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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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910612.tiff
RESOLUTION RE: APPROVAL OF RENEWAL REQUEST FOR TAVERN LIQUOR LICENSE ISSUED TO ROBERTA AND C. RAY HINDERLITER, D/B/A I-76 MOTEL AND CAFE - EXPIRES JULY 31, 1992 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, Roberta and C. Ray Hinderliter, d/b/a I-76 Motel and Cafe, presented to the Board of County Commissioners of Weld County, Colorado, an application for the renewal of a Tavern Liquor License for the sale of malt, vinous and spirituous liquors for consumption by the drink on the premises only, and WHEREAS, pursuant to Weld County Ordinance No. 6, Section II, C., said applicant has paid the sum of $98.75 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: 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 91-11 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 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 to the Board, of Weld County, Colorado, which license shall be in effect until July 31, 1992, 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. 910612 nom, AP Page 2 RE: TAVERN LIQUOR LICENSE - I-76 MOTEL AND CAFE The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 10th day of July, A.D., 1991. ATTEST: :'y,„mk44 r Weld County Clerk to the Board By: Ltigies Deputy erk to the Board APPROVED AS ,T6 FORM: County Attorney BOARD OF COUNTY COMMISSIONERS WELD COUNTY. COLORADO Gordo 'Iiac airman Geoe Kenn €3y Pro-Tem Constance L. Har C. W. Kir W. H. Webster 910612 f1Ci Of C a 1Or : ei) waft Off 1°3maa 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 eft. Muer femme esre Lida* 0W Coes es. Poe ucuua WINES AT MOW 14-27452-002 03 206 7011 5 080188 JUL 31. 1992 TYes Nrs.M O..mML. d Lbmr. F.. I TAVERN LIQUOR LICENSE — MALT, VINOUS, AND SPIRITUOUS $ 50.00 COUNTY 85 PERCENT OAP FEE $ 276.25 TOrw.ar* $ 326.25 This license is issued subject to the laws of the State of Colorado and especially under the provisions of Tide 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 Shaman Street, Denver, CO 80261. In testimony whereof. I have hereunto set my hand. gOtei.5 JLC Division Director JUL 1 6 1991 Executive Director 01 a a r: - e!) as . v .>.`PFi R 8401 (4/90) Attachment {Liquor/3.2 License Rena_✓al Application This page must be completed and attached to your signed renewal application form. Fall to include this page with the application may result in your license not being renewed. Trade Nantloff State IL' Li else N be - '-001, 1. Do you have legal posessio of the premises for which this application for license is made? YES' NO ❑ Are the premises owned or rented? 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. ■ NOX NOV / 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 alcoholic beverage license suspended or revoked? YES (c) had interest in any entity that had an alcoholic beverage license suspended or revoked? YES If answer is "yes" to any of the above questions, explain in detail and attach. ❑ ❑ ■ NO NO 0 N0' 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 ❑ Nllit - or irdiree,t interest -in any other Oelerado-E ,,j license (include bars tour from any licensor, or-intorett in a bewEo-ayekrencse)2 „—.------ If answer is yes," explain in detail and attach. 5. Identify the persons, firms or corporations who now or will 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 (i.e., bank, relatives, friends, previous owners, etc.), expressed in dollars or other items of value, such as inventory, furniture or equipment. Use separate sheet if necessary. Name ti /-, ,ev i/'f/+}//A% Address /� , - 1/065rilitly/Jc - U ra Interest 40276 ype and Amount // / Irr 6. List on a separate sh t the narpe ndirsses of all liquor businesses Jn which,nybf the:persons in gn*)on No. 5 are material interested. /l ,p-'tU/r` / 7. : t ,a' D P464,7 /WagU 7� i s �/ Gf`/� i ,r / D„te o Bich i ,/ / ,,/ i ! iJ 8. If applican 's partnnetship,(p4iceptikifbelid`IaK6'+ff'de,� N5gargerie"rafpaitfierB/.. UUselfepar�rslilfeet, t if necceesssaary. Name o LLL"' Address - Date of Birth Name Address / Date of Birth 3: j ILthe; applicant is a corporation, answer the following: ;'(a);Corporation is organized under the laws of the State of: Date Incorporated: (b) Principal place of business is: (c) Date of filing last annual corporate report to the Colo. Secretary of State: (d) Name of each officer listed below: President ��,,. _. .... ____ _ .._...___...,.... Home Address ess Date of Birth 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, Of a public corporation) including 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'/frustees of Corporation Name Address Date of Birth Name Address Date of Birth Q1 nal 9 NAME: DR 8400 (8/89) Colo. Dept. of Revenue Liquor 375 SheenrenStreet mtDivision 1 Denver, Colorado 80261 866-3741 Liquor or 3.2 Beer License Iene,rl Application HINUEkLITEK RJBERTA HINDERLITER C kAY I SEVENTY SIX MOTEL& CAFE PC Flux 28 RCGCLN CU 4O652 -4O28 YOUR PROMPT ATTENTION IS REQUIRED. FAILURE COMPLETE THIS FORM ACCURATELY AND PROMPTLY MAY RESULT IN YOUR ENSE NOT BEING RENEWED. L OUT THIS FORM. COMPLETELY AND CH PPROPRIATE BOX BELOW. ltlis renewal reflects no changes from last ❑ There are changes from last application. (Report tbe ges on form DR 8176 - "Report of Changes • Liquor and 3.2 Beer Licenses" and attjSrat form to this renewal application.) Title of Signe/(if corporation): Ace License NuMber: 14x27452-OO2 Liability Indlrination: 03 2O6 7O11'5 O8O138 BusinessLLcation: 35929 I 76 ACCESS R') ROGGEN CO Current Upstate Expires: JUL 31,1991 License Type: T r1g7V,/COURTY ©DM? • SIGNTIMFORM • ENCLIMOTOTAL AMOUNT DUE • SUBMW*RM TO LOCAL (CITY/COUNTY) uCEN AUTHORITY FOR APPROVAL • CHECK*H LOCAL AUTHORITY FOR AMOUNT OF LOCAL FEES. application and ataftachmenrs we true, correct, and dlrAplete to the best of my knowledge. "3* Sell Tn. / /.SQL_. ATTACHE 8401 MUST BE COMPLETED (ALL 3 COPIES) SUBMIT THE STATE COPY AND LOCAL (CITY AUTHORITY COPY TO YOUR LOCAL (CITY/COUNTY) LICENSING AUTHORITY. NO LATER 45 DAYS BEFORE YOUR LICENSE EXPIRES. EXCEPTION Wholesaler, manufacturer, importer, algid public transportation system license renewals do riot need Local Licensing Authority approval and must be returned directly to tftPrelplorado Department of Revenue no later than 30 d or to license expiration. The foregoing application has been examined tory, and we do hereby report that such licensee THEREFORE TH(S APPCf ATRDN.!$ APPROI� Local Licensing Authordylor. / "9 Weld County, Colorado - ■: TOW4CITY EXCOUNTY signature: t , *., ' nee Chairman, Weld Bounty Board of Commissioners Attest: 4a / ! / BY: /7 ,�r � � � Date . 7/10/91 Deputy Cier4c 'to BDa Te premises, business conducted and charactirof the applicant are satisfac- anted,.Will comply with the provisions of Title 12, Articles 46 and 47, C.R.S. BUSINESS LOCATION: A c 0 1 Eti. CO. AR.tlk>T DETACH • DD NOT DETACH • OC NOT OEF8 • YO NOT DETACH • USE LICENSE NUMBER FOR ALL REFERENCE r.INUERL I rt:R RUBE TA 14-27452-OO4 NOT DETACH• DO NOT DETACH LIABILITY INFORMATION COUNTY CITY INDUST. TYPE L$6/PATE O3 206 7011 5 080188 RENEWED LICENSE EXPIRES AFTER 07-31-92 CITY 85% OAP TYPE OF LICENSE ISSUED TAVERN LIOOOR LICENSE - MALI, VINJUS, :AN I; SFIKITUCUS (3) 40 Make check payable to: COLORADO DEPARTMENT OF REVENUE '.;BASH FUND W) 25.00 STATE FEE 41.9 (9) 25,00 45-9 (9) (9) CO 85% OAP 49.1 (9) "L 276.2 TOTAL AMOUNTDUE ta► EXTENDED HOURS — s only to Hotel and Restaurant, Beer and Wine, Club, Tavern, and Arts licenses. If desisett, check "yes" and enclose Total Amount Due PLUS $170.00. .$ 326.2' Extended'%urs? ❑ Yes o 910612 ► LCtsoIs-$ DPSBIB20 DEE .IPTION OF MESSAGE IN IN -B. KET Message : I have checked the records for I-76 Motel and Cafe and also C. R : & Roberta Hinderliter. No cases were found dealing with liquor : violations over the past year of business. Fliethman Received from : PCJLTN02-MAIN Received : 07/08/91 08:13 Sent : 07/08/91 08:13 Select an option and type it below; then press ENTER. 3 Send 8 Reply 9 File 10 Delete PF1=Help PF7= ___> 4B ono/5 -15 9/-I' 09i 95 2= 3= 4=Main Menu 5= 8= 9= 10= 11= 6=Fast Path 12=Quit SM 910612 O -O01 P 387 472 701 RECEIPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) Colorado Dep't of Revenue Liquor Enforcement Div 1375 Sherman Street Denver, CO 80261 PS Form 3800, June 1985 Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt showing to whom and Date Delivered Return Receipt showing to whom. Date. and Address of Delivery TOTAL Postage and Fees Postmark or pate SENDER;.-- • Complelilllems 1 and/or 2 for additional services. • Completantems 3, and 4a & b. • Print y®vname and address on the reverse of this form so that we cgh"return this card to you. • Attach this form to the front of the mailpiece, or on the back if space does not permit. • .Write "Return Receipt Requested" on the mailpiece next to the article number. 3. Article Addressed to: Colorado. Dep't of Revenue LiqudhhEdforcement Div 1375 Merman Street Denver, CO 80261 5.- Signature (Addressee) 6. Signature (Agent) PS Form 3811, October 1990 I also wish to receive the following services (for an extra fee): 1. O Addressee's Address 2. O Restricted Delivery Consult postmaster for fee. 40 Art de Number 4b. Service Type O Registered O Insured 3$?` n 1"col 7. 'r&te of Delivery ;OdresJN uLhs if requested au.8. GPO: 1990-2$861 d fee is paid) REVENUE MAIL ROCS. %TA?E OF COLUCan• oit P 387 472 705 RECEIPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) ROBERTA AND C. RAY HINDERLITER DBA I-76 MOTEL AND CAFE 35929 1-76 ACCESS ROAD ROGGEN, CO fik1 tiffiR PS Form 3800, June 1985 80652-9609 Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt showing to whom and Dale Delivered Return Receipt showing to whom. Date. and Address of Delivery TOTAL Postage and Fees Postmark or Date DOMESTIC RETURN RECEIPT SENDER: • Complete items 1 and/or 2 for additional services. • Complete items 3, and 4a & b. • Print your name and address on the reverse of this form so that we can return this card to you. • Attach this form to the front of the mailpiece, or on the back if space does not permit. • Write "Return Receipt Requested" on the mailpiece next to 1111 article number. 3. Article Addressed to: ROBERTA AND C. RAY HINDERLITER'. DBA I-76 MOTEL AND CAFE 35929 I-76 ACCESS ROAD ROGGEN, CO 80652-9609 5. S`:uTture (• •dre PS orm 3811, October 1990 ature (Agent) I also wish to receive the following services (for an extra fee): 1. O Addressee's AddrMIF... 2. O Restricted Delivery Consult postmaster for fee, 4a. Article Number P. 387- d/707— 7o r 4b. Service Type ❑ Registered ❑ Insured `Certified ❑ COD ❑ Express Mail ❑ Return Receipt 16r Merchandise 7. Date yt,Delivery •//gee 9/ 8. Addressee's Address (Only if requested and fee is paid) .. *L1.3. GPO: LY90--273861 DOMESTIC RETURN RECEIPT tA 910612
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