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Home My WebLink AboutMT D of Rev - Shotgun WilliesDan Bucks Director November 4, 2005 Montana Department o! i~j~ ~.i~_ ~ ~ IJ~ L/',,UREL RE: Application for Transfer of Ownership of Montana Retail On- Promises Consumption Beer/Wine License No. 03-044-9569.301, SHOTGUN WILLIES, 3422 South Frontage Rd, Laurel, Yellowstone County, Montana 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 promises 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 any agency determines deficiencies exist that should be considered in the issuance of this license, please advise this office in writing by December 4, 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 no response is received, it will be assumed them am no problems that would affect the issuance of a license. If you have any questions, please call 444-0713. Compliance Specialist Liquor Licensing P O Box 1712 Helena MT 59604-1712 C: Annette Rinehart, Department of Labor & Industry 'Deanna Uithof, Food and Consumer Safety Customer Service (406) 444-6900 · TDD (406) 444-2830 · www,mt.gov/revenue CERTIFICATE OF SERVICE 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 YELLOWSTONE COUNTY SANITARIAN BOX 35033 BILLINGS MT 59107 YELLOWSTONE COUNTY TREASURERS OFFICE P O BOX 35O1O BILLINGS MT 59107-5010 ADMINISTRATIVE ASSISTANT FIRE PREVENTION AND INVESTIGATION BUREAU 303 NORTH ROBERTS BOX 201417 HELENA MT 59620-1417 SEP, 29.2005 8:LAM GAMBLING C011TA,DL DIV State of Montana AlCoholic Beverage/Gambling Operator Combined License Application 1. Gamblfeg Operator Licenses Gambling Licensing Fee Schedules RECEIVED BY SEP ~ $ 7.005 Proce'=slsg fee: SGO if the sppltcent is e nonprofit o~~OL 80~ ~ the applican[ is a ~le prop~e~'~p; or 1,000 ~e applles~ i;; ~dnership or corporation. ~0,6078 P, 15 Office Use Only Ucenee No.: Fee Paid: Additiortel Fees: Refund: 09-28-05A10:04 RCVD Note: A new gambling oparater Iicensee application is subject to a processing fee to cover the actual cost of conducting a background investigalion to determine whe{her an applicant qualifies ~or licensure. Based on the aciual costincurred by the Gambling Control DMsion in processing the license, the division will refund any overpayment of the fee or collect an amount sufficient to reimburse the division Ibr any underpayment of actual costs. The Division will provide Jhe applicant with an itemized accounting of expensas. ~ Alcoholic Beverage office Use Only 2. Alcoholic Beverage Licenses Processing Fee: $200 (AIIApplications) Check all appropriate boxes below: 3. Liquor Uaense Fee Liquor License [] On-PremiSe Beer- $200 (If new) [] On-Premise Bee~,&rme - $400 (if neW) [] NI-Beverage - $400-$800 C[f new and depending on location and popul~i0n) Fee Schedules $: RestaurarK Beer/Wine [] Annual License Fee- $400 [] Sesflng of 60 or lees- $5.000 [] Seeting of 61 ~10D [] Seat~gof 101 ormore-$20,000 National Fraternal Organizations [] Or~PmmtSe Beer- $200 [] Or,-Premise I~eerNV'~e - $400 r~ Ali-Beverage - $400 to $800 (c~epending on Ioca~n and population) $. Secured Party [] Sacurecl Path/Addition - $20 [] Seeursd Party Termination - St 0 Nationally Chartered Veterans Organizations [] On-Premise [] O~-Premise [~eer/V~ne - S250 [] All-Beverage-S250 to $650 (depending on focetion and 4. Catering Endomement [] Cetedng ($200 beer/wine and $250 all beverage) License No.: Check No.: Fee Paid: Additional Fees: Refund: Resort License [] AIFBeveraGeAnnuaJ [] Ali-Beverage Original Licensee Fee- $20,000 Golf Course Beer/Wine [] Annual License Fee - $4DD D IniaalApptication Fee-$~_0,000(For Profit Entities only) · Enter the amount due from the corresponding schedules abov..~ 1,GamblingLicensePmcessngFee $ , ~o~o Ib~O' 2. Alcoholic Beverage Processing Fee $ 200 3. Liquor License Fee $ 0 4. Catering Endorsement 5. RBWSeating Fee 6. Secured Party Total Make payment payable to the "Gambling Control Division'~ I SEP-~9-E005 08:~3RM FRX:4064449157 ID:DEPT OF REUENUE PRGE:015 R=95x SEP. 29.20(15 8:2 AM GAMBLING CONT ,OL BIV NO. 6078 P. 16 Cheek The Appr~,fiate Boxes To Designate The Purpose Of This Application Mcoholic Beverage Designate The Type Of License Of Your Appticatior [] NewAIcehoiic Beverage LicenseApplicaL[on D On-Premises Beer li~ Existing Alcoholic Beverage License; Transfer Of OwnemNpApplica~on E~ On-P remises Beer/Wine [3 Existing Alcoholic Beverage License; Corporate Structu re Change [] PdI-Beverage [] E×i~ng Alcoholic Beverage License; Transfer Of Loc~tbn Application D Reste urant. Beer/wine [] ExistingAJcoholic 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 e new gambling license application reflecting the proposed transfer is submitted to the department and the department approves the transfer.) [] New Gambling - No Alcoholic Beverage ~cense Is Requi~ed for Live Keno/Binge. r3 Ams nded Gambling License Application - {.~_g..t.~ No fee is required for this application) (An ownemhip interest in a licensed gambling operation may not be transferred to aha[her owner or group of owners el~an interest or int~ in ~e ~me licensed gambling operation without submi~ing an amended gambling license application to the department and obtaining department approval.) [] Existing Gambling License Change Among Existing Corporate Shareholder(a) [] Existing Gambling License ChangeAmong Existing Partners or LLCILLP Members [] E~s§ng Gambling License Deletion of Owner(a) r'l Ex, sting Gambting Location ChangeAppticafion [] ExisLing Gamhlhlg License Type ChangeApplication [] O~heF - (Explain) Print Or Type Name of Applicant: Business/Trade Name: Mailing Address: General Information Carran(~o, (Sole Prop~etor/Part nemhips/Corp.lLLC/LLP) Shotgun Willies (Doing business aa .....) 303 Emerald Drive; Billings, MT ~9~OB (aox or Street) 3422 South Frontage Rd Address ~ Premise fo be Licensed: City I Slam I Zip Coda: Business Phnne / Cell Phone: Fax: Federal Tax I.D.; Alcohol Beverage Lisense Number: [ ) (S~eet. Suite No., Building No.) Billings ! 62G,-291G Business Are the premises for licensing Iocst~: MT / 59044 ) Cell [] Check if applied for but not yet received. 03-044-95~9G0l (N/A if not applicable) [] Within the boundaries elan incorpor~ted city/lawn (Gambling Licensing.) E~ Within a distance of five miles of an incorporated c~itewn (Liquor Licensing,) [] Within an unincorporated city/town or autsicle the boundaries of and more than fi~ miles distance from any city/lawn whether Jncerporeted or unincorporated (UquorLicenaing.) Laurel in Coun.ty of Yellowstone City Name Count~ l~arne 2 SEP-29-~005 08:23AM FAX:4064449157 ID:DEPT OF REVENUE PAGE:O10 R=95~ SEP, 29.2005 8:24AM C. Provide ~a Information ~quested aelow',~or each: [3 Individu~o~ Pmpfi~r ~ Gene~ or ~ Limited P~An~rship ~ Um~ Lisbili~ Company [Member ~...) ~ Offi~ ~ a Co~omtion ~ Dim~or of a Co~om~on ~ Shareholder o~ e Co~omfion D Shareholder ~ing ~A or mom ~ ~e slo~ of a pubady Vaded ~ P~ofl(s) a~/or ~mm~ee manqi~ the ~bling GAMBLING COI~TqOL DIV ~JO. 6078 P, 17 Check appropriate box (Use additlonal paper if necessary) Person(s) holding an option to pur~heca the business or any interest in the business g O[her [] Check this box if ownership in the liquor license is held as Joint Tenants with Rights of Survivorship or Tortonis in Common (TEN CQM1 a~d make certain each individual with dQhts of survivomhip or common are listed betow. JTROS FI ofTEN COM I'1 organizalion Louis J. C, srranco Drive; 303 Emerald Drk, e; Bias President 8/4/43 517-46-1707 1D0% 100 (JTROS) Note: Each indi~dual listed above mt~st submit with ~ia application a personal hieto~ statement, (Fo~m 10), Authod2~t[on for Examination and Re)ease cf In¢ormetion, (Foal 1.} and a completed Fingerprint Card. Use additional sheet ~ paper if necessary. Fir applying for an Atcoholic Beverage License, answer the following question: / ! ), Ate all applicants, padnem, members or 10% or more shareheldem Montana Residents, qualified to vote in a state eleven? [ [] Yes E~ No D. Charltable, ReligiOUs, Veteran~'orFm~rnat Organi;~a'~on If the applicant is a charitable, religious, veterans' or fraternal orga~a§on, complete the following informalion. It not applicable InUlcete; [] ~ Date qualified for exemption under 2~ U.$.C. 501 (eX$). (c)(4-), (c)(8) or Menlh Day Year ~- Date local charter issued or p~-~ organ~.ed: Month Day Year ~- Has notional orger, lzatlen been in axiatenc, e f~r a peHm:l ef five years prig[to DYes [] No ~ I~,ovide Addreas of Nationa] HeaJlqaai'~m: Address) I (City) (State) A copy of your organization ~' post charter muSt accompany thi~ application. Location of Gambling Premises: ~p) (Sltee~ Address) I (City) (6'fate) How many days, per year, ie gambling cendu~.--ted at this [ecation? Days, (Zip) SEP-8S-8005 08:84RM FP~(:4064449157 ID:DEPT OF REUEHUE PRGE:O17 R=95~. Is the premises within any defined zones: 1. Where the sale of alcoholic beverages is prohibited by city or county ordinance? [] Yes [] No 2. Where gambling is prohibited by city or county ordinance? []Yes []No D. is the building ready for use for an alcoholic beverage business: l. For a newconstructed premises? [] Yes [] No If No, indicate an estimated date of occupancy 2. For remodel of existing building? [] Yes [] No IfYes, indicate an estimated date of completion I~Yes r'lNo 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 8-1/2" x '11" sheet of paper and number of tables and chairs indicated. If you are applying for a restaurant beer and wine license, be Sure the floor plan has the se~ice 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 ofthe establishment, physical address, liquor license number (if applicable) and date of submittal. : SEP. 29, 2C05 8:24A~ GAk~BLING CONTqOL DI¥ NO. 6078 P. 20 Declaration and Arid avit I declare under the penalties of false swearing anchor the revocation of any [[canse~ granted pursuant hereto, that I am the applicantorduly authorized representative or,he firm or corpora~on mailing this application and that I examined the application, including any accompanying information, and ~at the Fesponsea are Due, correc~ and complete. I understand if b'qis appllsatien orattachment(s) contains false information, I am subject to the r~minat penalties of Section 45-7-202, 45-7-203 end 4§-7-208, Montana C~e AnnoL~[~d, end/or revocation of any alcoholic beverage or gambling licenses granted pursuant to ~his application. STATE OF MONTANA County of Yellowstone Louis J Carran~o , , being duly swam, if for himself or hareelf, deposes and says~ and that hetahe i~ the applicant above named: ~ ~ be/she is ~d~t , of the a hove named corporaUon; that h~she has read the foregoing applio~on and a~h~n~ and ~t he/she kno~ ~e con.~ thereof, and .at all ma~ and .ings ~e~~ .e ~d --t--~ ~J~ PHnt Full Nam~ ? .... ~ign~m Da~ " This application must be completed in full, and all requested attachments mum accompany if- Delay, denial ortho return ortho application will result if incomplete, SEP-29-~.O05 08:24AM Additional Information Ma~, Be Required During the Investigation of Your License Application lB FAX:4064449157 ID:DEPT OF REVENUE PAGE:020 R=95~ ~00~ 8 ~ d3S 0 ~