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Home My WebLink AboutMT Dept of Revenue Beer LicenseDan Bucks Director July 28, 2005 Montana De artment of Revenue Brian Schweitzer Gavernor RE: Application for Transfer of Location of Montana Retail On-Premises Consumption Restaurant BeerNVine License No. 03-044-9490-301, TIN HORN CASINO (formerly Little Big Men Pizza), 413 4th Street S.E., Suite A/B, Laurel, Yellowstone County, Montana NEWLY LICENSED PREMISES The above referenced application was received at the Department of Revenue, Liquor 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. This is an application for a premises not currently licensed for the consumption of alcohol. Building, health and fire approval will be required before department approval will be considered. If any agency determines deficiencies exist that should be considered in the issuance of this license, please advise this office in writing by August 29, 2005. 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. In addition, if we receive a written protest against the issuance of this license, a public hearing will be scheduled. If you have questions, please call me at (406)444-0710 or fax me at (406)444-0722. ~ely, ,~fi~/~ Compliance Specialist Liquor Licensing P O Box 1712 Helena MT 59604-1712 , c: Annette Rinehart, Department of Labor & Industry Customer Service (406) 444-6900 · TDD 1406) 444-2830 · www.mt.gov/revenue CERTIFICATE OF SERVICE I certify that on this ¢,~¢¢~'day of ~-~ ,2005, a true and correct copy of tahnedf~rdedgr~isnsge~laaSsbfeo~l(~wS sated by pl~ng(~ame in the United States mail, postage prepaid, 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 YELLOWSTONE COUNTY SANITARIAN BOX 35O33 BILLINGS MT 59107 YELLOWSTONE COUNTY TREASURERS OFFICE P O BOX 35010 BILLINGS MT 59107-5010 ADMINISTRATIVE ASSISTANT FIRE PREVENTION AND INVESTIGATION BUREAU 303 NORTH ROBERTS BOX 201417 HELENA MT 59620-1417 Dan Bucks Director Montana Department of Revenue Brian Schweitzer Governor June 13, 2005 Curtis G. Riemann PO Box 575 Laurel MT 59044 RE: Request for Temporary Authority for License No. 03-044-9490-301, TIN HORN OASINO, 413 4th Street S. E., Suite A/B, Laurel, Yellowstone Ooun~, Montnnn Dear Mr. Riemann: Your request for temporary authority in regards to the above-reference liquor license is denied. Temporary authority cannot be granted when a liquor license is being transferred to a new location. You may continue to purchase and sell beer and wine at the currently licensed location (220 Avenue South). However, you cannot purchase or sell beer and wine at the 413 4th Street S.E., Suite A/B location until your application for a transfer of location has been approved by the Deparbment of Revenue. Should you have any questions, please call me. Sincerely, W. Scott Payton Compliance Specialist Liquor Licensing PO Box 1712 Helena MT 59604-1712 Phone: 406/444-0710 Fax: 406/444-0722 E-Mail: scpaytonC, mt.flov. c: ~Jeff Bryson, Chief investigation Bureau Alcoholic and Tobacco Tax and Trade Bureau Montana Beer & Wine Wholesalers Association Montana Tavern Association Customer Service (406) 444-6900 & TDD (406) 444-2830 · www.mt.gov/revenue Check The Appropriate Boxes To Designate The Purpose Of This Application Alcoholic Beverage Designate The Type Of License Of Your Application: [] New Alcoholic Beverage License Application [] On-Premises Beer [] Existing Alcoholic Beverage License; Transfer Of OwnersbipApplication N~'On-Premises Beer/VVine [] Existing Alcoholic Beverage License; Corporate Structure Change ~qAII-Beverage ,~'Existing Alcoholic Beverage License; Transfer Of LocationApplication [] Restaurant Beer/Wine [] Existing Alcoholic Beverage License; Death of Licensee [] Resort License Gambling [] New Gambling (An owner of an interest in a licensed gambling operation may not transfer an interest in the operation to a stranger to the license until a new gambling license application reflecting the proposed transfer is submitted to the department and the depadment approves the transfer.) [] New Gambling - No Alcoholic Beverage License is Required for Live Keno/Bingo. [~ Amended Gambling License Application - (,Note: No fee is required for this application) (An ownership interest in a licensed gambling operation may not be transferred to another owner or group of owners of an interest or interests in the same licensed gambling operation without submitting an amended gambling license application to the department and obtaining department approval,) [] Existing Gambling License Change Among Existing Corporate SharehoLder(s) [] Existing Gambling License Change Among Existing Partners or LLC/LLP Members [] Existing Gembiing License Deletion of Owner(s) I~ Ex st ng GamDhng Location ChangeApplication [] Existing Gambling License Type Change Application [] Other - (Explain) Name of Applicant: '~'~ Business/Trade Name: Mailing Address: Address of Premise to be Licensed: General Information R CEIVED BY JUN I ? 2005 (Sole ProprietodPartnershipslCorp./LLCll~LP) (Doing business es .....) (Box or Street) City / State / Zip Code: Business Phone / Cell Phone: Fax: Federal Tax I.D.: ~10~1 Alcohol Beverage License Number: (Street, Suite No., Building No.) Business Cell [] Check if applied for but not yet received, (N/A if not applicable) Are the premises for licensing located: J~'Within the boundaries of an incorporated city/town (Gambling Licensing.) ~ Within a dis(ance of five miles of an incorporated city/town (Liquor Licensing.) [] Within an unincorporated city/town or outside the boundaries of and more than five miles distanc6 from any city/town whether incorporated or unincorporated (Liquor Licensing.) City Name ~ County Name 2 A. The applicant is a: [] [] Ownership Information Check appropriate box individual(s) / Sole Proprietor(s); List all owners in Section ]1, Subsection "C." Partnership; List all general and Limited Partners in Section II, Subsection "C." (Attach copy of Partnership Agreement: Newly Formed Partnerships-Copy of Application/Certificate for Registration of the Partnership filed with Sec. of State's Office, Existing Partnerships - Copy of Renewal of Partnership filed with Sec. of State's Office and Release of Information, (Form 1 ), in the partnership name.) [] General [] Limited Limited Liability Company, List of members in Section II, Subsection "C." (Attach a copy of the Articles of Organization as filed with the Montana Secretary of State's Office; organization minutes; a copy of the Certificate of Fact; and other member agreements and an Authorization for Examination and Release of Information, (Form 1 ), in the Company's name.) Charitable or Non-profit Organization qualified under 26 U.S.C 50t (c)(3), (c)(4), (c)(8) or (c)(19); List all officers/ directors and gambling managers in Section fi, Subsection "C." (Attach a copy of IRS Letter of Non-profit designation and an Authorization for Examination and Release of Information, (Form 3), in the non-profit organization name.) If applicant is a charitable, religious, veterans'or fraternal organization, when are new officers elected? Date: Retirement home or nursing home. List all officers/directors and gambling managers in Section il, Subsection ~C.~ Corporation; List all shareholders, officers/directors) in Section 11, Subsection "C." (Attach copy of Articles of incorporation, By Laws. Certificate of incorporation; Certificate of Existence or Authority to do Business in Montana; all organizational minutes; share issuance records; copies of share certificates and an Authorization for Examination and Release of Information, (Form 1 ), in the corporate name.) Check Type of Corporation: [] C Corporation ~ Subchapter S [] Publicly Held (Registered with the Securities & Exchange Commission and Traded on a National Stock Exchange) State in which incorporated: ~1~ Om+A,. ~. Date ~ncorporated: ~s the corporation registered with the Montana Secretary of State to do business in Montana? ~'Yes [] No [] N/A ~s the corporation in good standing with the Secretary of State? [] No If No, explain: identify address where corporate organization records are maintained. Management ~nformation B. Provide the following information for each management employee. Attach management agreement if applicable: [] Gambling [] Alcoholic Beverage 1~ Both [] N/A Note: Each individual listed above must submit with this application a personal history statement, Form 10, Authorization for Examination and Release of Information (Form 1 ) and a completed Fingerprint Card. 3 C.~ovide the information requested below for each: [] Individual/Sole Proprietor [] General or [] Limited Partnership [] Limited Liability Company (Member of...) ~ Officer of a Corporation D Director of a Corporation [] Shareholder of a Corporation [] Shareholder owning 5% or more of the stock of a publicly traded corporation [] Person(s) and/or committee managing the gambling activity under a 26 U.S.C. 501 (c)(3), (c)(4),)(8) or (c)(19) organization Check appropriate box (Use additional paper if necessary) [] Person(s) holding an option t0 purchase the business or any interest in the business [] Other Check this box if ownership in the liquor license is also held as Joint Tenants with Rights of Survivorship (JTROS)) or Tenants in Common (TEN COM) and make certain each individual with rights of survivorship or common are listed below. JTROS ;~' orTEN COM Note: Each individual, sted above mu~, subm tw th tbs app cat one personal his,o~ statement, (Form ~ 0). Author ~:;:,or i atior and Release of Information. (Form 1.) and a completed FinoerDdnt Card. Use additional sheet of DeBar if nec ri( applying for an Alcoholic Beverage License, answer the following question: ! ~ > Are all applicants, partners, members or 10% or more shareholders Montana Residents, qualified to vote in a state election? L ~"Yes [] No D. Charitable, Religious, Veterans' or Fraternal Organization If the applicant is a charitable, religious, veterans' or fraternal organization, complete the following information. If not applicable indicate: ,~ N/A > Data quail(led for exemption under 26 U.S.C. 501 (c)(3), (c)(4), (c)(8) or (c)(19): Month Day Year > Date local charter issued or post organized: Month Day Year > Has national organization been in existence for a period of five years prior to January 1,194S? [] Yes [] No >' Provide Address of National Headquarters: (Street Address) / (City) (State) A copy of your organization or post charter must accompany this application. Location of Gambling Premises: (Zip) (Street Address) / (City) (State) How many days, per year, is gambling conducted et this location? __ Days. (zip) Premises Information A. Does the applicant's premises: (Use additional paper if necessary) 1. Have permanently installed walls extending from floor to ceiling? ~Yes []No , 2. Havea distinct address? ~!~,Yes [] No 3. Share an address with another business? [~'Yes [] No % 4. Have a public external entrance that is not shared with another premises for which a gambling operator license has been issued? [] Yes ,~No 5. Share a common internal wall with another premises to which a gambling operator license has been issued? _ ~...,.~...~]~ No If Yes, explain and submit copy of the floor plan, B. Describe where the premises is located: 1. Are the entrance doors of the premises proposed for licensing on the same street and within 600 feet of the entrance doors of a building occupied exclusively as a church, synagogue or other place of worship or school (except a commercially operated or post secondary school)? [] Yes ~ No 2. Is the premises located within 150 feet of another premises licensed for on-premises alcoholic beverage consumption? (As defined in 23-5-629 MCA) [] Yes ~No Ifyes, answerallthefollowing questions: [] Yes [] Yes [] Yes [] Yes [] Yes [] Yes [] Yes [] Yes [] Yes [] No Does the second premises already have a permit for placement of video gambling machines? [] No 'Is there a structure[ walkway between the two premises? [] No Is the second premises licensee affiliated with the applicant? [] No Is there an immediate family member related to the applicant within the ownership structure of the second premises licensee? [] No Do the two licensed premises share any common management personnel? [] No Would the applicant be considered a parent or subsidiary business entity to the second licensee? [] No Does any person or entity within the ownership structure of the applicant share a commonality of business interest with any other person or entity within the ownership structure of the second licensee? [] No Are there any contractual agreements or financing agreements between the applicant and the second licensee? [] No Are there any investors common to the applicant and the second licensee? 12 C. Is the premises within any defined zones: 1. Where the sale of alcoholic beverages is prohibited by city or county ordinance? 2.Where gambling is prohibited by city or county ordinance? ~ Yes ~'No D, Is the building ready for use for an alcoholic beverage business: 1. For a new constructed premises? U Yes ~ No If No, indicate an estimated date of occupancy 2. For remodelof existing building? ~ Yes ~ No lfYes, indicate an estimated date of completion E. Submit a copy of the floor plan area to be licensed, using approximate dimensional measurements, including external dimensions and general layout - preferably on an 8-I12" x 1f" sheet of paper and number of tables and chairs indicated. ]f you are applying for a restaurant beer and wine license, be sure the floor plan has the service bar area clearly designated thereon. Note: On the floor plan you will need to clearly mark the areas where alcohol will be served, stored and consumed. The floor plan must contain outside dimensions, the name of the establishment, physical address, liquor license number (if applicable} and date of submittal. t.I Declaration and Affidavit I declare under the penalties of false swearing and/or the revocation of any licenses granted pursu~b~eret~, that I am the applicant or duly authorized representative of the firm or corporation mailing this application and that I exa~'~:..d the application, including any accompanying information, and that the responses are true, correct and complete. I understa~?~j?is appiicaIion or attachment(s) con[a/ns false information, I am subject to the criminal penalties of Section 45-7-202, 45-7-20~P~nd 45-7-208 Montana Code Annotated, and/or revocation of any alcoholic beverage or gambling licenses granted pursuant to this application. STATE OF MONTANA ) County of L~;¢i~:;r~¢~-~o~-~_ ) ) , being duly sworn, if for himself or herself, deposes and says, and that he/she is the applicant above named; or that he/she is of the above named corporation; that he/she has read the foregoing application and attachments end that he/she knows the contents thereof, and that all matters and things therein set forth are true and corr~d[7) Print Full Name Signature Date On this /.~-I~' dayof Personally appeared ~.~-4,'S t'~,-e~,-~,r,¢ ~r:se a~blic.for the State of My Commission Expires 2005~ (Notary Signature) (Print Name of Notary) (Month, Day & Four Digit Year) This application must be completed in full, and all requested attachments must accompany it. Delay, denial or the return o~ the application will result if incomplete. Additional Information May Be Required During the Investigation of Your License Application West l Tin Hor~ Casino Laurel, MT Fl9o~!0?n