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Address Info: 1150 O Street, P.O. Box 758, Greeley, CO 80632 | Phone:
(970) 400-4225
| Fax: (970) 336-7233 | Email:
egesick@weld.gov
| Official: Esther Gesick -
Clerk to the Board
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890459.tiff
RESOLUTION RE: APPROVAL OF RENEWAL REQUEST FOR 3.2% BEER LICENSE ISSUED TO C. RAY AND ROBERTA HINDERLITER, DBA 1-76 MOTEL & CAFE - EXPIRES JUNE 23, 1990 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, C. Ray and Roberta Hinderliter, d/b/a I-76 Motel & Cafe, has presented to the Board of County Commissioners of Weld County, Colorado, an application for the renewal of a County Retail License for the sale of fermented malt beverages, containing not more than 3.2% of alcohol by weight, for consumption off the premises, and WHEREAS, pursuant to Weld County Ordinance No. 6, Section II., C., said applicant has paid the sum of $57.50 to the County of Weld for the renewal of the existing license, and WHEREAS, said applicant has exhibited a State License for the sale of 3.2% fermented malt beverages for consumption off the premises, outside the corporate limits of any town or city in the County of Weld at the location described as follows: 35929 I-76 Access Road, Roggen, Colorado 80652-9609 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 89-15 to said applicant to sell 3.2% fermented malt beverages for consumption off the premises, only at retail at said location and does hereby authorize and direct the issuance of said license by the Chairman of the Board of County Commissioners, attested to by the County Clerk and Recorder, of Weld County, Colorado, which license shall be in effect until June 23, 1990, providing that said place where the licensee is authorized to sell 3.2% fermented malt beverages 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. 890459 Page 2 RE: 3.2% BEER LICENSE - I-76 MOTEL & CAFE The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 15th day of May, A.D., 1989. ATTEST: Weld County Clerk and Recorder and Clerk to the Board C7'77c�t�.e (Deputy County C9�erk APPROVED AS TO FORM: County £"tt.rney BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO C.W. Kir7�z y, C airman son, Pro-Tem ene R. Brantner 890459 0 the off C o Ilor a do ®t off l3® a® Liquor Enforcement Division 1375 Sherman Street Denver, Colorado 80261 HINDERLITER ROBERTA HINDERLITER C RAY I SEVENTY SIX MOTEL& CAFE 35929 I 76 ACCESS RD ROGGEN CO 80652-9609 Alcoholic Beverage License Account Nunber dust. ,... County City Indust. Type LialsMy Date LICENSE EXPIRES AT MIDNIGHT 14-27452-001 03 206 7011 5 062487 JUN 23. 1990 Type Name and Description of License Fee J 3.2 PERCENT BEER RETAIL LICENSE $ 25.00 COUNTY 85 PERCENT OAP FEE $ 42.50 roTALFEEts) S 67.50 This license is issued subject to the laws of the State of Colorado and especially under the provisions of Title 12, Articles 46 or 47, CRS 1973, as amended. This license is non- transferable 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 Divison, 1375 Sherman Street, Denver, CO 80261. In testimony whereof, I have hereunto set my hand. Division Director DR 8402 (3-88) MAY 2 4 1989 Executive Director 890459 6SVO6S / •;6 S ,R \ ti..✓'r� R�� n I r 141 I,yX, (lf%E+'li I S.bjl Rl 11:. ��%li\t:`.� 4.�1 .�✓ `Q � t�� ��i 4litiJ=¢j ��w pm, jR .i i IT �'•l�i%•E6 \:�:Rt �.SaU.#�tt�fi3fit...R:\�1t e.fG�i V 49 e 1g, A�A` .P. 1 ..e y yM W fg, 09 �V q Pa A a o�C a �Hq o i I: I G �C 1, Gq �4) ) a 4 q am fg4E.6 I. 3 cu EC q 0 : C a 8 .� 14 ig z e°) °' a Q W oo� iW MN � � " cWh �'�—' W Z 11 734 N W� a aW a R Q II IIMII fJ {y. W F4 w .yai- w WO ogl F. U3 t S -al I -- tit o a v e)0 a IS 4 71 r~ x o a..1.13 21 m .14 d o c. .b dm a) 1- ..,i 0 aC) p d CO m 0 co W N O A = a m 0 o - G a) c. U a) N W .0 ..a C) U) g..-.i 2 OS Cl2 6 it CD 'O y ;d 0 r cd 0 O o oa.El En o v, E o U0 '.--, v o E w U N ti o - (4.,,a w otied) v b RI a) 5 O o O o y U !'6 3 c Lf x 6 w Ln H C no W V O W of co O O co w N O OO Pa LO .� h- O CD • I • O V H w x N •SENDER: Complete items 1 end 2 when additional services are desired, and complete items 3 and 4. Put your address In the "RETURN TO" Space on the reverse side. Failure to do this will prevent this card from being returned to you. The return receipt fee will provide you the name of the person delivered to and the date of delivery. For additional fees the following services are available. Consult postmaster for fees and check box(es) for additional service(s) requested. 1. 0 Show to whom delivered, date, and addressee's address. 2. 0 Restricted Delivery (Pura charge) (Emu charge) 4. Article Number y6;</ —/A/ Tempe of Service: LJ d 0 Insured candied ❑ COD 0 Express Mail ❑ Return Receipt for Merchandise Always obtain signature of addressee or agent and DATE DELIVERED. 8. Addressee's Address (ONLY if repeated and fee paid) 3. Article Addressed to: C. RAY & ROBERTA HINDERLITER 1-76 MOTEL & CAFE P.O. BOX 28 ROGGEN, CO 80652 5. Siigna ure Add ass Sr/Signature I- Agent _. x 7. Date of Delivery lco2 v9 DOMESTIC RETURN RECEIPT 390 459 DATE: 5/15/89 SHERIFF'S OFFICE REPORT FOR BEER OR LIQUOR LICENSE RENEWAL REQUESTS APPLICANT: ROBERTA AND C. RAY HINDERLITER, DBA I-76 MOTEL & CAFE P.O. BOX 28 ROGGEN, CO 80652-0027 TYPE OF LICENSE: 3.2% BEER RETAIL SHERIFF'S REPORT: SHERIFF'S OFFICE HAS BEEN NOTIFIED. - 5/11/89 HEALTH DEPARTMENT REPORT: 89 459 DR 8400 (3/88) Colorado Department of Revenue Liquor Enforcement Division 1375 Sherman Street Denver, Colorado 80261 866-3741 LIQUOR OR 3.2 BEER LICENSE RENEWAL APPLICATION Ht'4Lc KLITL:R RORERTA r*1'rUc.:LITER C RAY I SEV,'_NTY SIX MOTELC CAFE PU BIJX Ca rcUGGCN CO „.;oD2—C',:L7 License Number: 14-27452—OGI License Type: J Liability Information: _3 t. b 7x11 5 c624u7 Business Location: 35927 I lb ACCESS RD RUGvciv CU Current License Expires: JUN 2311983 o©©JUfl ©WY YOUR PROMPT ATTENTION IS REQUIRED. FAILURE TO COMPLETE THIS FORM ACCURATELY AND PROMPTLY MAY RESULT IN YOUR LICENSE NOT BEING RENEWED. • FILL OUT THIS FORM COMPLETELY, AND CHECK APPROPRIATE BOX BELOW. This renewal reflects no changes from last application. • SIGN THE FORM There are changes from last application. (Report changes on • ENCLOSE TOTAL AMOUNT DUE form DR 8176 -'Report of Changes - Liquor and 3.2 Beer • SUBMIT FORM TO LOCAL (CITY/COUNTY) LICENSING AUTHORITY FOR APPROVAL I icenses' and attach that form to this renewal application 1 • CHECK WRH LOCAL AUTHORITY FOR AMOUNT OF LOCAL FEES I declare under penalty ofpeg ury in the second degree that this application and all attachments are true, coned, and complete to the best of my knowledge. Authorize tg re: Date;,.. r, n Business Phone: 9Q' 3‘. 7 Title of Sig r (if corporation): Tax No. Z /LICENSING SUBMIT THE STATE COP AL ( O 4VRITY COPY TO YOUR LOCAL (CITY/COUN )'LICENSING AUTHORITY NO LATER THAN 45 DAYS EFORE YOUR LICENSE EXPIRES. EXCEPTION: Wholesaler, manufacturer, importer, and public transportation system license renewals do not need Local Licensing Authority approval and must be returned directly to the Colorado Department of Revenue no later than 30 days prior to license expiration. REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY The foregoing application has been examined and the premises, business conducted and character of the applicant is satisfactory, and we do hereby report that such license, if granted, will comply with the provisions of Title 12, Articles 46 and 47, C.R.S. THEREFORE THIS APPLICATION IS APPROVED. Local Uc. Auth. I.D. No.: Local Licensing Authority for: Weld County ■ [Rj TOWN/CITY COUNTY Signature: �t I 7 Title: Chairman, Board of County Commissioners Date: 5/15/89 A �V // so ( a/. GL/DG+ / Date: 5/15/89 Do not der Do not detach Do not detach Do not detach not detach' Dohot d h Do not detach easiness-lcratal. ,_fArizr fit^. .°..716-- •₹.t s&-attf'-_ R.0 t;', EN CO Name/Trade Name: -IltR T A Use License Number for All Reference 1 v 7452—tr. 1 LIABILITY INFORMATION County City Indust. Type (Jab. Date 3 236 7L: 11 5 co24c7 RENEWED LICENSE EXPIRES AFTER u6-23-94 TYPE OF LICENSE ISSUED 1. rCJNT dEt. k TAI. LIC.ae (i) 11 SIAIE FEE CITY 85% OAP CO 85% OAP 41-9 (9) 45-9 (9) 25.Cu 37-1 (9) Make check payable to : COLORADO DEPARTMENT OF REVENUE TOTAL AMOUNT DUE * EXTENDED HOURS - Applies only to Hotel and Restaurant, Beer and Wine, Club, Tavern, and Arts licenses. If desired, check "yes' and enclose Total Amount Due PLUS $170.00. DO NOT WRITE BELOW THIS LINE 49-1 (9) 42.5 r O! C O'I I; (4 IV CO 3 r' 0' RI U) m lx 67.Sv m, Extended hours? a DYES X NO r 890459 R 8401 (6/88) Attachment a Liquor/3.2 License Rel. _ wal Application This page must be completed and attached to your signed renewal application form. Faluro to Include file page wi h the application may resuk in your license not being renewed. Trade Name EstablisState 7 /11j "<<.. License Numbs /5�-175/32_— no l 1. Do you have legal posession of the premises for which this application for license is made? YES P. NO Are the premises owned or rented? 'W t'eL) If rented, effective and expiration date of lease: ■ 2. (a) Has the applicant, or any of the partners, or officers, stockholders or directors of said applicant (if a corporation) ever been YES convicted of a crime? If answer is 'yes,' explain in detail and attach. (b) Have persons lending assistance or financial support to the applicant or manager, or employees, ever been convicted of a crime? YES If answer is 'yes,' explain in detail and attach. ❑ ■ NOP NO®, 3. Has the applicant, or any of the partners, or officers, directors or stockholders of said applicant (if a corporation) or manager, ever: (a) been denied an alcoholic beverage license? - YES (b) had an al ohofic beverage icense suspended or revoked? YES (c) had interest in any entity that had an alcohoic beverage license suspended or revoked? YES If answer is 'yes' to any of the above questions, explain in detail and attach. ❑ ❑ ! NO® NO No 2, 4. Does or did applicant, or any of the partners, or officers, directors or stockholders of said applicant (if a corporation), have a direct YES'® - NO ❑. _. or indirect interesty o4i ferest in any —other Colorado I`gaorYwensetmetucibans to or from aMibenue, or int�er sir in a ban to any licensee. If answer is yes,' explain in detail and attach. A ✓EY N L / c E 't%5 E F O 2 I 76 cool Fc 17-.5,f 6E AO .0E/2 Ty 5. Identify the persons, firms or corporations who now or wil have a financial interest evidenced either by a loan to, 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 (Le., bark, relatkes, friends, previous owners, etc.), expressed in dolars or other items of value, such as inventory, furniture or equipment. Use separate sheet if necessary. Name , - /%�. E r F/Nf4Ncc- Address ILop aAAA"L.I O/tid f Iffiest '/74000 T and Amount f1x2 rC,kc 6. List on a separate sheet the names and addresses of all liquor businesses in which any of the persons in stD n No. 5 are materially interested. [LE r co4.L!J //A-ve- /I 4-47 kr- ff-A persons kit- 7. Operating Manager Address Date of Birth 8. If the applicant is a corporation, answer the following: NA (a) Corporation is organized under the laws of the State of: Date Incorporated: (b) Principal place of business is: (c) Date of fling last amual corporate report to the Cob. Secretary of State: (d) Name of each officer isted below: President Home Address Date of Bath Vice-Pres. Home Address Date of Birth Treasurer Home Address Date of Birth Secretary Home Address Date of Birth (e) List all stockholders,5% or over, (if a public corporation) inckxing actual owner or pledgee. (Use separate sheet if necessary) Name Address Percent of Stock Date of Birth Name Address Percent of Stock Date of Birth Name Address Percent of Stock Date of Birth ' (f) Name of all Directors'/lrustees of Corporation Name Address Date of Birth Name Address Date of Birth 8. If applicant is partnership list all general partners. Use separate sheet if necessary. Name,t? T /� ,.J�fdres 1` / / u` ,--7� nee t` 5f leg I la 6C Date of Birth Name 1' J ,4 = Address ct,Date of * / 890459 inn A ein z O Fw cn Z H i. m w r. H 7 Ca wWF H WOd+1/40 u1 H N 7 - . Z O O O F m S 2266� C w FA O Z O cz1 a x2cn x Z H 00 Z N1 .a v--, a i 1 and 2 when additional services are desired, and complete items IRN TO" Space on the reverse side. Failure to do this will prevent this =tyro nurnptt feewill Provide you the name of the person delivered �•eddido all en the seivicefollowing rep e�ices are available. consult postmaster da date, and addressee's endwise. 2. 0 Delivery I rd V Ey oc $o -ha DOD " —in', •••'• — to mxananaise Always obtain signature of addressee or DATE DEUVERED. 8. s sis Address — (ONLY 0' z A 3 2 v i— p 89 a x S. Signature Agent } lddressed to: )R ENFORCEMI tADO DEPT. SHERN,T,y 3R, C. `,, SOM I -a O IS I -, r< I 830159 EASURER'S OFFICE, WELD C �p � � Greeley, olorad RECEIVED OF. KQ:C,�. . D�i9 ,v -7 (111W QQ N9 4225 ./ .... a5 $ / Qt FOR 6Z r CREDIT �f General Fund 101 0000 Q/' j,L Lti L4-cLU --C7 gX 25 ,County vdIJ.A c76 c4. 3 tL/tF - 3% d1% Human Resources 121 0000 Social Services 112 0000 Housing Authority Road & Bridge Fund 111 0000 Airport 177 0000 County Clerk Cash Escrow 810 0803 Fee Fund 900 0912 District Gen Fund School District C R F School Q�� School District Bond Fund 890459 FRANCIS M. LOUSTALET I TOTAL AMOUNT /56, 025cntinty treasurer erk
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