us or by phone at 970-304-6415 extension 2206.
Thank you.
Dan Joseph
Environmental Specialist III
MEMORANDUM
t �j/ \ To: Jenny VanEgdom, Deputy Clerk to the Board July 23, 2010
r'� YID \1 From: Bethany Salzman, Zoning Compliance Officer, Dept. of Planning Services
Subject: LC0014
COLORADO
Review of the following liquor license renewal by the Department of Planning Services shows the following:
42-57803-0000
Jensen Entertainment, LLC
dba T -Bones Restaurant and Lounge
3815 Highway 119
Longmont, Colorado 80504
Zone District: Three Lot Minor Subdivision (C-3) - Commercial
This use is permitted through a Site Plan Review (SPR-364) permit.
Currently there are no active violations noted on the above mentioned property.
SERVICE, TEAMWORK, INTEGRITY, QUALITY
LIQUOR/BEER RENEWAL REVIEW FORM
Date: July 9, 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 request for a Hotel
and Restaurant Liquor License.
PLEASE RESPOND NO LATER THAN: ASAP, PLEASE
ESTABLISHMENT: JENSEN ENTERTAINMENT, LLC
DBA T-BONES REST AND LOUNGE
3815 HIGHWAY 119
LONGMONT, CO 80504
Current license expires: July 17, 2010
*******************************************************************************************************
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 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 Owner, Please Print Date
Establishment Signature Deputy'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.
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0 Return Receipt Fee
(Endorsement Required)
Restricted Delivery Fee
rL (Endorsement Required)
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U.S. Postal Service,.,
CERTIFIED MAIL,., RECEIPT
(Domestic Mail Only; No Insurance Coverage Provided)
Postage
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Certified Fee
Total Postage & Fees
Postmark
Here
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■ Complete items 1, 2, and 3. Also complete
Item 4 If Resbicted 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.
D. Is delivery address different from Item 1? ❑ Yes
If YES, enter delivery address below: 0 No
1. Article Addressed to:
Sev\SA.k1 Evert.} -at0,,LL d- LLC
96 \ \- \3ov'.a `“ Sly (`oak-wv{
LUUY. Wt
3815 Hwy 1\ 61
Visr. vY.o W V5)-}
3. Service Type
£.Certified Mall
0 Registered
0 Insured Mall
❑ Express Mall
❑ Return Receipt for Merchandise
❑ C.O.D.
2. Article Number
(fiansfer from setvlce labea _
PS Form 3811, February 2004 Domestic Return Receipt
7005 1820 0003 5224 7983
10259602-M-1540
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