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HomeMy WebLinkAboutDepartment of Revenue - Alcohol LicenseDan Bucks Director Montana Department of Revenue February 4, 2009 F E B e cos CITY OF LAUREL 0 Brian Schw6itzer Governor RE: Application for Transfer of Ownership of Montana All-Alcoholic Beverages License No. 03-044-9140-001, LUCKY LOUIE'S TAVERN & CASINO (formerly LAUREL BOARD OF TRADE), 117 % East Main. 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 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 gny agency determines deficiencies exist that should be considered in the issuance of this license, please advise this office in writing by March 5, 2009. 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 any questions, please call (406) 444-0713. Sincerely, Tanya Stelzer Compliance Specialist Department of Revenue Liquor Licensing P O Box 1712 Helena MT 59624-1712 cc: Department of Labor and Industry Customer Service (406) 444-6900 A TDD (406) 444-2830 A www.mt.gov/revenue CERTIFICATE OF SERVICE certify that on this day of , 2009, 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 YELLOWSTONE COUNTY SANITARIAN BOX 35033 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 201415 HELENA MT 59620-1417 a?? Check the Appropriate Boxes to Designate the Purpose of this Application Alcoholic Beverage Designate the Type of License ® New Alcoholic Beverage License Application of Your Application: Existing Alcoholic Beverage License; Transfer of Ownership Application 0 On-Premises Beer C3 Existing Alcoholic Beverage License; Corporate Structure Change ® On-Premises Beer/Wine 0 Existing Alcoholic Beverage License; Transfer of Location Application ® AII-Beverage ® Existing Alcoholic Beverage License; Death of Licensee © Restaurant BeerMine ® Resort License Gambling An ownership 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 department approves the transfer. 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. ® New Gambling ® New Gambling - No Alcoholic Beverage License Is Required for Live Keno/Bingo. ®Amended Gambling License Application-(Note; No fee is required for this application) © Existing Gambling License Change Among Existing ® Existing Gambling License Deletion of Owner(s) Corporate Shareholder(s) ® Existing Gambling Location Change Application ® Existing Gambling License Change Among Existing ® Existing Gambling License Type Change Application Partners or LLC/LLP Members [3 Other (Explain) General Information Print or Type Name of Applicant Tavern Partners, Inc. (Owning entity such as Sale Propdator/Partnerships/CorpJLLC/LLP) Business/Trade Name Lucky Louie's Tavern & Casino (An assumed business name must be flied with the Secretary of State and verification provided.) Mailing Address P.O. Box 39 1171/2 East Main Address of Premises to be City Laurel Business Phone ( 406 ) 6284721 Fax ( ) Federal Tax I.D. Number 26-3854655 (P.O. Box or Street) (Street, Suite No., Building No.) state MT Cell Phone Alcohol Beverage License Number 03 -044 JAN o 3 2oo9 GULING ?GNTAGL DIVNION zip 69044 in Check Ifapplied for but not yet received. 9140 _ 001 (N/A if not applicable) Are the premises for licensing located: ® Within the boundaries of an incorporated city/town (Gambling Licensing.) © Within a distance of five miles of an incorporated city/town (Alcoholic Beverage Licensing.) El Within an unincorporated city/town or outside the boundaries of and more than five miles distance from any city/town whether incorporated or unincorporated (Alcoholic Beverage Licensing.) . Laurel City Name in County of Yellowstone County Name C. Provide the Information requested below for each: 13 13 13 13 13 13 Individual/Sole Proprietor General or ® Limited Partnership Limited Liability Company (Member of... Officer of a Corporation Director of a Corporation Check appropriate box (Use additional paper If necessary) ® Person(s) holding an option to purchase the business or any interest in the business 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 Name (First, M.I., Last) Louis J. Carranco Date of Birth 12/29/1934 Social Security No. Address 2233 InterLachen, Billings, MT 59105 516-38-3469 Name (First, M.I., Last) John D. Johnson Date of Birth 09/19/1957 Social Security No. 520-70-1122 Title President Number of Shares 333.33 Percentage of Ownership 33.33% Title- Vice President Number of Shares 333.33 Address 1745 Lynnwood Place, Casper, WY 82604 - Percentage of Ownership 33.33% Name (First, M.I., Last) Richard J. Fairservis `litre Secretary/Treasurer Date of Birth 01/27/1954 Social Security No. 520-62-6114 Number of Shares 333.33 Address 5800 S. Cedar Street, Casper, WY 82601 Percentage of Ownership 33% Note: Each individual listed above must submit with this application a PersonaUCriminal History Statement (Form 10) and a completed Fingerprint Card and fee. Use additional sheet of paper if necessary. I hereby request smoking exception and affirm that 60% of the revenue generated by this business will be from the sale of alcoholic beverages and/or gambling. ® Yes I do not request smoking exception. ® No D. Charitable, Religious, Veterans' or Fraternal Organization If the applicant is a charitable, religious, veterans' or fratemal organization, complete the following information. If not applicable indicate: ® N/A Date qualified for exemption under 26 U.S.C. 501 (c)(3), (c)(4), (cx8) 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, 1949? ® Yes © No Provide Address of National Headquarters: Street Address city state Zip A copy of your organization or post charter must accompany this application. Location of Gambling Premises: Street Address city state Zip How many days, per year, is gambling conducted at this location? Days ® Other ® Check this box if ownership in the alcoholic beverage 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 or [3 TEN COM 4 C. Is the premises within any defined zones: 1. Where the sale of alcoholic beverages is restricted by city or county zoning ordinance? Dyes MNo 2. Where gambling is restricted by city or county zoning ordinance? © Yes ® No 0. Is the building ready for use for an alcoholic beverage business: ®Yes®No 1. Is this a newly constructed premises? ®Yes M o If Yes, indicate an estimated date of occupancy 2. Is this a remodel of an existing premises? D Yes ® No If Yes, 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 - on an 8-112" 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 service bar area clearly designated thereon. Note: On-the floor plan you will need to clearly mark the areas-where alcohol will be served; stoned and-consumed. The floor plan must contain outside dimensions, the name of the establishment, physical address, alcoholic beverage license number (if applicable) and date of submittal. 13 Section V11_., RECEIVED BY Declaration and Authorization JAN 0 2 2009 APPLICANT'S FORMAL DECLARATION AND AUTHORIZAT NG CONTROL nsioN FOR EXAMINATION AND RELEASE OF INFORMATION 17avem Partners, Inc. by Louis J. Camanca hereby declare under the penalty of law and/or the revocation of any licenses. granted pursuant hereto, that I am the applicant or duly authorized representative of the firm or corporation making this application and that I have examined the application, including any accompanying information, and that the responses provided herein are true, correct and complete. I understand if this application or attachment(g) contains false information, I am subject to the criminal penalties of Section 45-7-202, 45-7-203 and 45-7-208, Montana Code Annotated, and/or revocation of any alcoholic beverage or gambling licenses granted pursuant to this application. I further authorize a full review, disclosure and release to any duly authorized officer, agent or employee of the Montana Department of Justice, Gambling Control Division, of any and all records concerning me that the Montana Department of Justice property determines-relate to.my-_qualiflcations_for..gambling and/or_liq.uor_licensure, whether the--records-are of_a public, private, or confidential nature. '---i /` SIGNATURE PRINT FULL NAME Louis J. Carranco TITLE/POSITION President DATE This application must be completed in full,. and all requested attachments must accompany it. Delay, denial or the return of the application will result if incomplete. Additional Infonnatlon May Be Required During the Investigation of Your License Application. 18 GIN RECEIVED BY JAN 0 $ 2009 GAMBLING CONTROL DNISION y wt V ?J Ito R -1?r r,L? rrq?i?. ?srLbdw..- M c w c 1? VVA ?