HomeMy WebLinkAbout910559.tiffRESOLUTION
RE: APPROVAL OF RENEWAL REQUEST FOR 3.2% BEER LICENSE ISSUED TO ROBERTA AND C.
RAY HINDERLITER, DBA I-76 MOTEL AND CAFE - EXPIRES JUNE 23, 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, 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 91-08 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 providing that said place where the licensee is
authorized to sell 3.2% fermented 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 violations
thereof shall be cause for revocation of the license.
910559
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 17th day of June, A.D., 1991.
ATTEST: °
/GOYIlL GUGYf.77
Weld County Clerk to the Board
By: \31Jfl R ! r pt)
Deputy C to the Boar
APPROVED AS TO FORM:
County Atto e
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY C'. ORADO
Gordo
cy, . rman
Geo- a Kennedy, ro- em
Constance L. Harbert
910559
or•CCIoO
M@na@
Liquor Enforcement Division
1375 Sherman Street
Denver, Colorado 80261
HINOERLITER ROBERTA
HINOERLITER C RAY
I SEVENTY SIX MOTEL&
CAFE
35929 176 ACCESS RO
ROGGEN CO 80652-9609
Alcoholic Beverage License
Amount Nags
T .
Cam CMwa .a Li�al, Oa
rr0EN8a lanai AT MONONT
14-27452-001
03 206 7011 5 062487
JUN 23, 1992
Trp,
Nwn,d OwmipSn a Liorr
Fes
J
3.2 PERCENT BEER RETAIL LICENSE
$ 50.00
COUNTY 85 PERCENT OAP FEE
$ 42.50
TaTAt
$ 92.50
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
Shaman Street, Denver, CO 80261.
In testimony whereof, I have hereunto set my hand.
OR 8402 (348)
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DR 8400 (8/89)
Cob. Dept. of Revenue
Liquor Enforcement Division
1375 Sherman Street
Denver, Colorado 80261
888-3741
Liquor of 3.2 Beer License
Renewal Application
HINUERLITEg RCdERTA
HINDERLITER C RAY
I SEVENTY SIX MGTELri
CAFE
PG BOX 2R
ROGGEN CO 80652-0029
License Number:
14-27x52-•001
Liability Information:
03 206 7011 3 062437
Business Location:
35929 1 76 ACCESS r'5
ROGGrN CC1
Current License Expires:
JUN 23,1991
License Type:
J
MT/COUNTY COPY
YOUR PROMPT ATTENTTCNIS REQUIRED. FAILURE TO OONPLETE flR$ FORM ACCURATELY
AND PROMPTLY NAY RESULT IN YOURLICEASE NOT BEING RENEW
• FILL OUT THIS FORM COMPLETELY AND CHECK APPROPRIATE BOX BELOW.
❑ This renewal reflects no changes from last application.
❑ There are changes from last application. (Report changes on form DR 8176 - "Report of
Changes - Liquor and $:2 Beer Licenses" and attach that form to this renewal application.)
• SIONTHEFORM
• ENCLOSE TOTAL AMOUNT DUE
• SUBINTFORM TOLOCAL (CITY/COUNTY)
MOMS AUTHORITY` FOR APPROVAL
• CHESK WM LOCAL Atmertrry FOR AMOUNT
OFLOCAL FED.
-'I declare under penally of perflrryit the second degree that this application and all attachments are true, corral/ and congest. h
Authodzed'Slpr ture
i F.../
/
" ;
"f' ��
Date: ,
j/�
Busbies. Phone:
,k /
° y. J -.Sc;/l
Title
Signer (h corporat)on)
•
Sales Tax N�1;,
A Its ;
ATTACHED DR 8401 MUST BE COMPLETED (ALL 3 COPES)
best of ny knowledge.
SUBMIT THE STATE COPY AND LOCAL (CITYICOIR4TY). AUTHORITY COPY TO YOUR LOCAL (CITY/COUt1 ENSING AUTHORITY
NO LATER THAN 45 DAYS BEFORE YOUR LICENSE EXPIRES. 4*•
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 • = s • to license ex ratfort:
The foregoing application has been examined and license, if granted,
premises, business conducted and character of the applicant are satisfac-
tory,
APPLICATION IS APPROVED.
report PPVwill comply the pas of Title 12, Articles 46 and 47, C.R:S.
THEREFORE THIS CA
Local Uoendng Authority Sp-
f'l''
eld County, Colorado I1
• TOWN/CITY ® COUNTY
Signature:
<
'.j �,
-/.
Tiffs Chairman, Wild Contyy
Board of Commissioners
Attest::
f
'..a
""
/�,
BY•/t si9�%iy` cL�S1,G7A-f
Date
6/17/91
nuts" t ar. tD a"•
DO NOT DETACH • Do NOT DETACH • 06 NOT DETACH • Do NOT DETACH • Do NOT DETACH • Do NOT DETAL4r"bO NOT DETACH • DO NOT DETACH • Do NOT DETACH
ROGGEN CO
NAME:
USE LICENSE NUMBER
FOR AU. REFERENCE
LIABILITY INFORMATION
RENEWED LICENSE
EXPIRES. AFTER
COUNTY CITY INDUST. TYPE LIAR. DATE
HiNOERLITER ROBERTA 14-27452-001
03 206 7011 5 062467
06-23-92
TYPE OF LICENSE ISSUED
CASH FUND
STATE FEE
CITY BS%CAP,
CO85%OAP :
98-01 (9)
414 (9)
454 (9)
37-1 (9)
49.1 (9)
3.2 PERCENT BEER
RETAIL LICENSE (31 11
$ 25.00
$ 25.00
$ 42.50
Make check payable to:
COLORADO DEPARTMENT
TOTAL AMOUNT DUE W
a, 9 2.5 0
OF REVENUE
EXTENDED HOURS - Applies only to Hotel and Restaurant, Beer and Wine, Club, Tavern, Ext rs7
and Arts licenses. If desired, check 'yes" and enclose Total Amount Due PLUS $170.00. O Yes o
/neon — iiA)rrt 910553
R 8401 (4/90)
Attachment flLiquor/3.2 License Renflal Application
This page must be completed and attached to your signed renewal application form.
Failure to Include this page with the application may result M your license not being renewed.
Trade Name of Establishment -.
h '21,4,7--//'21,4,'21,4,7--//-,i (
7,' 71 c
State /aLicense Number
/ '7- -i 7 ii, 4,--cx - 1 ,.
1. Do you have legal posession 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 appicant, or manager, or employees, ever been convicted of a crime? YES
If answer is yes," explain in detail and attach.
NO ..1
NO2
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 Vi
NQ.fl
NO
4. Does or did applicant, or any of the partners, or officers, directors or stockholders of said appicant (if a corporation), have a direct YES Ns i
-or -tiny
-'indlrecfirtterest' in oilier Colorado 'liquor licaIse (include bans400rkomaryi'Kentoo;autkYestiwidaawtaaaylliceesee.?-
If answer is "yes," explain in detail and attach. /'/ a 7 47/y2 -C Cj/ ,e,1�y1 .3 a.m." .r,; ka_c,•i-+�,, /
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 -
r / % C �z.K-, u_e
Address a :NO N, 111 i I i-ktryT(4t.i 4 5, , • *M.
(,(,'St i n..8oa('h-Fl.. .33,F0�1
Interest
Li (-tn.,'
Type and Amount
yjr r,i:
,fl
6. List on a separate sheet the names and addresses of all liquor businesses in which any of the persons in question No. 5 are materially intert�sted.
7. 0pera$ing �(l,
,- Y-hw.11•Y --al e ,.� «
Address
A/c^ ;-'? g" /C "an ( v e� r 5-.2-
Date of firth
/e'Jy�S�
is a partnership (except husband and wife
, list all general partners. i - separate sheet if necessary.
Name
Address
Date of Birth
Name
Address
Date of Birth
9. If the 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 r v..
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, (if 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
Cl) Name pf all Directors'/Trustees of Corporation
Name / ;
Address
Date of Birth; ,
Name 2
Address , .i
Date of Birth
910553
P 387 472 698
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
00, June 1985
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Restricted Delivery Fee
Return Receipt showing
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Return Receipt showing to whom.
Date. and Address of Delivery
O Addressee's Address
TOTAL Postage and Fees
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P 387 472 1_79
RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
ROBERT AND C. RAY HINDERLITER,
DBA 1-76 MOTEL AND CAFE
35929 I-76 ACCESS ROAD
ROGGEN, CO 80652-9609
S Form 3800, June 1985
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Return Receipt showing to whom.
Date, and Address of Delivery
TOTAL Postage and Fees
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