HomeMy WebLinkAbout20100996.tiffRESOLUTION
RE: APPROVAL OF RENEWAL APPLICATION FOR RETAIL LIQUOR STORE LICENSE
FROM DOROTHY ZITEK, DBA HEREFORD PACKAGE LIQUOR AND AUTHORIZE
CHAIR TO SIGN - EXPIRES JUNE 18, 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, Dorothy 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 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 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 2010-07 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, 2011, 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.
C,C • S
- 1 O 2010-0996
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 12th day of May, A.D., 2010.
ATTEST.Y
Weld County Clerk to the
BY:
D
APPRO
Clerkk tp the Boar
ounty Attorney
Date of signature: Idaid10
BOARD OF COUNTY COMMISSIONERS
WELD C• - , COLORADO
A Inca
as Rade acher, Chair
XCUSED
arbara Kirkmeyer, Pro-Tem
C
Sean
11iam F. Garcia
EXCUSED
David E. Long
2010-0996
LC0024-B
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THIS LICENSE EXPIRES
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THIS LICENSE MUST BE POSTED IN PUBLIC VIEW
DR 8602
(1029/07)
DEPARTMENT
ALCOHOLIC
STATE OF COLORADO
OF REVENUE
Liquor Enforcement Division
1881 Pierce Street, Suite 108
Lakewood, Colorado 80214
ZITEK DOROTHY M
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, 2011
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.
WIC
�kUdzK.J Jl h i '''1'.K)
Division Director Executive
$ 312.50
under the provision
and shall be
the expiration
the Department of
X
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!
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
24-77634-0000
License Type
1941
Liability Information
03 206 445310 I 061998
Business Location
39520 WCR 136
HEREFORD CO
Current License Expires
JUN 18, 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 thisrenewal:.
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.
Au ized Signature
i/7.."/��y )/, (3..
Date
3 --SC - I G7
Business Phone
?OY%S'- fl 1O
Title� �17 (/
Cif W -
Sales Tax Number
REPORT AND APPROVAL OF CITY OR COUNTY LICENSING • ! '
The foregoing application has been examined and the premises, business conducted and c -r- lEer ant are satisfactory, and w
do hereby report that such license, if granted, will comply with the provisions of Title 12, A ICI s • • .�; g1t
THEREFORE THIS APPLICATION IS APPROVED.
Local Licensing Authority for ^ E ` ,t:
010
Weld County, Colorado ),>- Y;
Signatu .-vim
Title Chair, Board of Weld ( 1
County Commissioners �t
'
est
,�h
a i t f, 't_emu
�
Douglas edema her
DR 8400 (11/09/06)
COLORADO DEPARTMENT OF REVENUE
DENVER, COLORADO 80261
Business Name
HEREFORD PACKAGE
LICENSE NUMBER (Use for all reference)
24-77634-0000
PERIOD
06-11
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
LIQUOR OR 3.2 BEER LICENSE
RENEWAL APPLICATION
Make check payable to: Colorado Department of RevenueThe State may convert your
check to a one time electronic banking transaction. Your bank account may be debited as
early as the same day received by the State. if converted, your check will not be returned 21
If 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.
SUB -TOTAL $ 312.5
ADD $100.00 TO RENEW RETAIL WAREHOUSE STORAGE PERMIT2210-100(999) $ •
TOTAL AMOUNT DUE $
2010-0996
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 o
NERE-fed PAck A -g- %* r y'Uo L'a-244-77434
State License Number
OOO
1. Operating Manager
0Cilrn.Siik-
Home Address W . c' • J3 ev. '74' a-07.37
350-91-2 5 &Lie c4444 Ad, 1310 N, a !/)C'e.
Date of Birth
%07-
Do you have legal possession of the premises for which this application for lic nse is made? 6
Yes
No
Are the premises owned or rented: If rented, expiration date of lease:
gl
❑
❑
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 financial institutions) are
materially interested.
❑
4. Since the date of filing of the last annual application, has the applicant, or any of its agents, owners, managers, principals, or lenders
Yes
No
(other than licensed financial institutions), been convicted of a crime? If yes, attach a detailed explanation.
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 detailed01,
explanation.
6. Does the applicant, or any of its agents, owners, managers, principals, or lenders (other than licensed financial institutions), have a
Yes
No
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.
�I
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:
Yes
No
(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
Yes
No
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):
k 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.
Signature
Printed name
Date
7
&dze��! ) --re )
POP 0i' -kL m z iE is
3 -JO- I i
46WFi�YG
1crrig
COLORADO
MEMORANDUM
TO: JENNY VANEGDOM, CTB
FROM: DAN JOSEPH
ENVIRONMENTAL HEALTH SERVICE
SUBJECT: LIQUOR LICENSE INQUIRY
DATE: APRIL 16, 2010
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
water used in the production of this ice comes from a system that is being treated, but that
is not approved. However, the facility is currently in the process of obtaining a State
approved water treatment 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
dioseph@co.weld.co.us or by phone at 970-304-6415 extension 2206.
Thank you.
Dan Joseph
Environmental Specialist III
ostri,
COLORADO
MEMORANDUM
To: Jenny VanEgdom, Deputy Clerk to the Board April 21, 2010
From: Ann Siron, 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
LIQUOR/BEER RENEWAL REVIEW FORM
Date: April 8, 2010
TO: DEPUTY Lisa Carpenter
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: APRIL 22, 2010
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, 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:
id 4 -
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
conc rnj
A- It
or 4.
EstablishmettOwner e se Print Date
.4) i "a)''-/ /!J
����� !� • R:zT )
EstablishV nt Sign ure
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.
To: Weld County Board of Commissioners
From: Deputy Lisa Carpenter
Date: May 24, 2010
Re: Hereford Package Liquor
Dear Commissioners,
I have researched the Hereford Package Liquor; located at 39520 Weld County
Road 136, Hereford, CO 80732, for the calendar year of 2009 through present day. The
only reported call for service is a theft of a coke machine.
I find no grounds for disapproval for the liquor license to be processed for this
establishment.
Respectfully Submitted,
Deputy Lisa Carpenter
Community Resource Officer
WELD COUNTY SHERIFF'S OFFICE
Community Resource Office
LIQUOR ENFORCEMENT WORKSHEET
1950 ()'Street
Greeley, Colorado 80631
Voice (970) 356-4015 • Fax (970) 304-6467
3-7 Inspection Report
0 Incident Report CRO:
1---E(1s✓ rc�, t�C���S�f'•
Licera• Trade Name: i l 1v''l . F CT
License Name: i \ c• / .I1, -)t r kl • , ' I C IC
l(�
License % / Type. C C. ` t. t ; (-c <• f S.. ii /+l'
111
Date of Report / Incident (
c� L - toAddress:
_
C, C...../.... `, ��: J `, i J
Person Contacted:: y'J , / -T -` l 7 + -6 k
-Ill
City. State, Z E'"v-e-, \ =` f Chi ,,2` 67_ __
J
Telephone t C7 7-(\\ — ,`,?, ' , — D / (j
State Liquor License Posted
t,-
Manager Registered
-
.
State Sales Tax License Posted
1.."
License in Control of Premises
County Liquor License Posted
✓
Trade Name Property Registered
Federal Form 11 ' Call (800) 398-2822
✓
Premises Physical Control Adequate
Food Service License Posted
✓
Acceptable Dispensing S toms m
,
Minor Warning Sign Posted
Off Premise Storage Licensed
Meals and Snacks Available
,,
Only Permitted Items Sold
--
Cleanliness Adequate
Alcohol From Permitted Source
Books & Invoices Available
4-
Discuss Sales of Liquor to Minors
._-
Alcohol Beverage Stock Acceptable
+—
Discuss Sales to Intoxicated Persons
[Morning [Follow -Up inspection
Date
Violation:
Dale: I Time:
Subject
I Doe'
1 1-Ig1:
1 Wg :
I Eyes Hair:
Clothing:
DL 1 ID#.
State:
Address:
City:
Stale:
Zip:
Evidence: Yes NO
HAN Phone A:
Summons #:
i
Court Date:
l toe• Yes NO
N 'ye:
U L acct_ („,.
<2'4-./7/-t 06
Deputy:
#: U0 6 Date: 1 f_
7005 1820 0003 5224 7921
U.S. Postal Service,
CERTIFIED MAIL,., 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
Sent To
bcro+Int m. ?; 4kk db�. }F(yf .Eorc/ fact .f
Street Apt. No.: 3 9,5 a b CI 1.# 4 /1 Cf Wifr
or PO Sox No. Q. fax. tin
Postmark
Here
City, State, ZIP+4 �-
Co,3
;le re -d ; dC
PS Form 3800, June 2002 See Reverse for Instructions
• Complete items 1, 2, and 3. Also complete
hem 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 mallpiece,
or on the front If space permits.
1. Article Addressed to:
DoroX m. it OS
O�BIA \itxeCord-\aeKayt liquor
acv b CR \ 3�
0. 2,ox 145
zrcSo.-d Co gb13a
2. Article Number
(Transfer from service label)
D. Is delivery address different fror @_ ? 0 Yes
If YES, enter delivery address below: 0 No
Service Type
sr Certified Mall
❑ Registered
❑ Insured Mall
o Express Mall
❑ Retum Receipt for Merchandise
o C.O.D.
4. Restricted Delivery? (Extra Fee)
7005 1820 0003 5224 7921
❑ Yes
'S Form 3811, February 2004
Domestic PetReti ern Receipt
102595-02-M-1540 ;
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