HomeMy WebLinkAbout940140.tiffRESOLUTION
RE: APPROVAL OF RENEWAL REQUEST FOR 3.2% BEER LICENSE ISSUED TO FLORINDA
PESINA AND LUPE PESINA, DBA PESINA'S CAFE - EXPIRES JANUARY 11, 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, on the 6th day of December, 1993, Florinda Pesina and Lupe Pesina,
dba Pesina's Cafe, 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 on and off the premises, and
WHEREAS, the Board did, by Resolution dated January 5, 1994, approve
waiving the time limit concerning said renewal request, 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 on and off the premises, outside the
corporate limits of any town or city in the County of Weld at the location
described as follows:
Lots 15, 16, and 17, Block 7, Gill, Colorado 80624-0023
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 94-02 to said
applicant to sell 3.2% fermented malt beverages for consumption on and 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 January 11, 1995, providing that said
place where the licensee is authorized to sell 3.2% fermented malt beverages for
consumption on and 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.
940140
(7 )00)
CC:
RENEW 3.29, BEER LICENSE - PESINA'S CAFE
PAGE 2
The above and foregoing Resolution was, on motion duly made and seconded,
adopted by the following vote on the 5th day of January, A.D., 1994.
ATTEST:
Weld County Clerk to the Board
BY:
161
Deputy C (-irk to the Board
APPROVEAS TO FORM:
ounty Attorney
BOARD OF COUNTY COMMISSIONERS
WELD COUNTY, OLORADO
12 AL)
H. Webster, hai an
Dale j K,. Hall, Pro,Tem
:7. Baxter
aLeet
Constance L. Harbert
diti4J
Barbara J. Kiry
er O
940140
THIS LICENSE MUST BE POSTED IN PUBLIC VIEW
DR 8402110/921
`
STATE
DEPARTMENT
ALCOHOLIC
OF COLORADO
OF REVENUE
Liquor Enforcement Division
1375 Sherman Street
Denver, Colorado 80261
i
PESINA FLORINDA
PESINA LUPE
PESINAS CAFE
LTS 15 16 17 BK 7
GILL CO 80624
BEVERAGE LICENSE
Account Number
liability Information
LICENSE EXPIRES AT MIDNIGHT
County City Indust. Type Liability Date
14-26992-0001
03 206 5813 P 011287
JAN 11, 1995
Type
Name and Description of License
Fee
2123
2190
3.2 PERCENT BEER RETAIL
LICENSE (ON/OFF PREMISES)
COUNTY 85 PERCENT OAP FEE
$ 50.00
$ 42.50
TOTAL FEE(S)
This license is issued subject to the laws of the State of Colorado and especially
provision of Title 12, Articles 46 or 47, CRS 1973, as amended.
nontransferable and shall be conspicuously posted in the place above described.
only valid through the expiration date shown above. Questions concerning
be addressed to the Department of Revenue, Liquor Enforcement Division,
Street, Denver, CO 80261.
testimony whereof, I have hereunto set my hand.
t- c -t"./ G SL ile✓Pitit
-7-JAN241994
Division Director Executive
$ 92.50
under the
This license is
This license is
this license should
1375 Sherman
Cl
Director
940140
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DR 8400 (8/89)
Cob. Dept. of Revenue
Liquor Enforcement Division
1375 Sherman Street
Denver, Colorado 80261
866-3741
;.
.
Liquor or 4.2 Beer License
Renewal Application
�r
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.
Xl 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 3.2 Beer Licenses" and attach that form to this renewal application.)
License Number:
. L
Liability Information:
0 ; 20`.' H:13 F,
Business Location:
LIS 15 U
GILL CU
Current License Expires:
JAN ilt IY`1-i
License Type:
r i7/0OUJIWY COPY
• SIGN THE FORM
• ENCLOSE TOTAL AMOUNT DUE
• SUBMIT FORM TO LOCAL (CITY/COUNTY)
LICENSING AUTHORITY FOR APPROVAL
• CHECK WITH LOCAL AUTHORITY FOR AMOUNT
OF LOCAL FEES.
I declare under penalty of perjury in the second degree that this application and e11 1tachments are true, correct, and complete to the t of my knowledge.
Authorized Signature:
Title of Signer (if corporation):
Date:
Business Phone:
Sales Tax No.
ATTACHED DR 8401 MUST :BE. COMPLETED (ALL 3 COPIES)
SUBMIT THE STATE COPY AND LOCAL (CITY/COUNTY) AUTHORITY COPY TO YOUR LOCAL (CITY/COUNTY) LICENSING AUTHORITY
NO LATER THA►45 DAYS. BEFORE 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.
The foregoing application has been examined and the premises, business conducted and character of the applicant are satisfac-
tory, 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 Licensing Authority for:
Signature:
LQ TOWN/CITY f'COUNTY
Attest:
Do NOT DETACH • DO NOT DETACH • Da NOT DETACH • DO NOT DETACH • DO NOT DETACH •
Title .I1A-1.3w-..
COUNT?
j
aate
i
- — ✓ ,•v cn • UV NOT DETACH • UD NOT DETACH
L s -s_.,
NAME:
USE LICENSE NUMBER
LIABILITY INFORMATION
RENEWED LICENSE
FOR ALL REFERENCE
COUNTY CITY INDUST. TYPE LIAa. DATE
EXPIRES AFTER
14-,_"99 2 -..;1
s tO6 Hits P 0l.2 7
Ui- — 6a
TYPE OF LICENSE ISSUED
CASH FUND
STATE FEE
CITY 85% OAP
C085%OAP
68.071 (9)
41-9 (9)
45-9 (9)
37-1 (9)
IIrRRR..:
49-1 (g)
)_
Li'.-. { ./:I P'
C f Y ( L
I i _-')
.Ltr
J' 2.- .00
-. Nv •
Make Check payable to:
COLORADO DEPARTMENT
TOTAL AMOUNT DUE
6
OF REVENUE
EXTENDED HOURS —Applies only to Hotel and Restaurant, Beer and Wine, Club, Tavern, Extended hours?
and Arts licenses. If ...
jci-ms576o
/
931292.deril1
es
❑ No
94O14O
OR 8401 (4/90)
Attachment to auor/3.2 License Renev )Application
This page must be completed and attached to your signed renewal application form.
Failure to include this page with the application may result in your license not being renewed.
State License Number
Trade Name of Establishment
c_ ,v 5 ANF
1. Do you have legal posession of the premises for which this application for license is made?
Are the premises owned or rented? tO \/(%Ake %)If rented, effective and expiration date of lease:
/�-a69ga
_0p
YES NOE
2. (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 and attach.
(b) Have persons lending assistance or financial support to the applicant, or manager, or employees, ever been convicted of a crime?
If answer is yes," explain in detail and attach.
YES [II NO
YES 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?
(b) had an alcoholic beverage license suspended or revoked?
(c) had interest in any entity that had an alcoholic beverage license suspended or revoked?
if answer is yes" to any of the above questions, explain in detail and attach.
YES ❑ N
YES El N
YES NO
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
r'ect'iiitet t fiaiww'o h₹r"cb7$raot lf4u8?' olti Metals' r "si rfchifi3 ,"Orniteretti - fi'!`t�rtttT'3rry Itr:ens4e)f#' '..
If answer is yes," explain in detail and attach.
5. Identify the persons, firms or corporations who now or will have a financial interest, evidenced either by a loan to, or equity ownership in, the business foi
which this license is requested. State the names and addresses and the amount and source of such financial interest (i.e., bank, relatives, friends, previous
owners, etc.), expressed in dollars or other items of value, such as inventory, furniture or equipment. Use separate sheet if necessary.
Type and Amount
Name Address
PORGY 2 R aXL L c r�
5. List on a separate sheet the names and addresses of all liquor businesses in which any of the persons in question No. 5 are materially interested.
Lu P pL$rALq
Interest
'on
.62
7, Operating Manager
Address
Date of Birth
elf applicant is a partnership (except husband and wife , list all general partners. Use separate sheet if necessary:
Name
Address
Date of Birth
Y
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:
(b) Principal place of business is:
Date Incorporated:
(c) Date of filing last annual corporate report to the Colo, Secretary of State:
h officer listed below:
President....... _x.,, . . ,_ ..,__
.Home.AdtCess ..�..w.yr. �,. g-_. ,4. _ .s..o.,...t.
4lBldh,.- _..
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
(f) Name of all Directors'/Trustees of Corporation
Name
Address
Date of Birth
Name
Address
Date of Birth
4""P
910140
3422
PAY
TO THE
ORDER OF
WELD COUNTY REVOLVING FUND
915 - 10TH STREET
GREELEY, CO 80631
-Q U-' -4- % -< tZ
---4.-.400 Le'5
BANK ONE, GREELEY, N.A.
GREELEY, COLORADO
7794
199'4
82-3511070
$I 9a. 50
DOLLARS
FOR L( qqq'. -L'6 - Pc's � na'��
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P 387 472 5C9
RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
(See Reverse)
FLORINDA PESINA AND
LUPE PESIN A
DBA PESINA'S CAFE
PO BOX 23
GILL, GO 80624
Certified Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt showing
to whom and Date Delivered
Return Receipt showing to whom.
Date. and Address 01 Delivery
TOTAL Postage and Fees
5
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RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
(See Reverse)
FLORINDA PESINA
LUPE PESINA
DBA PESINA'S CAFE
PO BOX 23
GILL, CO 80624-0023
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 Date
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P 387 472 503
RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
(See Reverse)
COLORADO DEPT OF REVENUE
LIQUOR ENFORCEMENT DIVISION
STATE CAPITOL ANNEX
1375 SHERMAN ST
DENVER CO 80203
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
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