HomeMy WebLinkAbout20051609.tiff RESOLUTION
RE: APPROVAL OF RENEWAL APPLICATION FOR HOTEL AND RESTAURANT LICENSE
FROM SIMON CORP, DBA SIMON'S BAR AND GRILL AND AUTHORIZE CHAIR TO
SIGN - EXPIRES MAY 29, 2006
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 Corp, 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 2005-10 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, 2006, 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.
2005-1609
LC0014
�'C : S4 �00e.._ O7-/7-o,S'-
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 1st day of June, A.D., 2005.
/ /�� �_ BOARD OF COUNTY COMMISSIONERS
ELa
� 1 /�ial WELD COUNTY, COLORADO
h! /mil///�/, //i1� -t kLL
1861 Ii ` ;'. _, � William H rke, Chair
. •. y Clerk to the Board
O ?sr 4
®u bil
M. . i e, r -Tem
Deputy Clerk to the Board — U
D id E. Long
% ney
AS •
A \' V
Robe D. Masden
Glenn Vaad
Date of signature: _ ✓l`
2005-1609
LC0014
THIS LICENSE MUST BE POSTED IN PUBLIC VIEW
DR 8402102/03/041
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 80501
ALCOHOLIC BEVERAGE LICENSE
Liability Information
Account Number Count City Indust. Type LICENSE EXPIRES AT MIDNIGHT
Y Y Liability Date
14-45941—0000 03 206 722110 C 053002 MAY 29, 2006
Type Name and Description of License Fee
1971 HOTEL AND RESTAURANT $ 75.00
LIQUOR LICENSE - MALT, -
VINOUS, AND SPIRITUOUS
2180 COUNTY 85 PERCENT OAP FEE $ 425.00
TOTAL FENS) $ 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, 1375 Sherman
Street,Denver,CO 80261.
In testimony whereof.I have hereunto set my hand.
SOC 062005 01y) „- nC
° '�-ttQY
Division Director Executive Director
THIS LICENSE EXPIRES May 29 , 20 06
a
.E
F LICENSE FEE
Ii 49
STATE OF - COLORADO
COUNTY OF WELD
BY AUTHORITY OF THE BOARD OF COUNTY COMMISSIONERS
RETAIL LIQUOR LICENSE
, ,
FOR HOTEL AND RESTAURANT
SPECIFY: Retail Liquor Store,Liquor Licensed Drug Store,Hotel and Restaurant,Club,Tavern etc.
TO SELL AT RETAIL MALT,, VINOUS AND SPIRITUOUS LIQUOR
SPECIFY KINDS OF LIQUORS
'CCjig ig to (ertlfp, That SIMON CORP.a DBA SIMON"S BAR & GRILL
of the State of Colorado,having applied for a License to sell malt, vinous and spirjtutius
Liquors,and having paid to the County Treasurer the sum of one hundred t exity iiit and 0011Q0
($ 125.00 )Dollars therefor,the above applicant is hereby licensed to sell nits.yinpus.end
spirituous Liquors containing more than 3.2%Alcohol by weight
by the drink lox_cgnsumption 4n the premises
(Insert"by lbe drink for consumption on the premises"or"in sealed containers NOT for consumption at place where sold.")
as a HOTEL AND RESTAURANT at 3815 Hwy. 110,_Longmont,. C9_8_0594___in the County of
Weld,for a period beginning on the 30th day of_May ,20 05__,and ending on the_ grh,_
day of May ,2006__,unless this License is revoked sooner as provided by law.
This License is issued subject to the Laws of the State of Colorado and especially under the provisions of Article 47 of Title 12,
Colorado Revised Statutes,as amended.
IN TESTIMONY WHEREOF,The Board of County Commissioners has hereunto subscribed its name by its officers
duly au orized this__1st_day of June 20_Q$__.
ATTEST: 41 v��' l The Board of County Commissioners
Dep krk to the Ba I :. s'1 - Chairman.Board of il ��VC`o^unH(•, ) Com+aisrionen
v ) &r ,L i
•
DR 8404(10/211/04)Page 1 (�n 1 DEPARTMENT USE ONLY
COLORADO DEPARTMENT OF REVENUE
LIQUOR ENT ONISxNI
OEN ER CO 80261 COLORADO LIQUOR
RETAIL LICENSE APPLICATION
❑ NEW LICENSE 0 TRANSFER OF OWNERSHIP X LICENSE RENEWAL
• ALL ANSWERS MUST BE PRINTED IN BLACK INK OR TYPEWRITTEN
• APPUCANT MUST CHECK THE APPROPRIATE BOX(ES)
• LOCAL LICENSE FEE $
• APPUCANT SHOULD OBTAIN A COPY OF THE COLORADO LIQUOR AND BEER CODE(Call 303-370.2165)
1. Applicant is applying as a
❑ Individual
fig Corporation ❑ Limited Liability Company
❑ Partnership(includes Limited Liability and Husband and Wife Partnerships) O 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
5//12 OIL) CLOdef. <Pr —/E c..id'ta-
2a.Trade Name of Establishment(DBA) State Sales Tax No. Business Telephone
,5/me's 's Mee 6/2/u: /¢- 441'`- ) (R 3) 67a-- Pio0
3. Address of Premises(specify exact location of premises)
3�/S A1(4 //9
City 67 County kohl) State o ZIP code_ 3-b
Loiv M4r,vTH� j ,11
4. Mailing Address (Number and Street) City or Town State ZIP Code
54-nt5
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 Cl Ass of License Present Expirat n Date
57/2-742/11 '.5 842 ,- 62/t.-t_ / St-qtr.?to Aar,s440-44.ai-,,,e' o. .-q/os'
LIAB SECTION A NONREFUNDABLE APPLICATION FEES LAB SECTION B(CONT.) LIO 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 $92500 1988❑Add Related Facility to Resort Complex...$ 75.00 X Total
2310 D Application Fee for Transfer $825.00 1990❑Club License(City) $308.75
2312 o Application Fee forTransfer- 1991❑Club License(County) $308.75
w/Concurrent Review $925.00 2010❑Tavern License(City) $500.00
LIAR. SECTION B LIQUOR LICENSE FEES 2011 ID Tavern License(County) $500.00
1905 CI Retail Gaming Tavern License(City) Mao2012❑Manager Registration-Tavern $ 75.00
1906 O Retail Gaming Tavern License(County) $500.00 2020❑Arts License(City) $308.75
1940 CIRetail Liquor Store Ucense(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 0 Liquor Licensed Drugstore(City) $227.50 2031❑Racetrack License(County) $500.00
1951 El Liquor Licensed Drugstore(County) $312.50 2040❑Optional Premises License(City) $500.00
1960 O Beer and Wine License(City) $351.25 2041 O Optional Premises License(County) $50&00
1961 ❑ Beer and Wine License(County) $43625 2045❑Vintners Restaurant License(City) $750.00
1970 O Hotel and Restaurant License(City) $500.00 2046 O Vintners Restaurant License(County) $750.00
1971 Hotel and Restaurant License(County) $500.00 2220❑Add Optional Premises to H&R $100.00 X_Total
1975-Brew Pub License(Cltyj $750.00 2370❑Master File Location Fee $ 25.00 X_Total_
1976 0 Brew Pub License(County) $750.00 2375❑Master File Background $250.00 X Total
1980 O 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)
FROM TO
State City County Managers Reg
450(999) 2180-100(999) 2190-100(999) _-750(999)
Cash FYM Now Lions* Coll(Fund TnM,License
2300-100 2310-100 TOTAL
(999) (999)
$
2005-1609
l-Cool t/
DR 8404(10/28/04)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. Return 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
In 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
El A. Individual History Record(s)(Form DR 8404.1).
❑ 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)
❑ 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 Ollice).
❑ 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-p.
DR 8404(10/28/04)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? 0
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? 0 0
(b) had an alcohol beverage license suspended or revoked? 0 0
(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. ❑ 0
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. 0
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! 0 0
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. 0 0
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?
0 Ownership 0 Lease 0 Other(Explain In Detail) 0 0
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,fumiture 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.
13. Optional Premises or Hotel and Restaurant Licenses with Optional Premises Yes No
Has a local ordinance or resolution authorizing optional premises been adopted? ❑ 0
Number of separate Optional Premises areas requested. (See License Fee Chan)
14. Liquor Licensed Drug Store applicants,answer the following:
(a) Does the applicant for a Liquor Licensed Dmg Store have a license issued by the Colorado Board of Yes No
Pharmacy?COPY MUST BE ATTACHED. 0 0
15. Club Liquor License applicants answer the following and attach:
(a) is the applicant organization operated solely for a national,social,fratemal,patriotic,political or athletic purpose and ❑ 0
not for pecuniary gain?
(b) Is the applicant organization a regularly chartered branch,lodge or chapter of a national organization which is ❑ 0
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 dub?(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? 0 ❑
(Copy of permit or application must be attached)
17a. Name of Manager(for all on-premises applicants) (If this is an Date of Birth
application for a Hotel,Restaurant or Tavem 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 Slate of Colorado? If yes,provide name,type of license and account number. 0 0
18. 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(10/28/04)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 8404-1(Individual History record),
and submit finger print cards to their local licensing authority.
NAME HOME ADDRESS,CITY&STATE DOB POSITION %OWNED'
'If total ownership percentage disclosed here does not total 100%applicant must check this box
O 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 O Cert.of Incorp. O Cert.of Good Standing(If more than 2 yrs.old) O Cert.of Auth.(If a foreign corp.)
❑ PARTNERSHIP ❑ Partnership Agreement(General or Limited) ❑Husband and Wife partnership(no written agreement)
O LIMITED LIABILITY COMPANY O Articles of Organization O 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
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 Bear Code which affect my license.
Authorized - ature Title
Dat
/0/2e c/'DC Air- CYi�/a,-
REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY(CITY/COUNTY)'
Date application filed wtth local authority Date of local authority hearing(for new license applicants;cannot be less
than 30 days from date of application 1247-311(1))C.R.S.
THE LOCAL LICENSING AUTHORITY HEREBY AFFIRMS:
That each person required to fife DR 8404-I(Individual History Record)has: Yes No
❑ Been fingerprinted 0 0
❑ Been subject to background investigation,including NCIC/CCIC check for outstanding warrants ❑ 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)
0 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 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 - _
��� / ` .,, I Telephone Number ❑ TOWN,CITY
Weld County, Coar �► ` \ ` • (970)356-4000 X4200 J COUNTY
Signature ` g Date
/` �// It, ,Chair, oard of Weld
Will{A H. ,T- .I _.• I' ,,41'% an= y Commissioners 06/01/2005
Signature ra 1 V ► t . i —la:�lark to the Board Date
BY: _47/ ,L/1.. . , ,SIL'.uty Clerk to the Board 06/01/2005
'"so aw.s-/619
MEMORANDUM
/ a
To: Donna Bechler, Deputy Clerk to the Board April 29, 2005
IIIMf/� I From: Bethany Salzman, Zoning Compliance Officer, Dept. of Planning Services
c Subject: LC0014 160
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
�1 (f≥ S\
MEMORANDUM
TO: DONNA BECHLER, DEPUTY CLERK TO THE BOARD
' FROM: LORI SIEDELMAN
CSUBJECT:
AE05/09/05 R LICENSE INQUIRY
COLORADO CC: CINDY SALAZAR,
ENVIRONMENTAL HEALTH SERVICES
In response to your request, Environmental Health Services has reviewed the Retail Food Service
Establishment file for Simon's Bar & 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 2222 or via
e-mail at lsiedelmanna,co.weld.co.us
Thank you.
M:\ENVIRONMENTAL HEALTH SERVICESFOOD\Memos\Liquor License Inquiry Shell..doc
LIQUOR/BEER RENEWAL REVIEW FORM
Date: May 18, 2005
TO: (DEPUTY)
FROM: William (Bill)Wagner
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 11, 2005
ESTABLISHMENT: SIMON CORP
DBA SIMON'S BAR AND GRILL
3815 HIGHWAY 119
LONGMONT, CO 80504
Current license expires: MAY 29, 2005
No concerns C�Ac elkl� .
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 Commissioner's renewal hearing.
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