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Home My WebLink About930210.tiffRESOLUTION RE: APPROVAL OF RENEWAL REQUEST FOR 3.2% BEER LICENSE ISSUED TO LILLIAN GOOCH, DBA CROW VALLEY CAFE - EXPIRES FEBRUARY 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, Lillian Gooch, d/b/a Crow Valley 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 on and 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 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: Section 20, Township 8 North, Range 62 West of the 6th P.M., Weld County Briggsdale, Colorado 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 93-03 to said applicant to sell 3.2% fermented malt beverages for consumption on and 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 Clerk to the Board of Weld County, Colorado, which license shall be in effect until February 23, 1994, 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. 930210 RENEW 3.2% BEER LICENSE - CROW VALLEY CAFE PAGE 2 The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 17th day of February, A.D., 1993. ATTEST: n r Weld County Clerk to the,, Board BY: eliiirt-/� � Deputy Clerk to the Boa APPROVED AS T% FbRM: County Attorney BOARD OF COUNTY COMMISSIONERS WEL, COUNTY, COLORADO % (. (� Constance Dale /Barbara J. Kirkm t, Chairman yer 930210 THIS LICENSE MUST BE POSTED IN PUBLIC VIEW DR 8409 {101921': SATE OF COLORADO DEPARTMENT OF REVENUE Liquor Enforcement Division 1375 Sherman Street Denver, Colorado 80261 GOOCH LILLIAN CROW VALLEY CAFE SEC2O T8 R62W BRIGGSDALE CO 8O611 ALCOHOLIC BEVERAGE LICENSE Liability Information Account Number 14-21464-001 County City Indust. Type Liability Date 03 206 5411 1 022482 LICENSE EXPIRES AT MIDNIGHT FEB 23, 1994 Type Name and Description of License j Fee J 3.2 PERCENT BEER RETAIL LICENSE $ 50.00 COUNTY 85 PERCENT OAP FEE $ 42.50 TOTAL FEEESI, $ 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. CLti Division Director FEB 2 5 1993 Executive Director 330210 W W 2 n J 0 N W W CO N c'ri >— Z 0 c•C.Q_ la k.o-u-"'"� DR 8400 (8/89) Cob. Dept. of Revenue Liquor Enforcement Division 1375 Sherman Street Denver, Colorado 80281 866-3741 Liquor or 4.2 Beer License Renewal Application License Number: License Type: Liability Information: r Business Location: Current License Expires: t ('1 .. . l r -:r j c 11117/©CDC lV IJ ll ©OP 11 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. ❑ 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.) • SIGN THE FORM • ENCLOSE TOTAL AMOUNT DUE • SUBMIT FORM TO LOCAL (CITY/COUNTY) UCENSING AUTHORITY FOR APPROVAL • CHECK WITH LOCAL AUTHORITY FOR AMOUNT OF LOCAL FEES. 1 declare under penalty of perjury in the second degree that this application and all attachments are true, correct, and complete to the best of my knowledge. Authorized &gnatdibl!: . ;/ ✓J - ..-A..f / Data / -r..` fir Business Phone: (7-1-57 f /. Title of Signer (if corporation)://J / Sales Tax Nom//� /y '. '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 THAN 45 DAYS BEFORE YOUR LICENSE EXPIRES. EXCEPTION: Wholesaler, manufacturer, importer, and peblic transportzaion system license renewals do not need Local Licensing Authority approval and must be returned directly to the Color 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: ❑ TOWN/CITY ❑ COUNTY Signature: - Title .. ,:. I Attest: _ t ! Date Do NOT DETACH • DD NOT DETACH • Do NOT DETACH • Do NOT DETACH • Do NOT DETACH • Do NOT DETACH • Do NOT DETACH • Do NOT DETACH • Do NOT DETACH BU SINESStOCATtON:-----..-- . , I.1..,S, L LC, NAME: USE LICENSE NUMBER FOR ALL REFERENCE LIABILITY INFORMATION RENEWED LICENSE EXPIRES AFTER COUNTY CITY INDUST. TYPE LIAB. DATE j'''44-ttt..-1 Ui ii 1••• :-,tl , :3,124`._ TYPE OF LICENSE ISSUED CASH FUND STATE FEE CITY 85% OAP CO 85% OAP 66-01 (9) 41.9 (9) 45-9 (9) 37.1 (9) 49-1 (9) ...� -.tt.. z, I -I .. I'.:I_ t.IC:'.SE I:r) II Ci t - .H' b a-%., Make check payable to: COLORADO DEPARTMENT OF REVENUE TOTAL AMOUNT DUE *► } EXTENDED HOURS — Applies only to Hotel and Restaurant, Beer and Wine, Club, Tavern, Extended hours? and Arts licenses. If desired, check "yes" and enclose Total Amount Due PLUS $170.00. ❑ Yes l' No .... *9c 03 2,63021 bag- dw/3 ' 93O156 ab 3- a/ bJQ.i r4. y-m‘LA DR 8401 (4/90) Attachment to '41 Liquor/3.2 License ReneI 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. Trade Name of Establishment State License Number 1. Do you have legal posession of the premises fort it/ which �this application for license is made? YES ❑ NO ■ Are the premises owned or rented? -,�.. ,LIf rented, effective and expiration date of lease: . �� --:1-76 —-,r„/ en 2. (a) Has the applicant or any of the partners, or officers, stockholders or directors of said applicant (if a corporation). ever been YES ❑ NO Il 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 NOD If answer is yes," explain in detail and attach. 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 ❑ NOD (b) had an alcoholic beverage license suspended or revoked? YES ❑ NO (c) had interest in any entity that had an alcoholic beverage license suspended or revoked? YES ❑ NO If answer is "yes" to any of the above questions, explain in detail and attach. Il. N 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 D or indirect interest in any other Colorado liquor license (include loans to or from any licensee, or interest in a loan to any licensee)? 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 Address Interest Type and Amount 6. List on a separate sheet the names and addresses of al iquor businesses in with any of the persons in question No. 5 are materially interested. 7. Op g M��nn er / Address_ CI > 74 (,�/ Date Birth Vr 8. icl a� a partnership (except husband and wife , ist all general partners. separate sheet if necessary. Name >t Address Date of Birth Name - '. Address Date of Birth 9. If the applicant is a corporation, answer the folbwi • (a) Corporation istrganized under the laws of the State of: Date Incorporated: (bj_•.t'ria:,ipal place of business is: ' (c) Date of filing last annual corpora report to the Cob. Secretary of State: — President - t • • Home Address Date of Birth Vice-Pres. • • Home Address Date of Birth Treasurer a f 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 i Date of Birth Name Address Percent of Stock Date of Birth Name Address Percent -of Stock Date of Birth (f) Name of all Directdl'syfrustees of Corporation Name Address Date of Birth Name Address , ,; -.,� Date of Birth DPSBIB20 DESCRIPTION OF MESSAGE IN IN -BASKET Message...: no record on liquor license Vale 0 —Atti Received' from : PCJREC11-MAIN Received : 02/16/93 16:13 Sent : 02/16/93 16:13 Select an option and type it below; then press ENTER. 3 Send 8 Reply 9 File 10 Delete PF1=Help 2= 3= 4=Main Menu 5= 6=Fast Path PF7= 8= 9= 10= 11= 12=Quit M 930210 P 387 472 563 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 N cn c 3 O obi LL in a Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt showing to whom and Date Delivered Return Receipt showing to whom. 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