HomeMy WebLinkAbout982361.tiff RESOLUTION
RE: APPROVE PERMIT APPLICATION AND REPORT OF CHANGES (CHANGE OF
MANAGER) FOR CONO-SERVICES, INC., DBA CONOCO#06394, AND AUTHORIZE
CHAIR TO SIGN
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, Cono-Services, Inc., dba Conoco#06394, holder of a 3.2 Percent Beer
Retail License in Weld County, Colorado, has presented the Board with a Permit Application and
Report of Changes (Change of Manager), and
WHEREAS, said change is as follows: Steve Prentice replaces Marion Patterson as
manager, and
WHEREAS, after study and review, the Board deems it advisable to approve said Permit
Application and Report of Changes (Change of Manager).
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Permit Application and Report of Changes (Change of Manager),
submitted by Cono-Services, Inc., dba Conoco#06394, be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said report.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 7th day of December, A.D., 1998.
BOARD OF COUNTY COMMISSIONERS
/Le
WELD COUNTY, COLORADO
ATTEST:
Constance L. H rbe , C A
Weld County Clerk th , r )
ices , iLC7 i/((lll
W. Webster, Pro-Tern
BY: � ,_ i•Y� :e. -�
Deputy Clerk to t im � EXCUSED
E. Baxter
AP AST M:
Dal K`Hall
Con ttor ey / f
arbara J. Kirkmey r
982361
LC0031
Litz . 4.42 (Uti9f) rage 1 r21
(gQ�ORADO DEPARTMENT OF REVENUE 1
uoa ENFORCEMENT DIVISION
1375 SHERMAN STREET PERMIT APPLICATION
DENVER CO 80261
(303)205-2300 & REPORT OF CHANGES
CURRENT LICENSE NUMBER
ALL ANSWERS MUST BE PRINTED IN BLACK INK OR TYPEWRITTEN
LOCAL LICENSE FEE $
APPLICANT SHOULD OBTAIN A COLORADO LIQUOR&BEER CODE BOOK
TO ORDER CALL(303)321-4164 DO NOT WRITE IN THIS SPACE
1. Applicant is a PRESENT CLASS OF LICENSE
❑ Corporation ❑ Individual /24 t-- iY
❑ Partnership ❑ Limited Liability Company PRESENT LICENSE NUMBER
2. Name of Applicant 3.Trade Name ,,;}' p! ,-
�i. . -- Q 8 k 3
/
BUSINESS TELEPHONE
gat c U � 13�`' : , - '
4. Address
C
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City County ZIP
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th- . • •r• •ri•t• s-cti•n • •t•W •n• •r•C• - • t• th- Instructi•ns •n • • • • 2-
SECTION A-DELIVERY PERMIT SECTION C
1)O 2210-100(999)Retail Warehouse Storage Permit(ea) S 50.00
• License Account No. 2)O 2320-100(999)Wholesale Branch House Permit(ea) 50.00
3)❑2320.100(999)Change Corp or Trade Name Permit(ea) 25.00
O 3.2%On/Off Premises Only NO FEE 4)❑2230-100(999)Change Location Permit(ea) 100.00
❑ Liquor Store or Drugstore NO FEE 5)❑2280-100(999)Change,Alter or Modify Premises
5100.00 x Total Fee
SECTION B-MANAGER REG/CHANGE 6)❑1980-100(999)Addition of Optional Premises of Existing H/R
$75.00 x Total Fee
• License Account No. 7)❑2340-100(999)Bed and Breakfast Permit 25.00
SECTION D-DUPLICATE LICENSE
1970-750(999) O Managers Registration (Hotel&Restr.) 575.00
�y • LIQUOR LICENSE No. -
%f Change of Manager(Other Licenses) NO FEE
/ \ ,• 2330-100(999)DUPLICATE LICENSE $ 25.00
DO NOT WRITE IN THIS SPACE - FOR DEPARTMENT OF REVENUE USE ONLY
DATE LICENSE ISSUED LICENSE ACCOUNT NUMBER PERIOD
-100 (999) TOTAL -
9 a36;i
•
DA 8442(06/97) Page 2
INSTRUCTION SHEET
For all sections, complete questions 1-4 located on page 1
❑ Section A
For current 3.2% On/Off premises only a Retail Liquor Store or Drugstore licensees apply-
ing to deliver alcohol, check the appropriate box in section A and proceed to page 4 for Oath of
Applicant signature.
Section B
To Register or Change Managers, check the appropriate box in section B and complete question
10 on page 4. Proceed to the Oath of Applicant for signature (Please note: Hotel and Restaurant
licensees are required to register their managers).
❑ Section C
Check the appropriate box in section C and proceed below.
•
1) For a Retail Warehouse Storage Permit, go to page 3 complete question 5 (be sure to
check the appropriate box). Submit the necessary information and proceed to page 4 for Oath
of Applicant signature.
2) Fora Wholesale Branch House Permit, go to page 3 and complete question 5 (be sure to
check the appropriate box). Submit the necessary information and proceed to page 4 for Oath
of Applicant signature.
3) To Change Trade Name or Corporation Name, go to page 3 and complete question 6 (be
sure to check the appropriate box). Submit the necessary information and proceed to page 4 for
Oath of Applicant signature.
4) To modify Premise, go to page 3 and complete question 7. Submit the necessary information
and proceed to page 4 for Oath of Applicant signature.
5) For Optional Premises, go to page 3 and complete question 7. Submit the necessary information
and proceed to page 4 for Oath of Applicant signature.
6) To Change Location, go to page 3 and complete question 8. Submit the necessary information
and proceed to page 4 for Oath of Applicant signature.
7) For a Bed and Breakfast Permit, go to page 4. Submit the necessary information and proceed
to page 4 for Oath of Applicant signature.
❑ Section D
For a Duplicate license, be sure to include the liquor license number in section D on page 1 and
proceed to page 4 for Oath of Applicant signature.
. ..- b, 5. Retail Warehouse Storage Permit or a Wholesalers Branch House Permit
2 O Retail Warehouse Permit
CC
tu a O Wholesalers Branch House Permit(Does not require local licensing authority approval)
us 1) Federal Basic Permit#
ce If granted,will the proposed warehouse or branch house be in compliance with local building and zoning laws? Yes No
yName and title of Person in Charge of Premises ❑ ❑
O Attach a diagram of premises showing area of alcohol beverage storage
m Ili 6. Change of Trade Name or Corporation name
O z ❑ TradeJDBA Name Change only
wa
O o ❑ Corporate Name Change(Attach a Certificate of Amendment from Colorado Secretary of State)
V0 Old Name New Name
O
7. Modification of Premises or Addition of an Optional Premises to an existing HoteVRestaurant Liquor License
(a) Describe change proposed
co
W
in
(b) Will the proposed change result in the licensed premises now being located within 500 feet of any public
¢O 2 or private school that meets compulsory education requirements of Colorado law,or the principal campus
o o•
y a (If yes, explain in detail and describe any exemptions that should apply) O 0
W p (c) When will the proposed change
a-
0 Start (mo/day/year) End (mo/day/year)
aO (d) Is the proposed change in compliance with local building and zoning laws?
O =
Yes No
2 ° ❑ ❑
0 (e) If this modification is for an additional Hotel and Restaurant Optional Premises, has the local authority
a authorized by resolution or ordinance the issuance of optional premises? Yes No
(f) Are such changed premises owned or leased? O Owned O Leased ❑ ❑
(Attach a signed copy of deed or lease in the name of the licensee only)
(g) Attach a diagram of the premises showing the area where alcohol beverages will be stored,served,
possessed or consumed. Include food preparation facilities for Hotel and Restaurants.
8. Change of Location
•
(a) Address of current premises
City County ZIP
z
0 (b) Address of proposed New Premises (Attach a copy of the deed or lease that establishes possession of
the premises by the licensee)
C.)
O Address
LL
O City r County ZIP
W
z (c) New mailing address if applicable
ct
= Address
City County ZIP
•
(d) Attach a diagram of the premises showing the area where alcohol beverages will be stored, served,
•
possessed or consumed. Include food preparation facilities for Hotel and Restaurants.
..:R 8442(0697) Page 4 .
9. Change of Manager or register manager of a HoteVRestr.liquor license
O (a) Change of Manager(attach Jndrvidual History DR 8404-I H/R only)
Former manager's name "' /n 412 to-VA tcto AA 4.,„_,4 New manager's nameC. 11 C /1 4-id .e
C (b) Compensation of-Mgr. C\g Ly Date of Emp. Exp. Date
tub Has manager ever managed a Liquor licensed establishment? ❑ Yes tie
e
aZ Does manager have a financial interest in any other liquor licensed establishment? IDYes [1.640-
= If yes, give name and location of establishment
U
10. Bed and Breakfast Permit
• Attach a copy of a deed or lease in the exact name of the applicant only, reflecting possession of the permitted area
for at least the minimum duration of this permit(1 year from date of issuance).
• Attach a diagram of the premises which accurately reflects the area where alcoholic beverages will be stored, served,
possessed or consumed.
F 1. Applicant is a: .
X 0 Corporation (attach DR 8177) 0 Partnership
W
n El Individual (attach DR 8404-I El) LTD Liability Company (attach DR 8177)
F 2. Name of Applicant
Cr
a 3. Trade Name of Establishment (DIM)
Y 4. Address of Premises (specify exact location)
a
Ill 5. State Sales Tax Number
CC
Business Phone ( )
m
CI 2 Pursuant to 12-47-410, C.R.S., Applicant hereby states that it qualifies for a Bed and Breakfast Permit to serve complimentary
a alcoholic beverages, and does certify to the State Licensing Authority:
W That it has no more than 20 sleeping rooms, and
m That it provides at least 1 meal per day at no charge other than for overnight lodging, and
That it does not sell alcoholic beverages by the drink or in sealed containers, and
That it shall not serve alcoholic beverages for more than 4 hours in any one day, as follows:
MONDAY HOURS TUESDAY HOURS WEDNESDAY HOURS I THURSDAY HOURS FRIDAY HOURS SATURDAY HOURS SUNDAY HOURS
From: m. From: m. From: m. From: m. From: m, From: m.l From: m.
To: m. To: m. To: m. To: m.! To: m. To: m.I To: m.
OATH OF APPLICANT
!declare under penalty of perjury in the second degree that!have read the foregoing application and all attachments thereto,
and that all information therein is true, correct, and complete to the best of my knowledge.
Signature Title Date
2 �j V; c e President Conft Services /G, ��06.REP RT AND A ROVAL OF LOCAL LICENSING AU f AUTHORITY (CITY/COUNTY)
The foregoing application has been examined and.the premises,business conducted and character of the applicant is satisfactory,and we
do report that such permit,if granted,will comply with the applicable provisions of Title 12,Articles 46 and 47,C.R.S.,as amended.
THEREFORE,THIS APPLICATION IS APPROVED.
r
Local Licensing Authority(City or County) Date filed with Local Authority
Weld County, Colorado November 30, 1998
Signature Titre Protem, Weld County Board Date
'i-•( ' (C✓( , jng A LT? of Commissioners 12/07/98
REPORT OF STATE LICENSING AUTHORITY
The foregoing has been examined and complies with the filing requirements of Title 12,Article 47,C.R.S.,as amended.
Signature Title
Date
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