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Home My WebLink About930597.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, 1994 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, dba 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 93-09 to said applicant to sell 3.2% fermented malt beverages for consumption off the premises, only at retail at said location; and the Board does hereby authorize and direct the issuance of said license by the Chairman 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 June 23, 1994, 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. 930597 RENEW 3.2% BEER LICENSE - I-76 MOTEL AND CAFE PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 21st day of June, A.D., 1993. ATTEST: Weld County Clerk to the Board BY: Deputy Clerk to theaar� APPROVED AS TO i 7 �� FORM: my Attor ey BOARD OF COUNTY COMMISSIONERS WE COUNTY, COLORADO C -C Constance L. Harbept, Chairman 1iLit''F Z W. H ;Webster, Pro7Tem -Cou Dale K. Hall Barbara J. Kirkmey r J 930597 THIS LICENSE MUST BE POSTED IN PUBLIC VIEW DR 8402110/92) STATE OF COLORADO DEPARTMENT OF REVENUE 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 Number Liability Information LICENSE EXPIRES AT MIDNIGHT County City InEust, Type Liability Date 14-27452-001 03 206 7011 5 062487 JUN 23, 1994 Type Name and Description of License Fee J 3.2 PERCENT BEER RETAIL LICENSE COUNTY 85 PERCENT OAP FEE $ 50.00 $ 42.50 TOTAL FEEISI $ 92.50 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. testimony whereof, I have hereunto set my hand. . Division Director SL J1✓ JUN 291993 Executive Dire b for 930:;97 5 a a '0 U 0 tt Q 0 0 a w oa 0 03 is w Fu - DR 8403 (5/89) / N. / 1 L_____. I 1.VV.,. c�� V , Colo. Dept. of Revenue------ vv ad° far Liquor Enforcement Division 1375 Sherman St. Fermented Malt Beverage Denver, CO 80261 (3.2% Beer) License Application IMPORTANT: For those retail licenses described in Column A below, this application and all supporting documents must FIRST BE FILED IN DUPLICATE WITH, AND APPROVED BY, THE License Issued Through (Expiration Date) Use License Account No. for all reference LOCAL LICENSING AUTHORITY (CITY, TOWN, COUNTY). Applications will not be accepted unless all applicable questions are fully answered, all supporting documents correspond exactly ti _2 3 ,C/ - ,„J,7T '_, 46, / 7 S with the name of the applicant(s), and proper fees are attached. LIABILITY INFORMATION You may attach separate sheets or additional documents if necessary to fully complete this County. City Industry Type Liability Date application. All documents must be typewritten or legibly printed in black ink. Form DR 8404-I, "Individual History Record" must be completed and filed in duplicate by the following: FEE PAID • Each applicant • All general partners Cash Fund State City County • All officers/directors of a corporation • Over 5% limited partners 66.1 45-9 37-1 49-1 • All stockholders of a corporation not subject • Managers to the Securities and Exchange Act of 1934 • Each person required to file form • Over 5% stockholders of a corporation subject DR 8404-I must submit fingerprints to the Securities and Exchange Act of 1934 to the Local Licensing Authority. NOTE: License status will not be given over the telephone. License will be mailed by the Liquor Enforcement Division to the Local Licensing Authority upon issuance. ALL ANSWERS MUST BE PRINTED IN BLACK INK OR TYPEWRITTEN TOTAL APPLICANTS FOR BRAND NEW LICENSES, OR TRANSFERS OF OWNERSHIP MUST CHECK THE APPROPRIATE BOXES BELOW IN EITHER COLUMN A OR COLUMN B AND MUST ALSO CHECK EITHERBOX'(18) OR (19). 45 - 9 (3) COLUMN A STATE FEES 45 - 9 (3) COLUMN B STATE FEES 18 0 New License Application Fee $250.00 19 0 Transfer of Ownership Application Fee $250.00 18 0 New License Application Fee $250.00 19 ❑ Transfer of Ownership Application Fee $250.00 11 0 Retail 3.2% Beer (Fermented Malt $71.25 Beverage License) - City 11 Kj Retail 3.2% Beer (Fermented Malt $92.50 Beverage License) - County 12 ❑ 3.2% Beer Wholesale License (Fermented Malt Bev,) $125.00 13 ❑ 3.2% Beer Manufacturer's License (Fermented Malt Bev,) 125.00 14 ❑ 3.2% Beer Importer's License (Fermented Malt Bev,) 125.00 16 0 Nonresident Manufacturer License 125.00 (Fermented Malt Beverage) 1. ame of Applicant(s : If artnershi ist partners' names (at least two); if corporation, name of corporation: Coca. A `Y'�r CAc- //"6CZc. iele Date filed with Local Authority: 1a. Applicant is a: J Corporation H Individual Partnership 7 Other (specify) F —/C-6 752 2. T Na of s ablishment: (DBA) I State Sales Tax No.: .. 4ti �41r.� lit—ZJgs2- Social Security No.: /s5=3c-s)&y'. 3. Address of Premise m s ape exac location of preisps.Diagram of premises must accompany this application. Business Telephone: C eel c � CA/ County: L f/« 0 Stabs,: Zip Coe: j��L_ CO l� 4. Mailing ddress: (Nurgper and Street) pox .7--(� _ City pp -Town., / ,l -T ow ` . /4� StL c // at ,., Zip C, ge !G 5„ . If this is a transfer of ownership application or renewal, you MUST answer the following questions about this business: Present Trade Name of That Establishment (DBA): I- rllc (1101- CI Oa le, Present State License No.: I L{ cl izi�si Present Type of License: e,� 7a 8e.er Present Expiration Date: 06)/:?3/93 6. Is the applicant, or any of the partners, or officers, stockholders or directors of said applicant (if a corporation),or manager, under the age of eighteen years? 7. (a) Has the applicant, or any of the partners, or officers, stockholders or directors of said applicant (if a corporation) ever been convicted of a crime? If answer is "yes," explain in detail. Exclude minor traffic violations. (b) Have persons lending assistance or financial support to the applicant, or the manager, or employees, ever been convicted of a crime? If answer is 'yes; explain in detail. Exclude minor traffic violations. — YES y NO jv 9 3O 59 7. 93O537 1 YES NO • 8. Has the applicant, or any of the partners, or officers, directors or SIOGRI1OIadrs via iu ui.yovai n to a v...',al..,... v. �. manager, ever: (a) been denied an alcoholic beverage license? (b) had an alcoholic beverage license suspended or revoked? (c) had interest in an entity that had an alcoholic beverage license suspended or revoked? If "yes," explain in detail. _ 9. Has a fermented malt beverage license for the premises to be licensed been refused within the preceding year? If "yes," explain in detail. 10 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 other Colorado Liquor or Fermented Malt Beverage License (include loans to or from any licensee, or interest in a loan to any licensee)? 11 "yes," explain in detail. 11. State whether the applicant has legal possession of the premises by virtue of ownership or under a lease. If leased, list name and address of landlord and term of lease: 12. Identify the persons, firms, or corporations 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 of any such persons, and the amount and source of such financial interest expressed in dollars or other items of value, such as inventory, furniture or equipment (i.e., bank, relatives, friends, previous owners, etc.). Use separate sheet if necessary. NAME ADDRESS INTEREST W W et f! /1/i T.- % jLjt/zrG / c �'�/`r`AA-� 3_313. List the names and addresses of all liquor businesses in which any of the persons in the previous question are materially interested. Use separate sheet if necessary. NAME BUSINESS ADDRESS /(1/t/. l<frow4/ Attach copies 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. 14. Colorado Manufacturer or Wholesaler applicants, answer the following: (a) Does the applicant own, lease or operate any Colorado warehouse or storage plant in connection with this business? If "yes," give full address. (b) If the applicant is a wholesaler, does or did any owner, part 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 beverage, or malt, vinous or spirituous liquor? If "yes," attach explanation in detail. (c) Does the applicant have a valid Federal Basic Permit? If "yes; attach a copy of the permit; if "no," explain whether one has been applied for. i Page 2 of 4 930:-.97 .. *4_... e� -- �Lt'w1• -Lrrfsr * ,. i w+".+.au+�Wwi�. 15. Nonresident Manufacturer (fermented malt beverages) or Importer (fermented malt beverages) applicants, following: (a) To what Colorado licensed wholesaler do you intend to ship your merchandise? (b) Does or did any owner, part owner, shareh.,lder, director or officer of the applicant have any direct or indirect interest in an importer, manufacturer or retailer already licensed by the State of Colorado to sell fermented beverages or malt, vinous or spirituous liquor? If 'yes,' attach explanation in detail. (c) Does the applicant have a valid Federal Basic Permit? If "yes," attach a copy of the permit. (d) Are you the primary source of supply in the U.S.? If "no," explain in detail. answer the YES NO financial malt 16. If the applicant is a partnership, answer the following: (Attach separate sheet if necessary.) (a) Name of each general partner and each limited partner holding a greater than 5% interest Home Address, City and State A 55 Social Security # Date of Birth % A- 2% G (T' l- o't5(iii > -d i/ i-t6' t -M -C. (b) On what date was the partnership formed? Attach a copy of the partnership agreement (except for partnerships consisting only of a husband and wife). Date: �M` / L " e 7 17. If the applicant is a corporation, answer the following: (a) Corporation is organized under the laws of the State of: Date of Incorporation: (Attach rtificate of Authority (b) Out-of-state corporations, give date authorized to do business in Colorado: from Colo. Secretary of State) (c) Date of filing last annual corporate report to the Secretary of State: (d) Name of each officer listed below: Home Address, City and State: Social Security # Date of Birth: President: Vice -President: Treasurer: Secretary: (e) Name all 5% or greater stockholders; include actual owner or pledgee Home Address, City and State % of stock Date of Birth: (f) Name of all Directors or Trustees of Corporation: Home Address, City and State 18. Manager: Page 3 of 4 930 P37 OATH OF APPLICANT 1 declare under penalty of perjury in the second degree that this application and all attachments are true, correct, and complete th est o y owledge. Aut ed we: —, � 2c'i l7 REPORT AND APPROVAL OF LOCAL LICENSING AUTHORITY (Manufacturers, nonresident manufacturers, Importers, wholesalers, limited wineries, and public transportation licensees disregard the section below.) Ehi S NO Is this application for a: New License Transfer of Ownership Ni Other (specify): f Each person required to file DR 8404-i: Has Background The liquor licensed premises is ready for occupancy If "no," the building will be completed and ready been fingerprinted NC1C and CCIC checked and has been inspected by the Local Licensing Authority. for inspection by (dale) rxi J X C.R.S., as amended, 12-46-117 (1) (a) The local licensing authority shall restrict (I) Sales for consumption -OFF" (II) Sales for consumption "ON" the (III) Sales for consumption "BOTH (b) The provisions of paragraph (1)(a) shall for under this article prior to July 1, the use of said license to: CHECK ONE the premises of the licensee; or premises of the licensee; or ON AND OFF" the premises of the licensee. not apply to any license issued or applied 1967, nor to any renewal or reissuance thereof. 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 inhabitants, and will comply with the provision of Title 12, Article 46, C.R.S. THEREFORE, THIS APPLICATION IS APPROVED. Local Licensing Authority tor: Weld County, Colorado E TOWN, CITY COUNTY signature ~ . ,','�! `� ' _� itle:Chairman Pro-Tem, Weld County " Board of Commissioners Date: 06/21/93 Sgnatu : ( [test):� if `✓Title: i ,l 4!, !.A f Weld County Clerk to Board By: 74 ..t10 7� c-- Date: 06 21 93 / / If premises are located within a town or city, the above a(PARNIsot_ Srtjnal b {f31 Lrtd clerk, if in a 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 4of4 93M-.97 P 387 472 582 RECEIPT FOR CERTIFIED MAIL No NSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) �I. COLORADO DEPT OF REVENUE LIQUOR ENFORCEMENT DIVISION STATE CAPITOL ANNEX 1375 SHERMAN ST DENVER CO 80203 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 S Postmark or Date T 3 w 0 OL m 0 N Nl1f113l1 OIIS3WOO m S rn as r,.0y bCD T y'Co n O)a> O el 11i l in $3 0 H CA r n tf w H H O 3' v' 5' •• y <cn-a o �`r° 0D< OO t1 HCO v /A0 3330 t+7 C+7 0 ,J D '» - �; v zti za ..,m„,,0m aim �q H C7 a 3 c ate, 0J N N ;7i O z "0 a m J y O' 3 m 03 o rn H m � 2s3,J.,vw_, s m o m ?Cm m J 13 S 0 Co a a m a s 0 3 o m m n » O w 2° O O Q, C � ? Q S N (A b7 m H 2 M t a 2z X H tn C 1-4 <X H C" H m H 0 < CD n p a� a \` 2 0 N C C D N 0 CO O m o <' m O CD a O O ?yi 991 S 93(V97 PS Form 3800. June 1985 P 387 472 580 RECEIPT FOR CERTIFIED MAIL NO INsuRANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) Se' C. Ray Hinderliter 1-76 Cafe 35929 1-76 Access Rd. Roggen, CO 80652 Specs' Delivery Eee Restricted Delivery Fee Peturn Receipt showing to whom and Date Delivered Return Receipt showing to whirr - Date and Address of Delivery TOTAL Postage and Fees Pon^re'k or Date 00 sr Bodo •S'il O c 3 m n I\ C g 2 m n (aassaippy) ainleuf'S '5 o VI I n W 7..4 oo n0T GO l0 -JID 00ID 6\ W p . n o �, oEti ,<9a m o. a-° 0 m 53 HP J'i5n?J N N.. 1 Mx c00 J-'-' D N C] --JCL) F• a 3 30 .x°.333 °- a 3 2 o c 3 3 3 orn a y, DN3'tD00 Go n n m ^ o o? DI W J O n F., a a m °' J a M F'• 0 (9DS N s.aa In tll rt y. aA0 IV m ID o 3= a." o M a - o 0 m PA c » » O y R° -.. a m J w Q 0 a a., N a " NI y N` a °C m 033 nor m V, Co CO tow a ❑< ❑Q rn fl D D N tO N d 0 0 O a a 0 a _I 0 E II c) J roe", O co c O c, J3 a to Dto Cl. 0 0 0 0 A N D •Q•?•••w 0 < ° °Q°i o ° J aco »c ? 3 m d. < T D i R 3 CO 0 v o 0 co A 0 z o K m 3 0 'saainjas 101.104pp ssaippy s aasseiPpy ❑ CO O a o 0 5 N ro °f N < 5 N J 0 rn o o00 o r?. J < ri x - m 920.97 COLORADO PLEASE June 21, 1993 OFFICE OF BOARD OF COUNTY COMMISSIONERS PHONE (303) 3564000. EXT. 4200 FAX (3031 3.52,02•)2 P.O. BOX 758 GREELEY, COLORADO 80632 POST NEAR EXISTING LICENSE TO WHOM IT MAY CONCERN: On the 21st day of June, 1993, the Board of County Commissioners of Weld County, Colorado, did approve the renewal request of C. Ray and Roberta Hinderliter, dba I-76 Motel and Cafe, for a 3.2% Beer License. The previous license will expire on June 23, 1993; therefore, the Board did formally waive the 45 -day time limit, said waiver being effective as of June 21, 1993. The required documents have been submitted to the State Department of Revenue for its approval. Until notification has been received from the State advising whether this renewal request has been approved or disapproved, the Board hereby authorizes the continued sale of 3.2% Beer at this establishment which is located at 35929 I-76 Access Road, Roggen, Colorado. If there are any questions concerning this matter, please feel free to contact the Clerk to the Board's Office at 356-4000, Extension 4225, between the hours of 8:00 a.m. and 5:00 p.m., Monday through Friday. Sincerely, ,T.7); Constance L. Harbert, Chairman Board of County Commissioners Weld County, Colorado skm pc: Sheriff's Office Liquor Enforcement Officer 930537 930:97 DPSBIB20 DESCRIPTION OF MESSAGE IN IN -BASKET Message : Reply to your message of 06/15/93 14:29 : WE HAVE NO RECORD OF ANY LIQUOR VIOLATIONS ON THE ABOVE : SUBJECTS. JUDY Received from : PCJREC07-MAIN Received : 06/16/93 08:16 Sent : 06/16/93 08:16 Select an option and type it below; then press ENTER. 3 Send 8 Reply 9 File 10 Delete PF1=Help PF7= ===> 9 DPSBFC30 Message Tag • 2= 3= 4=Main Menu 5= 8= 9= 10= 11= DESCRIPTION OF MESSAGE IN FILE CABINET WE NEED A REPORT C. RAY & ROBERTA ROAD, ROGGEN, CO 06/18/93, PLEASE. Date filed : 06/15/93 6=Fast Path 12=Quit OF ANY LIQUOR VIOLATIONS IN THE PAST YEAR FOR HINDERLITER, DAB I-76 MOTEL, 35929 I-76 ACCESS 80652. WE NEED THIS REPORT BY NOON ON FRIDAY, THANK YOU - CTB/SKM Date due : 06/18/93 Select an option and type it below; then press ENTER. 3 Send 10 Delete 11 Change description PF1=Help PF7= 2= 3= 4=Main Menu 5= 8= 9= 10= 11= 6=Fast Path 12=Quit 930.9 Hello