HomeMy WebLinkAboutDept of Rev. Beverage LicenseCustomer Service Center
Sam W. Mitchell Buildin Montana Department of
p 1111W
MAY 1 0 200 D
2
CITY OF LAUREL
Neil Peterson, Administrator REVENUE P. O. Box 1712
Helena, Montana 59604-1712
May 8, 2002
RE: Application for Transfer of Ownership of Montana All-Alcoholic
Beverage with Catering Endorsement License No. 03-044-9403-002,
PALACE BAR & LANES, 305 E. Main, Laurel, Yellowstone County
The above referenced application was received at the Department of Revenue,
Registration & Licensing. Notice is being provided to you to give you an opportunity to
advise if the applicant and premises meet all the laws and ordinances your office is
responsible for regulating. We will be happy to provide any additional information that is
needed.
Local laws are not enforced through the alcoholic beverage licensing process; however,
if there are local laws affected by this application, compliance with those laws may
influence the final determination to issue the license.
If you determine any deficiencies exist that should be considered in the issuance of this
license, please advise this office in writing by June 10. 2002. If we receive a
determination of a local deficiency, the license application process cannot be completed
until the issue is cleared up at the local level. If no response is received, it will be
assumed there are no problems that would affect the issuance of a license. In addition,
if we receive a written protest against issuance of the license, a public hearing will be
scheduled.
If you have any questions, please call 444-0713.
Since eid
Sharon
Blunn
Compliance Specialist
cc: Howard Reid, Bureau Chief Food & Consumer Safety
Customer Intake, Lee Baedocher / Document & Information Processing, Reed Knudson
Accounts
Telephone (406) 444-6900 Fax (406)444 01 50 & Internet Address htip://www.state.mt.us/revenue/rev.htm
CERTIFICATE OF SERVICE
I certify that on this cF4i?' day of `M r 2002, a true and correct copy of
the foregoing has been served by placing same in the United States mail, postage prepaid,
and addressed as follows:
LAUREL CITY COUNCIL
PO BOX 10
LAUREL MT 59044
LAUREL CITY ATTORNEY
PO BOX 10
LAUREL MT 59044
LAUREL POLICE CHIEF
MIKE ATKINSON
PO BOX 10
LAUREL MT 59044
LAUREL CITY BUILDING INSPECTOR
PO BOX 10
LAUREL MT 59044
CITY-COUNTY PLANNING
PO BOX 1178
BILLINGS MT 59103
YELLOWSTONE COUNTY SANITARIAN
BOX 35033
BILLINGS MT 59107
YELLOWSTONE COUNTY TREASURERS OFFICE
P O BOX 35010
BILLINGS MT 59107-5010
GAIL POCHA ADMINISTRATIVE ASSISTANT
FIRE PREVENTION AND INVESTIGATION BUREAU
303 NORTH ROBERTS BOX 201417
HELENA MT 59620-1417
CHANGE ORDER
On Premise Transfer
Cate Received: March 26, 2002
City: Laurel County: Yellowstone
License No. 03-044-9403-00,Z
Type of Transfer OWNERSHIP
Present Listing
Palace Bar & Lanes
305 E Main St
Laurel MT 59044
OWNED BY: Palace Bar & Lanes
PHYSICAL DESC. 305 E Main St - Laurel
SECURED PARTY: Yellowstone Bk list MTG
r . ' " received $200.00 processing fee.
2) Current renewal app and fee rcvd and paid?
3)'?Y N Rec. and reviewed complete and accurate app
documents.
a)' Recvd Corp Statement if other than sole proprietor.
Y Rec. & reviewed assignment or purchase agreement
For license. S }O c?
6) Y xt- Rec. and rvwd lease/purchase agrmnt and proof of
ownership of premise.
7) Y' NRec. and reviewed complete/accurate mt
_ form. If sec.party added before 9/1/90, rcvd t -f6.00 fee.
8) 'y?N Is there a secured party? If so, send TRFSEC letter.
Rec. and reviewed mortgage addition form and $20.00 fee
10¢ Y Received current Cart of Eyas?ipnce/Partnership/Fact
for LLC. )Req Corp doc., stock register, certificates,
by laws, articles, & balance sheet
1 -Y/N Check Unix for currentlactive PHS/R01. If not on Unix,
request for Apps of 10% or more or for officers or directors
if 16-4-401(2)(b)iii applies
Rcvd menu for on-premise beertwine
13 N Rcvd copy of current bank signature card.
14L-Y)4 Received floor plan with general layout and exterior
dimensions.
15) Y. Ipp documents indicate that there will be a Mgr other
Than applicant. Was a Mgmt agreement submitted?
rtVDIs erify Sale of Tobacco?
L,1? heck POINTS to determine if seller owes money to DOR
` 18) there another application pending for this location.
(if yes, return this application and refund fees)
19 Y Check SOS f r good standing if corporations
Con mue if TWO& r TrfIL
Y f fl app - check quota in/quota out.
a le
Y N s location been denied in the past five years from
re i f app. (If yes, return this app and refund fees.)
Y N cvd an viewed certified survey.
# 5 is OT needed for a IocaGon change only"'
Notes-??_a'j p ? ? C'I Corp S f4'? ?r-tee.- ?
'??'?lAq 6` ?e.Cr2,2 c.? d?S} rset:-le m,?„+
Q IC'da `F ?-0r\')i M?2+-toy }ors
103 goo Owed b rick { UCH
Money Rcvd Cashier No.
License $
S
Processing Fee $ }?,y
Mortgage S
Change To
Same
APPLICANT: Palace Bar & Lanes, Inc.
PHYSICAL DESC. Same
SECURED PARTY:
Liens:
1Ca fJ.U^ C& C64 I
Application cosidered complete on:
info letter deadline:
Investigation report rcvd: Reviewed Ccncerns Y,N
Pub date
end protest Paid
Approval Date: by
TA Issued by Extended
New Construction or Remodel? Y N
B F H
W. Scott Green
West Patten Bekkedahl & Green PLLC
Attomevs at Law
301 North 27th Street quite 110 Old Chamber Bld
Billings MT 59101
259-2101/Phone
248-4770/Fax
ON-PREMISES
LIQUOR LICENSE APPLICATION
(I,.CCILides Restaurant Beer. Wine License)
Check appropriate boxes:
I. Business Entity
Side Iholn ietnr IOne Indlrldual l
XJ ( orporullo)
C then
Return to: PKT 532
Montana Department of Revenue
Customer Intake
Liquor Licensing
P.O. Box 1712
Helena, MT 591
Section 1: Entity/Transaction
3. License Type,/Fec
O On-PRn1LJe facer - 5:141 on II' Neat )
O On-Premi..e Beervq'ine - S1on pit (It Nc as I
AII-13cecr,;,, - Satn.omS i,,u.110111 Nra l
Depending un location :Ind I... liun 1
O Add ('alcring Fndorsemnll -.Sec Sectlm
O Processing Fee - SF Olj rAII)
ATTACH ADDITIONAL PAGES IF MORE SPACE IS NEEDED ZING
2. Transaction
Xna 1-ieen,e
Y7 frnmfer-Licrnar#aq_o4l n1
?Uo ncrshga O nil
n I nca6on
'TRUCTIONS FOR COMPLETING APPLICAN SNuction AME 2: General Information
• If sole o"nership (one individual) list individuals' name.
• If a corporation, list corporate name and all stock holders owing 10% or more of the total stock (attach currenr corporate staremen, i nd i'rri!1cu lr
OF Existence or Authority to Do Business in Montana ) IN('1-L;DrS S-CORP & C-CORP.
• If other...
- more than one Individual, list all individuals names
SU RCh ORSHIP and indicate if license will he held as-JOINT TENANTS NN 11-11
or as TENANTS IN C-OMfrION
RICIITS OP
- If a partnership, list partnership name and all individual partners' names-attach copy of the
Fact, or a CcrtrFcatc of Reei=rration ('crtificate of IJmiied P:utner.hip.
- If LLC or LLP. list LLC'LL.P name and all members' names - attach a ( erlllealL of
Cumc of 'apph...!,Sl
\sn!c n;Pcrson :\fanavin,.
cops of the Certificate nF I-,,,
Fin\aC6-528-875y Business 7clcpltone,NuLA R7A3
Vederal ax 1
O T'ES '_ \i CI Pms-Idcd Personal fiistor)' & Releasco(Informaliun forms furcach indivrduallC)partner- 811-0404999
Palace Bar & Lanes ?srockholdcr, mcmhtt and m:m.ucr
Businessifradc .game
Mailing Address- 4D5 FA?+ fif_ _
City, State, zip Laurel, MT 590114
4. Address of the premise to he licensed, if different from the mailing address. (IVE EXACT LOCATION OF PREMISES, including a siren
and number. If there Is no street and number, provide a detailed narrative description of the location.
City
Are the pre m.... for Ireensing located: State
29 'A thin the boundaries of in incorporated citytoan Zip Code
? Within a distance OF 5 miles of in incorporated city I
O `,''thin an unincorporated city town OR Outside the boundaries of and more than 5 mdcs diel:rncc
from any city/town whether incorporated or unincorporated
Are the entrance doors of the premises proposed for licensing on the same street and within 600 feel of a building occupied esdnstl'ely as a church.
i5mfeo_ uc ur uthel, place of taorhlp or school"
O 1'ES 29 NO
Arc the larenncea w shin and dcfinc,f ionce a here its county mdm,mces prohibit the site of alcohoirc berero Gcs"' O ES f7 NO
Arc all appl!c?nr,, p,Irtncrs- mcml•cre or L1^„ Dr more shareholder-, Montana Residents, qualified to soto in a state clecnrnt:' M 1.ES ?7 V'11
9. Does the app!tnmt n,vn the building proposed for licensing,
?.1 e FS If Yes, provide evidence of ownership, i.e.. tax statement or deed (include any other associated or related documents).
I \0 - It \o. provide a current or proposed lease, rental or current or proposed purchase agreement showing the applicant has authonr. to operate to
this locanon. including any other associated or relaicel documerns.
L. Is the building ready for use loran alcoholic bevera°e business, (FOR NF W CONSTRUCTED PREMISES) O YES ? NO
If NO. ilia icale an estimated date of occupancy'
! 1V] I! }nu be remodeling the premise, (FOR EXISTING BL ILDINGS) O YES rl NO
IN mdtcate an est i muted date of completion
?. Sl'13NII I COPT' OF FLOOR PLAN OFAREA TO BE LICENSED. FLOOR PLAN NIL'SI HE i'0 SC.U.E, INCLUDE EXTERNAI.
DUIF.NSiONS AND GENERAL LAYOUT- PREFERABLY ON AN 8 1i2" X 1 I" SHEET OF PAPER.
I'. Do you or any members of the applicants immediate family (i.e. spouse, dependent children or dependent parenrs) have a financial or ms nership
;nMv,t in any other establishment licensed for the sale of alcoholic beverages" OYES ENO (If YES. hst person, license number and
business [rude name)
NA\IE LICENSE NUMBER BUSINESS TRADE NAME
i Drr: the mdi%,dual or ind:•. ;duals that comprise the applic:inl or my member of the applie.!Il : immediate fum?l„ h V c apv friancing from or am.
all,'[ Iclaonhtoorsah;p ntu is) fac[urcr. boob: r, or distributor of alcohol bevcr
„ hat rc ngc .' O S ES )ONO (If Y'ES its: oafnc bc!o v and gt,e hnM'cy:lunat;un of
-
NAME.
E\PL%NA
ADDRESS
!he uidt.lanai or m:dn )IlualS that comprise the applicant hale any financial nr ownership interest m a 1,:tjil Liquor Store ES
N \ME
ADDRESS
F\PI
G Do in) ' person; or entities, other than those listed in Section 2 ( I ), have any financial or ownership interest in. derive income from, or have liabilities
as.octatcd with the business proposed for licensing? (This could include, but is not limited to, any person or entity as ho has a right or oblication
associated with an alcoholic beverage business (including. but not limited to assignees, landlords, etc.) Or to whom any interest has been pledged as
security G)t the performance of a contract or sale related to the business proposed for licensing) 0 YES NNO
NAME
EXPLA
%II 9c,erage:
ADDRESS
Section 3: Catering
Do yon xish to add a catering endorsement to the all•ateoltolic hansrege Ircense, OYES \'O
If Y'F.S. an additional S35000 fee moat aecompanv this appticmioo.
f in.I'ram6ec (nit ,nmplion Iker k wine:
Drs you n'ish m add a eatering endonentem in the beer, ker & ,tine licni.,c'f
If SFA.lit additional SYXI oil fee most,Ccoo,p,op Ihi% appticmiun. OYES ?'1 SO
hu!icn"e arc pncmagc or "'fall sales or an'cip¢'cd sate for cad' of the folimvinp:
_'•- ulc of fw,d sale if inter _ Salle of ,cone
Section 4: Wine Amendment for On-premises Beer License
Do you operate a restaurant or food prepared business as defined below ? O YES ONO
Do you have a minimum of 12 scats at tables or booths? ? YES O NO NIA
• "Restaurant" means a public eating establishment allowing for seated service fora minimum of 12 persons at tables or booths where the sale of food
is prepared on site. A "Prepared Food Business", means a restaurant, except the food need not be prepared on site.
• Submit a copy of your menu with this application. Food must be served to qualify for the wine amendment.
Section 5: Temporary Authority
Temporary Authority' CANNOT be granted on a transfer of location or issuance of a new license.
The undersigned applicant, requests authority to operate pending final approval of the transfer. The undersigned ugre is that during the period of
temporary operating authority. the applicant shall be responsible for all alcoholic beverages purchased pursuant to Section 16-3-243. MCA (the set cn-day
credit ]initiation). I realize temporary authority will be immediately revoked if my employees or I oiolale am pro%isions ol'Ti le 16. MCA or the
department rules.
I would like temporary authority issued by (UATE).
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TO BE COMPLETED BY RECORDED OWNER/CURRENT LICENSEE
I DO / DO NOT(circle one) aulhonzcd Temporary Operating Authority be granted to the applicant by Liquor Licensing, pending final appro\ al I
understand the heart may not operate until Temporary Authority has been granted. I understand Section 42.12.208, Adntinistrntice Rulc; of Vr.nc:no.
states in pa thVn
p ropos7,14 suspension. or resocation arising ou! of a violation will be assessed against and is' the responsibility of the re: udrd
mvncr o e. - Z1 a
g o T.
Signature of Recorded Owner+Current Licensee Date
Section 6: Notice To Applicants
In order l1for P4mu;nrg check a ck k sheet et to be considered complete you
she accwnpan must include all associated or related documents as indicated b }our specific circumsianm in
y.
Section 7: Declaration and Affidavit
NO I F. Section 6-4.206 MCA, nroctdes "upon proof that am'
s: applicant made false olulemenl in any earl ?rl the appl¢annn, the a
,I ;ma ! hr limn>< m he re, irked " PPhca;e :n liar ha"nse rte: i,c Jc m:'d. amt
e s 'tied
and slat, ;heo bile by a!I oldie, k. partners or memhers or IF C. In the ca%e ula cmporalc a hcan, aY he si 6 ned by one Pp n mn ,
.\ppl supon nmst h citer her. with au,hnr, ., ..c,;
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