HomeMy WebLinkAbout20170628.tiffRESOLUTION
RE: APPROVE PERMIT APPLICATION AND REPORT OF CHANGES TO REGISTER A
MANAGER AND AUTHORIZE CHAIR TO SIGN - R.M. INC., DBA ROOM 119
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, the Board has been presented with an Application and Report of Changes
from R.M. Inc., dba Room 119, to register a manager, in connection with its Tavern Liquor
License, for the sale of malt, vinous and spirituous liquors for consumption by the drink on the
premises only, located at 3101 Highway 119, Longmont, CO 80504, and
WHEREAS, after review, the Board deems it advisable to approve said application.
NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld
County, Colorado, that the Application and Report of Changes from R.M. Inc., dba Room 119, to
register a manager, in connection with its Tavern Liquor License, for the sale of malt, vinous and
spirituous liquors for consumption by the drink on the premises only be, and hereby is, approved.
BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized
to sign said application.
The above and foregoing Resolution was, on motion duly made and seconded, adopted
by the following vote on the 1st day of March , A.D., 2017.
BOARD OF COUNTY COMMISSIONERS
ATTEST:d�@� .Jetorg1
Weld County Clerk to the Board
puty Clerk to the Board
APP DASTOF
ounty Attorney
Date of signature: O?1O� 117
Cc • SO CRS) , r H�,
CL -PP
WELD COUNTY, COLOR/ PO
Julie. Cozad, Chair
teve Moreno, Pro-Tem
EXCUSED
Sean P. Conway
ike Freeman
2017-0628
LC0019
DR 8442 (09/21/16)
COLORADO DEPARTMENT OF REVENUE
Liquor Enforcement Division
(303)-205-2300
Permit Application
and Report of Changes
FOR DEPARTMENT USE ONLY
Current License Number
All Answers Must Be Printed in Black Ink or Typewritten
Local License Fee $ O . OO
1. Applicant is a
g Corporation ❑ Individual
• Partnership • Limited Liability Company
Present License Number
2. Name
.M
of Licensee
ING Um: Roorn'L1q
3. Trade Name
4.Location
3101
Address
HWY ' tii
City
LOngmom-
County Weld
I d
ZIP
gOatif
SELECT THE APPROPRIATE SECTION BELOW AND PROCEED TO THE INSTRUCTIONS ON PAGE 2.
Section A — Manager reg/change
Section C
• LicenseAccount No.
• Retail Warehouse Storage Permit (ea) $100.00
• Wholesale Branch House Permit (ea) 100.00
• Change Corp. or Trade Name Permit (ea) 50.00
• Change Location Permit (ea) 150.00
• Change, Alter or Modify Premises $150.00 x
• Managers Registration (Hotel & Rest..) $75.00
XManagers Registration (Tavern) $75.00
• Managers Registration (Lodging & Entertainment) $75.00
❑ Change of Manager (Other Licenses pursuant to section 12-47-
301(8), C.R.S.) NO FEE
Total Fee
• Addition of Optional Premises to Existing H/R $100.00 x
Section B — Duplicate License
• Liquor License No.
Total Fee
❑ Addition of Related Facility to Resort Complex $75.00 x
■ Duplicate License $50.00
Total Fee
❑ Tavern Conversion No Fee
Do Not Write in This Space — For Department of Revenue Use Only
Date License Issued
License Account Number
Period
The State may convert yourcheckto a one time electronic banking transaction. Your bank account TOTAL
may be debited as early as the same day received by the State. If converted, your checkwill not
be returned. If your check is rejected due to insufficient or uncollected funds, the Department AMOUNT DUE
of Revenue may collect the payment amount directly from your bank account electronically.
$ .00
DR 8442 (09/21/16) Page 2
Instruction Sheet
For All Sections, Complete Questions 1-4 Located on Page 1
Section A
To Register or Change Managers, check the appropriate box in section A and complete question
8 on page 4. Proceed to the Oath of Applicant for signature. Submit to State Licensing Authority
for approval.
❑ Section B
For a Duplicate license, be sure to include the liquor license number in section B on page 1 and
proceed to page 4 for Oath of Applicant signature.
❑ 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.
Submit to State Licensing Authority for approval.
2) For a 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.
Submit to State Licensing Authority for approval.
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. Retail Liquor License submit to Local Liquor Licensing Authority (City or County). Manufacturer,
Wholesaler and Importer's Liquor Licenses submit to State Liquor Licensing Authority.
4) To modify Premise, go to page 4 and complete question 9. Submit the necessary information and
proceed to page 4 for Oath of Applicant signature. Retail Liquor License submit to Local Liquor Licensing
Authority (City or County). Manufacturer, Wholesaler and Importer's Liquor Licenses submit to State
Liquor Licensing Authority.
5) For Optional Premises or Related Facilities go to page 4 and complete question 9. Submit the necessary
information and proceed to page 4 for Oath of Applicant signature. Retail Liquor License submit to Local
Liquor Licensing Authority (City or County). Manufacturer, Wholesaler and Importer's Liquor Licenses
submit to State Liquor Licensing Authority.
6) To Change Location, go to page 3 and complete question 7. Submit the necessary information and
proceed to page 4 for Oath of Applicant signature. Retail Liquor License submit to Local Liquor Licensing
Authority (City or County). Manufacturer, Wholesaler and Importer's Liquor Licenses submit to State
Liquor Licensing Authority.
7) Tavern Conversion, go to page 4 and complete questions 10. Submit the necessary information and
proceed to page 4 for Oath of Applicant signature. *(Must be completed by August 10, 2017, as the tavern
conversion will no longer be permitted). Submit to Local Licensing Authority (city or county) for approval.
DR 8442 (09/21/16) Page 3
Storage Permit
5. Retail Warehouse Storage Permit or a Wholesalers
Branch House Permit
etc.)
• Retail Warehouse Permit for:
❑ On —Premises Licensee (Taverns, Restaurants
■ Off —Premises Licensee (Liquor stores)
❑ Wholesalers Branch House Permit
Address of storage premise:
City , County , Zip
Attach a deed/ lease or rental agreement for the storage premises.
Attach a detailed diagram of the storage premises.
Change Trade Name or
Corporate Name
6. Change of Trade Name or Corporation Name
supporting documents)
of State, or
of State and
• Change of Trade name / DBA only
❑ Corporate Name Change (Attach the following
1. Certificate of Amendment filed with the Secretary
2. Statement of Change filed with the Secretary
3. Minutes of Corporate meeting, Limited Liability
Members meeting, Partnership agreement.
Old Trade Name
New Trade Name
Old Corporate Name
New Corporate Name
Change of Location
7. Change of Location
NOTE TO RETAIL LICENSEES: An application to change location has a local application fee of $750 payable to your local licensing
authority. You may only change location within the same jurisdiction as the original license that was issued. Pursuant to 12-47-311
(1) C.R.S. Your application must be on file with the local authority thirty (30) days before a public hearing can be held.
Date filed with Local Authority Date of Hearing
(a) Address of current premises
City County Zip
(b) Address of proposed New Premises (Attach copy of the deed or lease that establishes possession of the
premises by the licensee)
Address
City County Zip
(c) New mailing address if applicable.
Address
City County State Zip
(d) Attach detailed diagram of the premises showing where the alcohol beverages will be stored, served,
possessed or consumed. Include kitchen area(s) for hotel and restaurants.
DR 8442 (09/21/16) Page 4
Change of Manager
8. Change of Manager or to Register the Manager of a Tavern, Hotel and Restaurant, Lodging & Entertainment
liquor license or licenses pursuant to section 12-47-301(8).
(a) Change of Manager (attach Individual History DR 8404-I H/R, Tavern and Lodging & Entertainment only)
Former manager's name
New manager's name Lisa Ruiz- Pncto
(b) Date of Employment our reni-
Has manager ever managed a liquor licensed establishment? Yes ■ Nod
Does manager have a financial interest in any other liquor licensed establishment? Yes ■ Na
If yes, give name and location of establishment
Modify Premises or Addition of Optional
Premises or Related Facility
9. Modification of Premises, Addition of an Optional Premises, or Addition of Related Facility
NOTE: Licensees may not modify or add to their licensed premises until approved by state and local authorities.
(a) Describe change proposed
(b) If the modification is temporary, when will the proposed change:
Start (mo/day/year) End (mo/day/year)
NOTE: THE TOTAL STATE FEE FOR TEMPORARY MODIFICATION IS 5300.00
(c) Will the proposed change result in the licensed premises now being located within 500 feet of any public or
private school that meets compulsory education requirements of Colorado law, or the principal campus of any
college, university or seminary?
(If yes, explain in detail and describe any exemptions that apply) Yes ■ No ■
(d) Is the proposed change in compliance with local building and zoning laws? Yes • No ■
(e) If this modification is for an additional Hotel and Restaurant Optional Premises or Resort Complex Related
Facility, has the local authority authorized by resolution or ordinance the issuance of optional premises?
Yes■ No■
(f) Attach a diagram of the current licensed premises and a diagram of the proposed changes for the
licensed premises.
(g) Attach any existing lease that is revised due to the modification.
Tavern Conversion
10. Tavern Conversion
(Note* Must be completed by August 10, 2017 as the Tavern conversion will no longer be permitted.
Only Tavern licenses issued before August 10, 2016, that do not fit the definition of a tavern as defined in section
12-47-103(38), C.R.S. may convert to a different license type.) Please pick one of the following choices:
(a) I wish to convert my existing Tavern Liquor License # to a Lodging and Entertainment
Liquor License? Yes ■ No ■
(b) I wish to convert my existing Tavern Liquor License # to a
Liquor License? Yes ■ No ■
DR 6442 (09/21/16) Page 5
Oath of Applicant
I declare under penalty of perjury in the second degree that I 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
� R4i PrlsD
Title
MG.nGqr.
Date
O1-1•Zor-i
Report and Approval of LOCAL Licensing 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.
Local Licensing Authority (City or County)
Weld County, Color do
Date filed with Local Authority
February 8, 2017
Signature---- / /1
1/d/(,Y 1/11 -f -t
Title
Chair, Board of County Commissioners
Date
3/1/2017
Report of STATE Licensing Authority
The foregoing has been exa ned and complies with the filing requirements of Title 12, Article 47, C.R.S., as amended.
Signature
Title
Date
DR 8404-1 (08/10/16)
COLORADO DEPARTMENT OF REVENUE
Liquor Enforcement Division
(303) 205-2300
Individual History Record
To be completed by the following persons, as applicable: sole proprietors; general partners regardless of percentage ownership, and
limited partners owning 10% or more of the partnership; all principal officers of a corporation, all directors of a corporation, and any
stockholder of a corporation owning 10% or more of the outstanding stock; managing members or officers of a limited liability company,
and members owning 10% or more of the company; and any intended registered manager of Hotel and Restaurant, Tavern and
Lodging and Entertainment class of retail license
Notice: This individual history record requires information that is necessary for the licensing investigation or inquiry. All questions
must be answered in their entirety or the license application may be delayed or denied. If a question is not applicable, please indicate
so by "N/A". Any deliberate misrepresentation or material omission may jeopardize the license application. (Please attach a
separate sheet if necessary to enable you to answer questions completely)
1. Name of Business
room
_0
I
it P g
_3`` -'`m//►1aan(Ly�,Gother�i/names
_el 7 i0
f G
-1 llo • Gr, 4242
uiz-P1rie
.(las�rt,..((fiJJrst,
middle)
sa
you have used
4. Mailing address (if different from residence)
Ema Addre
rpte231isa
i yahbnn•
corn
5. List current residence address. Include any previous addresses within the last five years. (Attacli separate sheet if necessary)
Street and Number
City, State, Zip
From
To
2i0e� CR41
LaSalle CO &Xo4.5
2DIlo
Cuvrult
l 5EctoleRve
•
Mead 1 Co • 80542.
102.
201&
6. List all eiiiMoyment within the last f ve years. Include any self-employment. (Attach separate sheet if necessary)
Name of Employer or Business
Address (Street, Number, City, State, Zip)
Position Held
From
To
Nero Management
Coloi'ado
Springs en •
Rotep*ion
2 -DH
20i ,a
1
7. List the name(s) of relatives working in or holding a financial interest in the Colorado alcohol beverage industry.
Name of Relative
Relationship to You
Position Held
Name of Licensee
8. Have you ever applied for, held, or had an interest in a Colorado Liquor or Beer License, or loaned money,
furniture, fixtures, equipment or inventory to any licensee? (If yes, answer in detail.)
•
yesNo
9. Have you ever received a violation notice, suspension, or revocation for a liquor law violation, or have you yes‘74 No
applied for or been denied a liquor or beer license anywhere in the United States? (If yes, explain in detail.)
10. Have you ever been convicted of a crime or received a suspended sentence, deferred sentence, or forfeited ❑ YesNo
bail for any offense in criminal or military court or do you have any charges pending? (If yes, explain in detail.)
11. Are you currently under probation (supervised or unsupervised), parole, or completing the requirements of a ❑ YesNo
deferred sentence? (If yes, explain in detail.)
'
12. Have you ever had any professional license suspended, revoked, or denied? (If yes, explain in detail.) ❑ Yes No
Personal and Financial Information
Unless otherwise provided by law, the personal information required in question #13 will be treated as confidential. The personal
information required in question #13 is solely for identification purposes.
13a. Data of Birth
1O.8O.
NNum er
. I�,W1
\
of firth
�vthnd
CO IOW
d. U.S. Citizen Yes
■
No
e. If Naturalized, state where
f. When
g. Name of District Court
h. Naturalization Certificate Number
i. Date of Certification
j. If an Alien, Give Alien's Registration Card Number
k. Permanent Residence Card Number
I. Fleight
5 4"
m. Weight
13n
n. Hair Color
&0al,
v Eye Color
Haiti
p. der
pI Race
111'Xknit
r. Do you
❑Yes
have
•
a current Driver's License/ID? If so, give number and state.
No # State
14. Financial Information.
a. Total purchase price or investment being made by the applying entity, corporation, partnership, limited liability company, other.
$
b. List the total amount of the personal investment , made by the person listed on question #2, in this business including any
notes, loans, cash, services or equipment, operating capital, stock purchases or fees paid. $
* If corporate investment only please skip to and complete section (d)
** Section b should reflect the total of sections c and e
c. Provide details of the personal investment described in 14b. You must account for all of the sources of this investment.
(Attach a separate sheet if needed)
Type: Cash, Services or Equipment
Account Type
Bank Name
Amount
d. Provide details of the corporate investment described in 14 (a). You must account for all of the sources of this investment. (Attach a
separate sheet if needed)
Type: Cash, Services or Equipment
Loans
Account Type
Bank Name
Amount
e. Loan Information (Attach copies of all notes or loans)
Name of Lender
Address
Term
Security
Amount
Oath of Applicant
I eclare under penalty of perjury that this application and all attachments are true, correct, and complete to the best of my knowledge.
rite 'gnat^rq�
/nucJ7Jl'�S
_ I
f/i.
ri'�Signaturba
PAM—
/
Ttl Manager 1' Y�?`�f''I
pl/�
Edgar Sosa
630 Lashley St #C-109
Longmont, CO
February 1, 2017
To Whom It May Concern:
This letter serves to vouch for the personal and professional character of Lisa Ruiz -Prieto. I have
known her for the last 18 years, on a personal level and professional. I can confirm that she is very
professional in all aspects of her life and is of great integrity as well. She is extremely dedicated to her
Kid's and her life working in whatever field that she has decided to work in. Lisa has always shown to
be a trustworthy and honest person. I have faith that Lisa will be successful in the new path that she
has been asked to do and help run a business and to grow as a human. Hope this letter helps her in
her future endeavors. I have always known Mrs.Ruiz-Prieto to be of good character she is an amazing
hard working woman!
Please do not hesitate to call me if you would like to discuss this recommendation further.
Sincerely,
EdgaNSosa
(720) 325-6223
January 28, 2017
Rodolfo Montes
153 Eagle Ave
Mead, CO 80542
I Rodolfo Montes would like to say that my daughter Lisa Ruiz -Prieto is a very
responsible person. I have had the privilege to work hard all my life to have something to say I
worked hard for. I have worked at our family business for many years and It has come time for
me to work less and to start the transition for my daughter to step in. This transition will be easy
for Lisa She is a smart young woman she is my oldest daughter. Lisa became a mother at a
young age on her own this goes to show me that she has the ability to take care of things that
life puts in her way. Lisa has shown me as her father that she can and will someday be able to
conduct and take care of the family business as I would like her to.
The business that we are in is a challenge but she has shown me out of my two other
children that she has the ability to conduct the business, also to grow as a human. She has
accepted my invitation to become a partner with me till I finally decide to retire but for now my
job is to show her how to become a successful woman in our community and to set an example
for my grandchildren. I hope that Usa can some day later in her life pass this business down to
her children and be just as successful with it like i was myself.
Thank you for taking the time to review my letter on why I recommend my daughter to
have and to share the liquor license responsibilities and help her grow as an individual. If you
have any other questions please feel free to contact me at (720) 491-2896.
Thank you!
R tedo (fa nal at,es
Rodolfo Montes
February 7, 2017
Irma Lorena Ramirez
1346 Sunset St #16
Longmont, CO 80501
To whom it may concern,
This letter is to recommend Lisa Ruiz -Prieto for a liquor license. I have known Lisa on a
personal level and also professional for over 16 years. She has always shown to be a
responsible and a honest woman. I know that she is taking a new path in life and I wish nothing
but success for her. Lisa is a hard worker and a very driven individual, she is known well in the
community and respected.
I hope this will help the county with determination of the license for her, if you have further
questions please do not hesitate to contact me.
Sincerel
Irma LorenVRamirez
(720) 352-4406
ic1'YYYyy, 1
2017-0628
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