HomeMy WebLinkAbout800325.tiffRESOLUTION
RE: APPROVAL OF TRANSFER OF LOCATION REQUEST FOR FERMENTED MALT
BEVERAGE LICENSE FOR THE SALE OF FERMENTED MALT BEVERAGES
CONTAINING NOT MORE THAN 3.2% OF ALCOHOL BY WEIGHT, FOR CON-
SUMPTION OFF THE PREMISES ISSUED TO ALVIN V. AND JUANITA
GARCIA, D/B/A GARCIA STORE - EXPIRES SEPTEMBER 9, 1981.
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, Alvin V. and Juanita Garcia, d/b/a Garcia Store,
1517 North 25th Avenue, Greeley, Colorado 80631, have presented
an application for a County Retail License for the sale of fer-
mented malt beverages, containing not more than 3.2% of alcohol
by weight for consumption off the premises only, and
WHEREAS, pursuant to Weld County Ordinance No. 6, Section
I., B., said applicants have paid the sum of $150.00 to the County
of Weld for the transfer of location of the existing license, and
WHEREAS, said applicants have paid to the County of Weld the
sum of $50.00, pursuant to Section 12-46-117(5), CRS 1973, as
amended, of which sum, $42.50 has been paid over to the State
of Colorado, Department of Revenue for credit to the Old Age
Pension Fund, pursuant to the requirements of Section 12-46-110,
CRS 1973, as amended, and said applicants have produced a State
Retail License for the sale of 3.2% fermented malt beverages
for consumption off the premises only, outside the corporate
limits of any town or city in the County of Weld at the location
described as follows:
1517 North 25th Avenue, Greeley, Colorado
NOW, THEREFORE, BE IT RESOLVED by the Board of County Com-
missioners of Weld County, Colorado, having examined said appli-
cation and the other qualifications of the applicants, does
hereby grant License Number 80-28 to said applicants to sell 3.2%
fermented malt beverages for consumption off the premises only,
at retail at said location, and does hereby authorize and direct
,yt{'fA2 (;),
U
8colt
the issuance of said license by the Chairman of the Board of
County Commissioners of Weld County, Colorado, attested to by
the County Clerk and Recorder of Weld County, Colorado, which
license shall be in effect from the 10th day of September, 1980
to the 9th day of September, 1981, providing however, that said
place where the licensees are authorized to sell the 3.2% fer-
mented malt beverages, for consumption off 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 violation thereof shall be
cause for revocation of the license.
BE IT FURTHER RESOLVED by the Board that approval is hereby
given to add Juanita Garcia's name to said license.
The above and foregoing Resolution was, on motion duly made
and seconded, adopted by the following vote on the 6th day of
October, A.D., 1980.
ATTEST:,
BOARD OF COUNTY COMMISSIONERS
t nnvt.444A -{- LI WELD COUNTY, COLORADO
Weld County Clerk and Recorder
and Clerk to the Board
Deputy Coun y Clerk
APPROVED AS FORM:
C�nty At -r e
Norman Carlson
C. W Ki¢by, cj'hairman
(Aye)
ABSENT DATE PRESENTED (Aye)
onard L. Roe, Pro-Tem
(ABSENT)
a Dunbar
K. S einmar
e k
DATE PRESENTED: NOVEMBER 12, 1980
r - .:41:::::;;;64;e14±17.4:::: ¢_ r '1< r•M. t,r v i)A,Sixt',40400.
t.!
.ti
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DEPARTMENT OF REVENUE
GARCIA ALVIN V
GARCIA JUANITA
GARCIA STORE
1517 N 25 AVE
GREELEY COLORADO 80631
3.2% FERMENTED MALT
BEVERAGE LICENSE
{(( EE FOR THE YEAR ENDING --i
USE UALL REFEREN1Eyy NCE! FOR COUNTYI AC�L 1 T INDUST.IN, TYPE LIABILITY LIITN
DATE
14-02836 03 206 5411 5 091079 SEP 09 1981
TTFE NAME AND DESCIIFTION OF UCINSI
J 3.2 PERCENT BEER RETAIL LICENSE
$25.00
COUNTY 85 PERCENT OAP FEE $42.50
THIS LICENSE IS ISSUED SUBJECT TO THE LAWS OF THE STATE OF
COLORADO AND ESPECIALLY UNDER THE PROVISIONS OF TITLE 12,
ARTICLE 46, CRS 1973, AS AMENDED.
THIS LICENSE IS NON -TRANSFERABLE AND SHALL BE CONSPICU-
OUSLY POSTED IN THE PLACE ABOVE DESCRIBED.
IN TESTIMONY WHEREOF, I HAVE HEREUNTO SET MY HAND AND
SEAL N(1V 5 vgin
DRL 401 L (Rev. 3/75) EXECUTIVE DIRECTOR
.(Note
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tidic OF COLORADO
DEPARTMENT OF REVENUE
LIQUOR ENFORCEMENT SECTION
APPLICATION FOR A FERMENTED MALT BEVERAGE LICENSE
Data of Issuance:
FMB License Number:
Expiration Date:
This application, and all applicable fees and attachments, must be filed with
the Colorado Department of Revenue, Liq for Enforcement Division,
State Capitol Annex, 1375 Sherman Street,
Denver. Colorado, 80261, (303) 839-3741.
Each applicant (including all general and over 5% limited partners of
partnership and all officers, directors and over 5% stockholders of a
corporation) and managers must complete and file form DRL 404•I
"Individual History Record" in duplicate, with this application.
COLUMN A
State
Fees
Local
Fees
For those retail licenses described in Column A, below, this application
must FIRST BE FILED WITH AND APPROVED BY THE LOCAL
LICENSING AUTHORITY.
IMPORTANT: Check the appropriate box for the type of licensels)
being applied for. This is an original application and a copy must be
kept in your files for reference when applying for renewal licenses. You may
attach separate sheets or additional documents if necessary to fully complete
this application.
COLUMN B
State
Fees
❑RETAIL 3.2% BEER: FERMENTED MALT $46.25 $ 3.75
BEVERAGE LICENSE —City
❑RETAIL 3.2% BEER: FERMENTED MALT $67.50 $ 7.50
BEVERAGE LICENSE —County
❑WHOLESALE 3.2% BEER LICENSE* $100.00
❑MANUFACTURER'S 3.2% BEER LICENSE'
$100.00
❑CHANGE OF CORPORATE STRUCTURE OR LOCATION
❑OTHER (Specify)
The undersigned hereby makes application for a state license as indicated above, under the provisions of Title 12, Article 46, CRS 1973, as
amended, and for that purpose makes the following answers to the questions contained in this application. Every applicable question must
be answered. Any false answer or statement made by the applicant herein or in an attachment hereto constitutes perjury and the person
making such false statements subjects any license iuued herein tq revocatlgrl
ALL ANSWERS MUST BE PRINTED IN BLACK INK (or typewritten)
1. Name of A0plrcant(s): Social Security or Taxpayer I.D. Number:
2. Trade N Business Telephone:
Name
of Establishment: '
GA-2Cr4 ' oR.e- 135-alp��'
3. Address of PremIses: (Exact location of premises must be given. Give street and number, when possible. If place to be licensed Is located in a town or rural
district whore n is impossible to give street and nurtiber, the lot andDock number or parlpf section whers4ocala must beyiven.)
15 17 h S A -CD . o $
CITY: COUNTY: ST TE: ZIP CODE:
Cx- Yee ley Wei D r mLa-raAO g'04-314. Mailing address: (Number d Street)
1,512_6n _
City : State : Zip Code :
Cx-r c e/ e rTo Lo'Yarl n t o 1p 31
5. Are these premises now license nder the State Liquor or Beer Code? If answer is "yes", to whom Is the license issued?
EYES ENO
Trade Name of Establishment :
(arr.a
6. Doefe) applicant have legal possession of the premises for which this application for license Is made? If answer is "no", explain In detail:
LYfVES ONO
State License No.:
Expiration Date:
Type of License:
RPL°r
7. Are the premises owned or leased? If leased, from ;ROWNED ELEASED
Attach copy of deed, lease or contract, and interior plan and specifications of building, if built, or if not built, attach plot plan, interior sketch
and architect's drawing of the building to be constructed.
3. If this is a transfer of location, on what date do you plan to move?
ILL RP /VI o vc�d
9. Has rtt� 7a �aapplicant filed a orm 1 with the Internal Revenue Service? If answer is "no", explain in detail.
WV ES ENO
10. Is applicant; or e(I over 6% partners; or officers, over 5% stockholders or directors of the corporation; citizens of the United States? If answer is "no", give
name en lien's Registration Card Number end Prominent Residency Card number.
YES ENO
11.15 the applicant; or any of the over 5% partners; or officers, over 5% stockholders or directors of said applicant (if a corporation); or manager of applicant;
under the age of eighteen years?
EYES
pans 1
12. Has the applicant; or any of -the over 5% partners; , Vicars, over 5% stockholders or directors of said app. .t (If a corporation); or employees of applicant;
or persons lending assistance or financial support to the applicant; ever been convicted of a crime? if answer if "yes", explain in detail.
EVES. ONO
13. Has any person, as applicant, partner, officer, Dirac or, stockh{y4ayor employee, ever:
(a) bean denied an alcoholic beverage license? LJYES IN NO
(b) Had an alcoholic beverage license suspended or revoked? DYES V°
If the answer is "yes" explain in detail; (Attach separate sheet If necessary.)
14. Does the applicant have a Colorado State Sales Tax Account? If answer is "yes", give the Account number.
❑YES ❑JO
15. Do the applicable zoning laws permit ermy-the sale of alcoholic beverages on 16. Has a Fermented Malt Beverage license for the same location �-�/
the licensed premises? EKES ❑ NO been refused within the preceding one year? ❑ YES '{2 NO
17. Does or did the applicant; or any of the partners; or officers, directors or stockholders of said applicant (if a corporation), have a direct or Indirect interest
in any Colorado Liquor or Fermented Malt Beverage License (include loans to or from any licensee, or interest in a loan to any licensee)? If the answer is
"yes" , explain in detail.
OYES U/NO
18. Identify the persons, firms orcorporations who now or Will have, a financial interest, evidenced either by loans or equity Ownership in the business for which
this license Is requested. State the names and addresses, and the amount and source of such financial interest expressed in dollars or other items of value, such
as Inventory, furniture or equipment. (Use separate sheet if necessary)
NAME:
ADDRESS:
INTEREST:
19. List the names and addresses of all businesses in which any of the persons In the previous question are materially interested. (Use separate sheet if necessary):
NAME: BUSINESS: - ADDRESS:
Attach copy of all notes and security instruments, and any written agreement or details of any oral agreement, by which any person (including a corporation)
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.
20. If the applicant is an Individual or partnersh p, answer the following: (Attach separate sheet if necessary)
INDIVIDUAL PARTNERSHIP
(a) Name of individual or name and class of each
partner:
Home address and city:
Date of Birth:
% of ownership:
(b) Name of Manager.
Home address and city:
Date of Birth:
(C) if partnership, when did said partnership commence doing business? (Attach a copy of the partnership agreement (except husband and wife) and trade name
affidavit)
21. if the applicant is a corporation, answer the following:
(a) Corporation is organized under the laws of the State of:
Date:
(b) Principal business is conducted at:
ounty of:
State of:
(c) Date of filing last annual corporate report to the secretary of state:
(d) Name of each officer listed below:
President:
HomeAddress and City:
Date of Birth:
Vice -President:
Treasurer:
Secretary:
Manager:
Page 2
I (e
(f)
nama" actual own' ar
Name of Stockholder:
pnpese• tHN separate Inset or necessary.
Home Address and City:
% of stock;
Date of Birth:
Names of all Directors or Trustees
of Corporation:
Home Address and City;
Date of Birth:
Attach a copy of the certificate of incorporation, the articles of incorporation, stock certificates, the authority to transact business in Colorado (if a foreign
corporation), and the corporate minutes authorizing the filing of this application and electing the current officers and directors, or trustees).
When did applicant purchase this business, or If now, when does applicant pion to begin operating this business? If purchased, from whom?
If the applicant is a manufacturer, or wholesaler, answer the following;
(a) Does applicant own lease or operate any warehouse or storage plant in connection with its business? (If "yes", give full address)
DYES NO
(b) If the applicant is a manufacturer, does any owner, part owner, shareholder, director or officer have any direct or indirect financial interest in an importer,
manufacturer, wholesaler or retailer already licensed by the State of Colorado to sell fermented malt, malt, vinuous or spirituous liquor? If answer Is "yes"
attach explanation in detail.
FIVES ONO
(e) If the applicant Is a wholesaler, does any owner, pert owner, shareholder, director or officer have any direct or indirect financial interest in a wholesaler,
retailer, manufacturer or importer already licensed by the State of Colorado to sell fermented malt, malt, vinuous or spirituous liquor? If answer Is "yes"
attach explanation in detail.
DYES °NO
(d) If the applicant is a foreign wholesaler to what licensed wholesaler in Colorado does he intend to ship his merchandise?
(e) Does the applicant have a valid Federal Basic Permit? If "yes", attach a copy of the permit; if "no", explain in detail.
DYES ❑NO
I
STATE OF COLORADO
COUNT
COUNTY OF
AFFIDAVIT
This affidavit is to be signed and acknowledged by individual, each general partner or partnership and by corporate applicants.
SS
AND
being by me first duly sworn, if for himself, deposes and says: that he is the applicant above named, or a partner, or that he is
(title)
of the above named corporation; that he has read the foregoing application and attachments, and
that he knows the contents thereof, and that all matters and things therein set forth are true of his own knowledge and he agrees to conform
to all the rules and regulations promulgated by the State Department of Revenue in connection therewith.
SUBSCRIBED AND SWORN TO ME
This
Signature •f Notary Public
(ATTACH SEAL)
My commission expires: /)Air
INDIVIDUALS AND ALL GENERAL PARTNERS OF PARTNER•
SHIP ST SIGN HERE:
l
CORPORATION SIGN HERE: (Corporate Seal)
By:
(President, Vice -President, or Secretary)
REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY
(MANUFACTURERS AND WHOLESALERS DISREGARD THIS SECTION)
The foregoing application has been examined and the premises, business conducted and character of the applicant is satisfactory, and we
do report that such license, if granted, will meet the reasonable requirements of the neighborhood and the desires of the inhabitants, and
complies with the provisions of Title 12, Article 46, CRS 1973 as amended.
CRS 1973, as amended, 12-46-117 CHECK ONE
(1) (a) The local licensing authority shall restrict the use of said license to:
(I) Sales for consumption "off" the premises of the licensee; or
(I I) Sales for consumption "on" the premises of the licensee; or ❑
(Ill) Sales for consumption "both on and off" the premises of the licensee. ❑
(b) The provisions of paragraph (1) (a) shall not apply to any license issued or applied for under
this article prior to July 1, 1967, nor to any renewal or reissuance thereof.
THEREFORE THIS APPLICATION IS HEREBY APPROVED.
AT:
THIS
aid i 1 «.�L�:z
(Name of town, City and County)
DAY OFilig f �lir-e , A.D. 19
BY: //1
/ -i 'it'd
(Mayor, Chairman of oard of Cty Commissioners or other title of the licensing authorlt
ATTEST:
la GL wt1-atraw ttcol!
(Clerk, secrfJary or other officer having the official s fal otJttl� I cens�ut�y.
4
If the premises are located within a town or city, the above approval should be signed by the (Mayor anclerk; if in q county, then by
the chairman of the board of county commissioners and the clerk to the board. If, by ordinance or otherwise, the local licensing authority
is some other official, then such approval should be given by such official.)
Page 4
•DRL 416 (Rev. 3/77)
TO: STATE OF COLORADO
DEPARTMENT OF REVENUE
LIQUOR ENFORCEMENT DIVISION
1375 SHERMAN STREET
DENVER, COLORADO 80261
TELEPHONE: (303) 892-3741
THIS APPLICATION Ml's BE SUBMITTED TO AND
APPROVED BY LOCACLJCENING AUTHORITY FIRST.
The undersigned requests permission to change location:
Name of Licensee:
Trade Name:
FROM:
(Old) Address
TO:
Date:
1
t. 77c0
License No. /1/"" 04 tf, t to
v1/4-
/s- -7?6.,-e/ -7 s--4,
.(Street and No. or Legal Description)
(City or Tetwn) ( — 't/);
/ (Couunnty)
(New) Address 75—/ -x-4't SCLLa -
Trade Name
(Street and No. or Legal Description)
(City or Ttwn)
(County)
Are these premises located within 500 fee of a building occupied as a school, public or parochial, college, uni-
versity or seminary? ] /�
On what date do you plan to move?
Signed:
(A,rQMn.wt( v
kennel
rt_.ti-r
(President or Secretary of Corporation)
APPROVAL OF LOCAL LICENSING AUTHORITY:
The foregoing application for permission to change location has been examined and we do report that such
transfer, if granted, will meet the reasonable requirements and the desires of the inhabitants of the ne@hborhood.'
We do further state that the provisions of Title 1246-117, or 1247-136, CRS 1973, as amended (regarding the
posting and advertising of the premises) have been complied with.
Therefore, the c7cfo going application Is hereby approved.
Dated At
(City or To
Name of Town, City or County•
(j),tk
this
By:
Attest:
day of �L`7�'L A.D. 19 so
// t.
or Chairman f
(Mayor
Board of County Comminioners
or Other Title of Licensing Authority)
s /(Clerk or Secretary or O
-Hotel pa Official Se p M
rpffIcor
ng Autho
7
v1JPLTCV'T?("; T") 3.?
FE ':r TED MALT Rr't'2AGE LICFNS
c:. •..,lr'v, Colorado
er- 2.2 , 138O
date — —_
l.n.
TO THE BOARD OF COU'TTY COMMISSIONERS OF WELD COUNTY, COLORADO
The undersigned hereby makes application for a County Item i I 3. ?: Beverage
License.
I•I.ic;tnt (',)
Fenn ?r'dress of Applicant(s) /5/ r? Al ,n1j
Movie
4. Inl;:i,.,..•y; Telcnhone__ (e ~Js5^
n. Ift,..,,. ^•r•1'rDhone 'lumher(s) _� — �Q�. •35_,
r
Business Address /5-/r7 pC J dd 6¢'io- (_ 4
7. If Partnership, give names of partners; if a Corporation or Club give names
of Principal officers
Chic!.: the appropriate line for the type of retail license being applied for:
'or Sales for consurijption OFF the premises of licensee only.
1_ For Sales for consumption ON the premises of licensee only.
For sales for consumption ON and OFr the Premises of licensee.
). E::ACT.LOCTTION OF PREMISES. Give street and number, Lot and Block number
or Range, Township and Section (if possible give quarter of.Seection).
2,S-/ 7 A/ �. S Cc.t�—P �•pa.Y.o roc
4
J i•
I
Do von have legal possession of tie premises or
license is made? ^
which
this application for
lI. Are the premises owned or rented? zntjacek If rented, from whom?
state nature of husiness conducted:
13. If restaurant, state whether other puniness is conducted except sale. of
food, meals, drinks and tobaccos:
14. If club, state whether operating for a national, social, fraternal, patriotic.'
political or athletic nature:
15.. If club, state whether it is for pecuniary. gain:
16. If club, state whether the property and advantages of club belong to
members:
17. Is applicant(n) or all
United States?
officers of the• corporation a citizen(s) of the
In. (Jos applicant(s) a state license rC) Lie :;nli' of 3.2". ferf'`nt ed malt
I et,
I •eVr+rat`?
II q ,innl irant(s) over boon convicted of a f(`lonv?
20. If answer to nuesti.on
)n is ''"us", gig., full rlct•ttl:,.
L44/c/oP6
• -21. !Las allpl.i.cant been adjudged guilty I : a court of record of viol.rt inq the
ln;:scovering the prevention of q,ir inq under
laws of :ho Stole of
Chlorado, or nnric.' the laws of thy -oitel States?
If answer to question 21 is "yes',- give full details:
3
i
23. Will apoli.c.ant(s) permit any wholesaler or manufacturer to be
financially, by loan or otherwise, in applicant's business?
24. Tr answer to cuestion 23 is "yesc.
give full details:
interested
23. Will aoolicant(s) use any equipment, fixtures, chattles, decorations or
furnishings supplier; or loaned by any manfacturer or wholesaler? 2s-
2�. Is answer to question 25 is "yes", exolain: [-/]
"he ann) icant horehv agrees; i f
"alt B4Ve , license is issued for sale of 3.??
Fermented rage only, as herein requested, the place of business used therefor
will he conducted in strict: conformity with all laws of the State of Colorado,
and the rules and regulations of the Board of County Commissioners of Weld
County, Colorado, relating thereto, and any conviction of vi.o.latio.ns of said
laws, rules and/or regulations shall be cause for revocation of such license,
without further hearing thereon. The applicant(s) further agrees that he,
she (they) has full knowledge or the aforesaid state laws and Board rules and
requlat.ion:- existing at the date of this r r
wi 11 keno ndvis 1 ron and'agrees he, she (they)
cd as to all subsequent state law, Board rules and regulations,
that Tony he hereafter passed relating thereto (luring the Lerm of Said license.
"Arf OF COLO'?ADO)
CCtn.r-y np¶)rest 4S
Cur„,,,,)/ _being first duly sworn
`i'ial: ho, ail (they) on oath, disposes and
1•, ,) i s/arre the applicant(s) above named: has/have yr. real the ahOve and foregoing That he, she
q riper application and the answers made
,rrnl w-11 kno';s the contents e
h_renf, and that the answers mule to the
Ieferrare,-etorins therein set forth are true to his,
her. (their) own l nor,elclae.
Subscribed
a n d
sworn before me this 21
Aupl icant (s) —
PI , icant -
day of
_--✓ A.D. 1'J�
Dej'ury .ounty
Norary 'U)'I.ic
1/L//
says:
(they)
thereto,
AL 404-I i6./79l
STATE OF COLORADO
DEPARTMENT OF REVENUE/LIQUOR ENFORCEMENT
INDIVIDUAL HISTORY RECORD
To be completed by each individual applicant, each general and over 5% limited partner of a partnership, each officer, director, and over 5%
stockholder of a corporation, and the manager of the applicant.
NOTICE
This Individual History Record provides basic information which is necessary for the licensing authorities' investigation. ALL questions must be
answered in their entirety. EVERY answer you give will be checked for its truthfulness. A deliberate falsehood will jeopardize the application
as such falsehood within itself constitutes evidence regarding the character and reputation of the applicant.
'. Nam cf Business:
G ay -O t a 51 -r-e,
2. YouFull Name: (first/last/middle)
/.) (ea V/&i L
4. Height: we,ght
Hair Color:
Eye Color:
'Date:
9-1f7-19'Rso
3. Also Known As: (maiden name/nickname/etc.)
Sex: Race: 5. Do you have a Colorado Drivers License? If "YES'
K/, U t _ EI E S ❑ N O R /
fiA) Gi^
7. If Stockholder, Number of Shares Owned Beneficially or of Record:
8. if Partner State Whether:
Percent of Outstanding Stock Owned:
Social Security Number:
SA*-/¢-
number:
❑GENERAL ❑LIMITED
Percent of Partnership Beneficially Owned
9. Res,dence Address: (street and number/city/state/zip)
10. i syour residence:
D/OWNED ORENTED
11. Mailing Address, If Different From Residence:
If rented, from whom?
i2. Name of Present Employer:
14. Address of Butsiness Where EOoyed: (s eet and number/city/state/zip)
13. Type of Business of Employment:
15. Present Position:
CT—�."---k--..
16. Home Telephone: _
Z — L c4 7
Business Telephone:
S-6-,-,_____.
17. Oars of Birth:
Place of Birth:
15. U.S. itizen?:
tr. ES ONO
,f naturalized, state where: I
When:
Name of U.S. District Court:
Naturalization Certificate No.:
Date of Certificate:
If an alien, give Alien's Registration Card No.:
Permanent Residence Card No.:
19. Marital Stattus::,,"/)
20. If spouse is a e, wife's full maiden name:
er12--leiTh
21. Soo use' ate o girth:
Place of Birth.
22. If spouse's r silence ad rest is different than yours, list ere.: (street and nu //city/state/zip)
23. if spouse works, state name of pre "employer:
_ _ /...) L L fJ� /�,il/,^, I
Occupation:: / ,, `�
L - X124 (mil
e ten; emplpy,7r.
/ lC�
24. : ist the nemetsl of ail relatives working in the liquor industry, giving their:
Name of Relative:
Relationship to you:
Position held:
Name of employer:
V
Location of employer:
Name of Relat.ve:
Relationship to you:
Position held:
Name of employer:
Location of employer:
o yQu now, or have you eJvfer new a direct or rndlrect interest in a State of Colorado Liquor or Beer License? If "YES", answer in detail.
re
Q3
YES ❑NO
26. Do you now, or have you ever had a direct or indirect interest in a liquor or beer license, or been employed in a liquor or beer related business outside ofthe
State of Colored,If "YES", describe in detail.
YES
27. Have you ever been convicted of a crime, fined, imprisoned, placed on probation, received a suspended sentence or forfeited bail for any offense in criminal or
under the infl lice of alcoholic beverages.) If "YES", explain in detail.
military court? (Do not enclude traffic violations, unless they resulted in suspension or revocation of your driver's license, or you were convicted of driving
OYES NO
28. Have you ever receivers a violation notice, suspension or revocation for a liquor law violation, or been denied a liquor or beer license anywhere in the U.S.?
If "YES", explain in detail.
YES [NO
29. Have you ever held a gambling or gaming license or owned a Federal Gambling Stamp? If "YES", explain in detail.
Oyes NO
State/Federal:
State/Federal:
30. Military Service: branch:
Year:
Year:
City:
State:
City:
31. List all addresses where you have lived for the last five years.(Attach separate sheet if necessary)
Sue and Number:
Street and Number:
(From: jTo: (Serial No.:
City/State/Zip:
State:
!Type of Discharge:
From:
To:
City/State/Zip:
32. List all former employers or businesses engaged in within the last five years: (Attach additional sheets if necessary)
Name of Employer: (Address: (street and number)
Av f'o'rum ion expires:
rc ptary Public i
Name of Employer:
Address: (street and number)
(city/state/zip)
From:
To:
Position Held:
From:
To:
city/state/zip)
Position Held:
From:
To:
33. List the names and attach letters of recommendation from three persons who can vouch for your good character and fitness in connection with this application.
Name of Reference:
Name o Reference:
),1 Z rl c�
Name of Reference:
iii/Z / I I 'r�� 5 fi. a, d 5,
STATE OF
COUNTY OF
t\(
2,-63
Address: (street and number)
loo N a1 At
Address: (street and number)
/410
Address: (street and number)
/U 17
SS.
(city/state/zip)
CA--Yec3le1(e,dn c---0 t73 /
(city/state/zip)
aYee/ey co/o FrO431
(city/state/zip)
GfYeeley ( If) �i0(v3i
No.Years Known:
No. Years Known:
No. Years Known:
I understand that a false answer to any of the foregoing can subject the application to denial or a license to revocation. I certify that all of the
information in this Individual History Record is complete and correct to the best of my knowledge and belief.
Subscribed and sworn to me
In ;5
day of
,19
VvITNESS my hand and official seal.
(ATTA 7SAL)
i
,
Signature
irlf ()AA
RL 404-I (6/79)
•
STATE OF COLORADO
DEPARTMENT OF REVENUE/LIQUOR ENFORCEMENT
INDIVIDUAL HISTORY RECORD
To be completed by each individual applicant, each general and over 5% limited partner of a partnership, each officer, director, and over 5%
stockholder of a corporation, and the manager of the applicant.
NOTICE
This Individual History Record provides basic information which is necessary for the licensing authorities' investigation. ALL questions must be
answered in their entirety. EVERY answer you give will be checked for its truthfulness. A deliberate falsehood will jeopardize the application
as such falsehood within itself constitutes evidence regarding the character and reputation of the applicant.
Name of Business:
C.,Kr i :rf/ t
%°
Your Full Name: (first/last/middle) )
07`
Hair Color:
'13.k
Date: (Social Security Number:
3. Also Known As: (maiden name/nickname/etc.)
•
4. Height:
t/ y-
6. Your Relationship to Applicant: (sole owner/partner/corporate officer/director/stockholder or
7. if Stockholder. Number of Shares Owned Beneficially or of Record:
Percent of Outstanding Stock Owned:
8. If Partner State Whether:
❑GENERAL OLIMITED
Percent of Partnership Beneficially Owned:
9. Residence Address: (street and number/city/state/zip)
/ / IV 5 GL -,7
10. �s your residence: If rented, from whom?
I' NED RENTED
3
11. Ma.ling Address, If Different From Residence:
12. Name of Present Employer:
14. Address of Business
e..er_d-c�11
here Employed: (street and nu
l
er/city/state/zip)
T
13. Type of Business of Employment:
15. Present Position: \ • v
16. Home Telephone:
3 5-;R- a G )? ,c)--
Business Telephone:
.5 a. Iii. e.
17. Date of Birth:
/
Place of Birth:
74,-,4A ,Ai V, co
'3. U.S. Citizen?:
YES ENO
If naturalized, state where: V
When:
Name of U.S. District Court:
Naturalization Certificate No.:
Date of Certificate:
If an alien, give Alien's Registration Card No.:
Permanent Residence Card No.:
19 Marital Status:
20. If spouse is a wife, wife's full maiden name:
21, Spouse's Date of Birth:
Place of Birth:
22. If spouse's residence address is different than yours, list here.- (street and number/city/state/zip)
, state name of present employer:
Occupation:
Address of present employer:
24. List the name(s) of ail relatives working in the liquor industry, giving their:
.'lame of Relative:
Relationship to you:
Position held:
Name of employer:
Location of employer:
Name of Relative:
Relationship to you:
Position held:
Name of employer:
Location of employer:
EYES
now. Or hive you ever held a direct or indirect interest in a State of Colorado Liquor or Beer License? If "YES", answer in detail.
NO
26, Do you now, or have you ever had a direct or indirect interest in a liquor or beer License, or been employed in a liquor or beer related business outside ofthe
State of Colorado? If "YES", describe in detail.
DYES KO
27. Have you ever been convicted of a crime, fined, imprisoned, placed on probation, received a suspended sentence or forfeited bail for any offense in criminal or
military court? (Do not enclude traffic violations, unless they resulted in suspension or revocation of your driver's license, or you were convicted of driving
under the inf nce of alcoholic beverages.) If "YES", explain in detail.
DYES NO
28. Have you ever received a violation notice, suspension or revocation for a liquor law violation, or been denied a liquor or beer license anywhere in the U.S.?
If "YES", explain in detail.
EYES NO
29. Have you ever held a gambling or gaming license or owned a Federal Gambling Stamp? If "YES", explain in detail.
OYES
NO
State/Federal:
Year:
City:
State:
State/Federal:
36.
Year:
City:
State:
Military Service: branch:
From:
To:
Serial No.:
Type of Discharge:
31. List all addresses where ",.i, hat,. li„va 4,...we I4. 42......--- ,. ___ -
ssary
street and Number:
City/State/
From:
/11 7 //
�
(�
co.„). --C
ZiZip: ��
�,A,c6 i i,' t "
//,
W •
�
0
M I
/? 24
To:
/ 9 8-o
Street and
and Number:
C ty/ tate/Zip: \
From:
�,`�x//
_
(�(
/ . C ../\
t
///�',.
�C6D31
/?2?
To:
/F 526
32.
List all former emolaverc nr
.
o«o
;..-.:44,.....,...
L--
"
Name of Employer:
Name
Address: (street and number)
(city/state/zip)
Position Held:
From:
To:
of Employer:
Address: (street and number)
(city/state/zip)
Position Held:
From:
To:
33. List the names and attach letters of rornmmc"dmL... e...— ----- _______ L- -
_
ch for your good character and fitness in canna von with th
Name of Reference:
�"j([rS�� + i e�.iesi itt r .,�
"Name
Address: (street and ��{{number)
3 N r2 C., ..
(city/state/zip
'r n
G
h
No.Years ., Known:
of Reference:
r 7
NamefR fence. ��C�
o
(
Address: street and number) )
3 13 F
(city/state/zip)\
/
�G-. (te4
l 3 (
4 3 /
�./ .
No. Years Known:
D
Y,h� �`'A,,.r�r..,s—,
Address: (street and number)
i4 /o 7k
-
(tit /state/zip) `
4,,, (,)-7,--,
g--e‘3I
No. Years Known:
/O
STATE OF
COUNTY OF
4i
} SS.
I understand that a false answer to any of the foregoing can subject the application to denial or a license to revocation. I certify that all of the
information in this Individual History Record is complete and correct to the best of my knowledge and belief.
Subscribed and sworn to me
this O
day of
Vel T NESS my hand and official seal.
(ATTACH
LSSEE 1-1 / L
My tom n expires' d /Feb
,19 �.
o it
I led for record the ..._day of.
Reception No
1628037
Cnuw all Mien fig filet:.- larezenfs,
--2g 4/'��I/L°[��--" _RECORDER.,
'�—"' 12 --'DEPUTY.
That, whereas, the followin described property, viz
Lot 11 :1w':,::z Sec 36 T6` R66. Espanola Sub.
F~ II I situated in the County of... i.e ld
- - •------•_--_ _ and State of Colorado, was subject to taxation for the year (0r-
--a years) 62
And, Whereas, The taxes assessed upon said property for the year
at the date of the sale hereinafter named, (er-years) aforesaid remained due and unpaid
I
Ii6 is k AoTl,-Whereas, The Treasurer of the said County did, on the...j.1<.Sl..—..._.day of.—A.ec ein.heX_•__._.._-_....,,
dA.,if:•15:.f2.3,-, 1 virtue of the authority vested in him by law, at the sale begun and publicly held on the. n . day
,- of....DQcp-e,^ 1:tcr_,_•�._,__, A. D. 196.3....., expose to public sale at the office of the Treasurer in the County afore -
.1, K tilt ti conformity 9
•i, • t M with the requirements of the statute in such case made and provided, the real property
`3 ; tt s'brib)edfor the payment of the taxes, penalty interest, and costs then due and remaining unpaid on said prop-
C'
'-fin s-AtYhe-tmte�ld lace-a1oresai
1. whose streef•a dress is..._.._._.—.— j -, ..-.—.— ---- City or Town of _______________ -_--,C2_-,
i
I County of._.'----•-- . and State of—...—•------ — - - --------_...._...._....d
Property the sum of bid on all of the above described
and ...... ..._.-- d co DOLLARS
----..-_.........._:.._.CENTS, being the whole amount of taxes,
remaining unpaid upon said property for said penalty faterest�and costs then due and
Year-.-_-..; and the said _
having offered in his said bid to a the pay sum of ---.._..-_----
CENTS in excess of said Taxes, '-----•- --'-`— DOLLARS and
penalty interesLand costs, and the said bid being the largest amount
f which any person offered to pay in excess of the said taxes„penalty interest, and costs so due upon said property for
I
II said year...__, and payment of the said sum having been made by him to the said Treasurer, the said property was
I stricken off to him at that price;
*And, Whereas, the said.—_ -
I I
whose ftreet address is
5
COunty„4 .12. • ....—._ _.— - City or Town of
- ••----..._...and State of
..did, obi the.----
�' i >- .--•--•--•_day of.--__ .., A. D. 19.._._-, duly assign the certificate of
lI: the sale of the-joperty as aforesaid, and all his rights, title, and interest in said ro
P perry, to
_r
...„;.4A
se street add less is...__ ... City or Town of
.K`'County`6
• �-�c — -- .._. nd--s tc V!Isf_ —_ _
II c?� ))• •,A-od; "Thereas, At the sale so held as aforesaid by the Treasurer, no bids were offered or made by any person or
ilp�rfeobsjfor the said property, and no person or persons having offered to pay the said taxes,
costs upon the said property for said year.._ and the Treasurer having penalty interest, and
Herty could be had, therefore the said become satisfied that is sale off to ath prop -
County, property was, by the then Treasurer of the said County, stricken the said
Y and a certificate of sale was duly issued therefor to the said County in accordance with the statute 'in such
case made and provided;
`And Whereas, The said-. ie...^.-.•_.__ County acting by and through its Treasurer, and in
conformity with the order of the Board of County Commissioners of the said County, duly entered of record on the
.1.0.th..•--
----day of---De.k.4it:ber k D. 19.p 4_„ (
session -of -the -Board -of County{bmrrissionersof-thesaid-Counr,r), did duly assign prop-
erty, �repso issued as aforesaid to said County, the ty of y ofvirtue id id
and all its rights. title, and interest in said property held by of said
sale to ..... _.dl.V.111-3'r..i'G.ld._-_.------
i
whose street address is 3L..2._.7Q':;_.,9 •
—•---•-----------_......., City or Town of Greeley
County of..._.1YP_.1�_......._._.._.._...and State of..._._CQiCr.21.Q
-JaS7.EI1t.}f.-iWD for the sum of
— -•--•- DO:LSRS and...�77 .k3'—=.t�.G..it .CENTS.
`And, Whereas, The
whose street address
County of ;2D-] •,.._.
...._..-•----•-----._........._...---. ...and State
_ n.e.z ._ A. D. 1
did on the l.i.ul_..-.-_.-.da y • of. ;>•✓tii-P•�'
123-A-1973
City or Town of...vX.eelev
of ...i..Q.1.Q:A:.jQ
9_.1.3., duly assign the certificate of the sale of
TREASURER'S DEED SINGLE PARCEL— ME - ` G F. XJCCv,EL CJ., DE4:Eq, COLO. 28015
friovcrc
•
SOCK 706
1623031 g- _)
the property as aforesaid, and all his rights, title, and interest in said property, to
Alvin & Juanita Garcia
whose street address is Rt 2 Box 9
of the County of .field and State of C olorad�.o
*And, Whereas, The said Alain..ix. .J.uanita_Garc1H
whose street address is Rt. .2...B.ox...2 - City or Town of Gree.ley
County of Weld and State of .......i'Olor.acjo
has paid subsequent taxes on said property to the amount of_-T1J.o... .0 dead... i iS1e..ty---- — DOLLARS
and...Three-- CENTS;
And, Whereas, More than three years have elapsed since the date of the said sale, and the said property has not
been redeemed therefrom as provided by law;
And, Whereas, The said property was valued for assessment for said year at the amount of a 20__,_0_Q -
And, Whereas, All the provisions of the statutes prescribing prerequisites to obtaining tax deeds have been fully
complied with, and are now of record, and filed in the office of the Treasurer of said County;
Now, Therefore, I,.....Eran s..._•i__..L.O.Asl 1 et_ _._.,Treasurer of the County aforesaid, for and in
consideration of the sum to the Treasurer paid as aforesaid. and by virtue of the statute in such case made and pro-
vided,'have granted, bargained, and sold, and by these presents do grant, bargain, and sell the above and foregoing
dUef Ri3ea}kestate unto the said.._....A.1,tx.7.A-..&.-..S.L' 2.Ait3....GdS.Cia
Qr'3hdare s •€et;dd@ress is Rt 2....Box .---9..----...-•-.-- -•------.._..---., City or Town of Greg 1 ev
ke.ecc n f..._..: ;`��lsl —and State of G_Q1.O.rad.Q _
+-; •�, :CI their.,h...... .. heirs and assigns, forever, subject to all the rights of redemption by minors,
4 .. or incompetent persons, as provided by law.
^' t. OFFICbat,
C, �r.
S .tb In Witness Whereof,',aari 9 i. T,O.U.et.Zlet.___.__-, Treasurer
r!/s•'...... * N,) as aforesaid, by virtue of the authority aforesaid, have hereunto set my hand and seal
4 k f y.;;0 this 1.0.; h day of...-... iaauary A. D. 19.7_4....
1-1: r .
Certificate No. 3 35 Book No.. 13. Tax Sale Record u'=�<<•i.,'f... !_...:..4‘,42.:...: -.(Seal)
City or Town of Greeley
'Strike out in accordance with fact.
Treasurer of WeldCounty, Colorado.
STATE OF COLORADO,
}ss.
The foregoing instrument was acknowledged before me this. 10th day of January
1g 74,by_rranc1s M. Loustalet— astreasurerofsaidcounty.
N,t `(r3tness my hand and official seat.
Q %• •.•.••......I'(` My commission expires-_' ' -- -'•• u- 7a8�.iaiSIi.-
O :' •
c ; t10 T tom, cjsitSval)
: ,ar. _
Maytiaggib ress for
Future Tax Notices
& Juanita Garcia Rt 2 26x 9 Greeley,. Colo 80631
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COLORADO
mEmoRAnDum
To Commissioners Date 10-3-80
From Clerk to the Board's Office
Renew existing license at new locatio nd add Juanita's
subject. Garcia Store - 3.2% beer license name
Background for this request
Alvin V. Garcia has an existing 3.2% beer license which expires
September 9, 1980. The Sheriff's Office incident report for
this past year reflects no problems. The existing license is
for 1415 N. 25th Avenue (Spanish Colony) and for off premises only.
Mr. & Mrs. Garcia have had their new home and store build around
the corner at 1517 N. 25th Avenue (Spanish Colony). The deed which
is enclosed identifies the property as: Lot 11 NW'ZNE1/4 Section 36,
Township 6N, Range 66 West, Espanola Subdivision. Said deed is in
Alvin & Juanita Garcia's names.
Therefore, the Garcia's are requesting that their license be in
both of their names and at their new location.
Juanita Garcia has been fingerprinted and has completed the required
individual history record.
We have a diagram of the premises in our file and it is acceptable.
We didn't copy p
it for your files because it is too large.
A change of location does require posting the premises. We gave
Mr. Garcia one of our notices and he assured us that he would post
it for ten days before this date.
TREASURER'S OFFICE, WELD COUNTY
:t1 13
Greeley, Colo.
RECEIVED OF
\ NO. 5182
19 ..1..) ..5 7)
$ LC—
7
FOR
CREDIT
✓unty General Fund
t -!
999111����� r
/S-- 2
`t
Road and Bridge Fund
�
Colo. State Sales Tax
Weld County General Hospital Fund
Fee Fund
School District No Gen. Fund
Motor Vehicle Fund, Licenses
County Clerk Fees
Motor Vehicle, Add. Registration Fee
Specific Ownership Tax, Auto
FRANCIS M. LOUSTALET I ,
I
TOTAL AMOUNT
/c"
—)
County Treasurer. Clerk.
Hello