HomeMy WebLinkAbout20061653.tiff RESOLUTION
RE: APPROVALOF RENEWALAPPLICATIONFOR HOTEL AND RESTAURANTLICENSE
FROM SIMON CORPORATION, DBA SIMON'S BAR AND GRILL AND AUTHORIZE
CHAIR TO SIGN - EXPIRES MAY 29, 2007
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,Simon Corporation,dba Simon's Bar and Grill, 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$125.00 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
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 2006-08 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 May 29, 2007, 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.
2006-1653
C LC0014
SD, R-PPL-
RENEW LIQUOR LICENSE - SIMON'S BAR AND GRILL
PAGE 2
The above and foregoing Resolution was,on motion duly made and seconded,adopted by
the following vote on the 19th day of June, A.D., 2006.
BOARD OF COUNTY COMMISSIONERS
a 1 jE is WELD COUNTY, COLORADO
ATTEST: fn '1 ma A USED
Geil Chair
Weld County Clerk to the BI9 r¢
BY: '- it-4
. Jo. avid E. Long, Pro-Tem
De ty Cler o the oard
W 'am H. Jerke
A3 ) VEDAST • 1S,.
*-12
Robert D. Mas en
my Attorney a /�
Glenn Vaad
Date of signature:
2006-1653
LC0014
THIS LICENSE MUST BE POSTED IN PUBLIC VIEW
DR 8402(02/03/04)
STATE OF COLORADO
DEPARTMENT OF REVENUE
Liquor Enforcement Division
1881 Pierce Street,Suite 108
Lakewood,Colorado 80214
SIMON CORP
SIMON'S BAR & GRILL
3815 HWY 119
LONGMONT CO 80504
ALCOHOLIC BEVERAGE LICENSE
Liability Information
Account Number County City Indust. Type Liability Date LICENSE EXPIRES AT MIDNIGHT
14-45941-0000 03 206 722110 C 053002 MAY 26, 2007
Type Name and Description of License Fee
1971 HOTEL AND RESTAURANT $ 75.00
LIQUOR LICENSE - MALT,
VINOUS, AND SPIRITUOUS
2190 COUNTY 85 PERCENT OAP FEE $ 425.00
TOTAL FEE(S) $ 500.00
This license is issued subject to the laws of the State of Colorado and especially under the
provision of Title 12, Articles 46 or 47, CRS 1973, as amended. This license is
nontransferable and shall be conspicuously posted in the place above described.This license is
only valid through the expiration date shown above. Questions concerning this license should
be addressed to the Department of Revenue, Liquor Enforcement Division, 1 375 Sherman
Street,Denver,CO 80261.
In testimony whereof,I have hereunto set meet
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DR 8404(10/28/04)Page 1 21 DEPARTMENT USE ONLY
COLORADO DEPARTMENT OF REVENUE
LIQUORENFORCEMENT
MENfDNISION
DENVER CO Boni COLORADO LIQUOR
LENER CO
RETAIL LICENSE APPLICATION
0 NEW LICENSE 0 TRANSFER OF OWNERSHIP ,LICENSE RENEWAL
• ALL ANSWERS MUST BE PRINTED IN BLACK INK OR TYPEWRITTEN
• APPLICANT MUST• LOCAL LICENSE FEE $CHECK TH!APPRQPRIATE BOX(ES)
)
• APPLICANT SHOULD OBTAIN A COPY OFTH
E COLORADO LIQUOR AND BEER CODE(Call 303-370-2165)
1. Applicant is applying as a
Corporation ❑ Individual
❑ Limited Liability Company
❑ Partnership(includes Limited Liability and Husband and Wife Partnerships) ❑ Association or Other
2. Applicant If an LLC,name of LLC:If partnership,at least 2 partner's names;if corporation,name of corporation Fein Number
�1 MOkd toe eekrloM
2a.Trade Name of Establishment(DBA) / State Sales Tax No. Business Telephone
u4 fmo, S BA-R- 9 u. J4 - 4151q( (363) 6'73 --ytoa
3. Address of Premises(specify exact location of premises)
3Qr5 F1wj I14
City County State ZIP Code
LoNE7Mvnli WaLb Co 8'05-04f-
4. Mailing Address (Number and Street) City or Town State ZIP Code
5. If the premises currently have a liquor or beer license,you MUST answer the following questions:
Present Trade Name of Establishment DBA) Present State License No. Present Class of License Present Expiration Date
S/mC All s BAI2- 0 ruLC. Hvlrl ';ustasnt. �- Mau 2/1 , 2Ctic
Lall SECTION A NONREFUNDABLE APPLICATION FEES lag SECTION B(CONT.) LI OR LICENSE FEES
2300 O Application Fee for New License $825.00 1985❑Resort Complex License(City) $500.00
2302 0 Application Fee for New License• 1986❑Resort Complex License(County) $500.00
w/Concurrent Review $925 00 1988❑Add Related Facility to Resort Complex...$ 75.00 X Total
2310 O Application Fee for Transfer $825.00 1990❑Club License(City) $308.75
2312 ❑ Application Fee for Transfer• 1991❑Club License(County) $308.75
w/Concurrent Review $925.00 2010❑Tavern License(City) $500.00
LIAQ SECTIONS LIQUOR LICENSE FEES 2011❑Tavern License(County) $500.00
1905 O Retail Gaming Tavern License(City) $500.00 2012❑Manager Registration-Tavern $ 75.00
1906 O Retail Gaming Tavern License(County) $500.00 2020❑Ms License(City) $308.75
1940 O Retail Liquor Store License(City) $227.50 2021❑Arts License(County) $308.75
1941 O Retail Liquor Store License(County) $312.50 2030❑Racetrack License(City) $500.00
1950 ❑ Liquor Licensed Drugstore(City) $227.50 2031 O Racetrack License(County) $500.00
1351 Liquor Drugstore(County) $312.50 2040❑Optional Premises License(City) $500.00
❑ Licensed Coun
1960 O Beer and Wine License(City) $35125 2041❑Optional Premises License(County) $500.00
1961 0 Beer and Wine License(County) $43625 2045❑Vintners Restaurant License(City) $750.00
2046❑Vintners Restaurant License(County) $750.00
1970 O Hotel and Restaurant License(City) $500.00
Hotel and Restaurant License(County) $500.00 1971�' 2220❑Add Optional Premises to H&R $100.00 X Total
1975 El Brew Pub License(City) $750.00 2370❑Master File Location Fee $ 25.00 X_Total_
1976 0 Brew Pub License(County) $750.00 2375 O Master File Background $250.00 X_Total
1980 0 Hotel and Restaurant License w/opt premises(City).... $500.00
1981 O Hotel and Restaurant License w/opt premises(County) $500.00
1983 O 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)
tateIyFROM TO
-750(999) 2180-100(999) 75 County Managers Reg
2190-100(999) -750(999)
i A
fah fund New Llano, 4e,Fund Tfn4w WNW.
2300-100 2310.100 TOTAL
(999) (999)
LCOv)q 2006-1653
DR 8404(1028/04)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
❑ 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. Retum originals to local authority.
❑ E. Additional information may be required by the local licensing authority.
II. DIAGRAM OF THE PREMISES
❑ 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.
III. PROOF OF PROPERTY POSSESSION
❑ A. Deed in name of the Applicant ONLY(or)
❑ B. Lease in the name of the Applicant ONLY.
❑ 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(I1 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(II Applicable)
❑ 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
❑ A. $75.00 fee.
❑ B. Individual History Record(DR 8404-I).
DR 8404(10/28V)Page 3
6. Is the applicant(including any of the partners,If a partnership;members or manager if a limited liability company;or officers,stock- Yes No
holders or directors if a corporation)or manager under the age of twenty-one years? O ❑
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? ❑ O
(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. ❑ ❑
8. Has a liquor license application(same license class),that was located within 500 feet of the proposed premises,been denied within the
preceding two years?If'yes,'explain in detail. O O
9. Are the premises to be licensed within 500 feet of any public or private school that meets compulsory education requirements of O O
Colorado law,or the principal campus of any college,university or seminary?
10. Has a liquor or beer license ever been issued to 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)?If yes,Identify the name of the business and list any
current or former financial interest in said business including any loans to or from a licensee. O O
11. Does the Applicant,as listed on line 2 of this application,have legal possession of the premises for at least 1 year from the date that
this license will be issued by virtue of ownership,lease or other arrangement?
O Ownership O Lease ❑ Other(Explain In Detail) O O
a. If leased,list name of landlord and tenant,and date of expiration.EXACTLY as they appear on the lease:
Landlord Tenant
Expires
Attach a diagram and outline or designate the area to be licensed(including dimensions)which shows the bars,brewery,walls,partitions,
entrances,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
to be to scale)
12. Who,besides the owners listed in this application(Including persons,firms,partnerships,corporations,limited liability companies),
will 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,
19. Optional Premises or Hotel and Restaurant Licenses with Optional Premises Yes No
Has a local ordinance or resolution authorizing optional premises been adopted? O O
Number of separate Optional Premises areas requested.
(See License Fee Chart)
14. Liquor Licensed Drug Store applicants,answer the following:
(a) Does the applicant for a Liquor Licensed Drug Stare have a license issued by the Colorado Board of Yes No
Pharmacy?COPY MUST BE ATTACHED. O O
15. Club Liquor License applicants answer the following and attach:
(a) Is the applicant organization operated solely for a national,social,fraternal,patriotic,political or athletic purpose and ❑ O
not for pecuniary gain?
(b) Is the applicant organization a regularly chartered branch,lodge or chapter of a national organization which is ❑ O
operated solely for the object of a patriotic or fraternal organization or society,but not for pecuniary gain?
(c) How long has the club been incorporated? (d) How long has applicant occupied the premises
(Three years required) to be licensed as a club?(Three years required)
16. Brew-Pub License or Vintner Restaurant Applicants answer the following:
(a) Has the applicant received or applied for a Federal Permit? ❑ O
(Copy of permit or application must be attached)
17a. Name of Manager(tor all on-premises applicants) _(If this is an Date of Birth
application for a Hotel,Restaurant or Tavern License,the manager must also submit an Individual History Record(DR 8404-I).
17b. Does this manager act as the manager of,or have a financial interest in,any other liquor Yes No
licensed establishment In the State of Colorado? If yes,provide name,type of license and account number. O O
16. Tax Distraint information. Does the applicant or any other person listed on this application and including its partners,officers, Yes No
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 lax distraint issued to them by the Colorado Department of Revenue? ❑ ❑
If yes,provide an explanation and include copies of any payment agreements.
DR 8404(1012&V4)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 8 STATE DOB POSITION %OWNED'
'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 0 Cert.of lncorp. 0 Cei.of Good Standing(if more than 2 yrs.old) 0 Cert.of Auth.(if a foreign corp.)
❑PARTNERSHIP 0 Partnership Agreement(General or Limited) 0 Husband and Wife partnership(no written agreement)
❑LIMITED LIABILITY COMPANY ❑Articles of Organization 0 Cart.of Authority(If foreign company) 0 Operating Agrmt.
❑ ASSOCIATION OR OTHER Attach copy of agreements creating association or relationship between the parties
Registered Agent(if applicable) Address for Service
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.I also acknowledge that it Is my responsibility and the responsibility of my agents and employees
to comply with the provisions of the Colorado Liquor or Beer Code which affect my license.
Authorized Sig re Title Date
�� �2elidFivr ,S/irj/off
REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY(CITY/COUNTY)
Date application filed with local authority Date of local authority hearing(for new license applicants;cannot be less
than 90 days from date of application 12-47-311(1))C.R.S.
THE LOCAL LICENSING AUTHORITY HEREBY AFFIRMS:
That each person required to file DR 8404-I(Individual History Record)has: Yes No
❑ Been fingerprinted ❑ 0
❑ Been subject to background Investigation,Including NCIC/CCIC check for outstanding warrants 0 0
That the local authority has conducted,or intends to conduct,an Inspection of the proposed premises to ensure that the applicant is in
compliance with,and aware of,liquor code provisions affecting their class of license 0 0
(Check One)
❑ Date of Inspection or Anticipated Date
❑ 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 he.z sonable requirements of the neighborhood and the desires of the adult inhabitants,
and will comply with the provisions of Ti j- A(t ple46.p47,C.R.S. THEREFORE,THIS APPLICATION IS APPROVED.
Local Licensing Authority for F" • ..a Telephone Number ❑ TOWN,CITY
W Coun y, of ado fr : `t` 1 (970)356-4000 X4200 Q COUNTY
Signe ure 185' i Title Sv)4.„£r Long, Chair Pro-Teat Date
e :. C gg5Y oard f Commissioners 06/19/2006
Signature(a e t) cixtI '1 Date
1 ,c.a1/4-01/4 --.
06/19/2006
s ei LD the Board
:,r '.• —
02.X<i -/(,53
MEMORANDUM
(it
TO: JENNY LUNA
FROM: DAN JOSEPH
I ENVIRONMENTAL HEALTH SERVICE SUBJEC DATE: 05/23/06
CT /
. LICENSE INQUIRY
COLORADO CC: CINDY SALAZAR; SARA EVANS
In response to your request, Environmental Health Services has reviewed the Retail Food
Service Establishment file for Simon's Bar and Grill, located at 3815 Highway 119,
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 at extension 2206
or via e-mail at dioseph@co.weld.co.us.
Thank you.
Dan Joseph
Environmental Specialist
,RLil(c- Ha S3
MEMORANDUM
Aricv ‘ lot \ To: Jenny Luna, Deputy Clerk to the Board May 26, 2006
From: Bethany Salzman, Zoning Compliance Officer, Dept. of Planning Services
O Subject: LC0014
COLORADO
Review of the following liquor license renewal by the Department of Planning Services shows the following:
14-45941
Simon Corp
dba Simon's Bar and Grill
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: June 14, 2006
TO: William (Bill)Wagner
FROM: John Broderius
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: MAY 31, 2006
ESTABLISHMENT: SIMON CORP
DBA SIMON'S BAR AND GRILL
3815 HIGHWAY 119
LONGMONT, CO 80504
Current license expires: MAY 29, 2006
X No concerns g 11 14o-+jner 1:1,4S_
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 of the date and time of the
Board of Commissioners renewal hearing.
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