Fillable Liquor Retail License Application

Fill Online, Printable, Fillable, Blank Liquor Retail License Application Form

Use Fill to complete blank online CITY OF EVANS COLORADO (CO) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Liquor Retail License Application

On average this form takes 54 minutes to complete

The Liquor Retail License Application form is 5 pages long and contains:

  • 0 signatures
  • 91 check-boxes
  • 173 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Evans Colorado

BROWSE CITY OF EVANS COLORADO (CO) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
1
Colorado Liquor
Retail License Application
New License
New-Concurrent
Transfer of Ownership
State Property Only
• All answers must be printed in black ink or typewritten
• Applicant must check the appropriate box(es)
• Applicant should obtain a copy of the Colorado Liquor and Beer Code: www.colorado.gov/enforcement/liquor
1. Applicant is applying as a/an Individual Limited Liability Company Association or Other
Corporation Partnership (includes Limited Liability and Husband and Wife Partnerships)
2. Applicant If an LLC, name of LLC; if partnership, at least 2 partner's names; if corporation, name of corporation FEIN Number
2a. Trade Name of Establishment (DBA) State Sales Tax Number Business Telephone
3. Address of Premises (specify exact location of premises, include suite/unit numbers)
City County State ZIP Code
4. Mailing Address (Number and Street) City or Town State ZIP Code
5. Email Address
6. If the premises currently has a liquor or beer license, you must answer the following questions
Present Trade Name of Establishment (DBA) Present State License Number Present Class of License Present Expiration Date
Section A Nonrefundable Application Fees Section B (Cont.) Liquor License Fees
Application Fee for New License ...............................................$550.00
Application Fee for New License w/Concurrent Review ...............$650.00
Application Fee for Transfer ......................................................$550.00
Lodging & Entertainment - L&E (County) ...........................................$500.00
Manager Registration - H & R ................................................................$75.00
Manager Registration - Tavern ............................................................... $75.00
Manager Registration - Lodging & Entertainment ................................$75.00
Manager Registration - Campus Liquor Complex ...............................$75.00
Master File Location Fee ........................$25.00 X ________ Total ________
Master File Background ...................... $250.00 X ________ Total ________
Optional Premises License (City) ......................................................... $500.00
Optional Premises License (County) ...................................................$500.00
Racetrack License (City) ....................................................................... $500.00
Racetrack License (County) .................................................................$500.00
Resort Complex License (City).............................................................$500.00
Resort Complex License (County) ....................................................... $500.00
Related Facility - Campus Liquor Complex (City) .............................. $160.00
Related Facility - Campus Liquor Complex (County) ........................ $160.00
Related Facility - Campus Liquor Complex (State) ............................ $160.00
Retail Gaming Tavern License (City) ...................................................$500.00
Retail Gaming Tavern License (County) .............................................. $500.00
Retail Liquor Store License--Additional (City) ......................................$227.50
Retail Liquor Store License--Additional (County) ................................$312.50
Retail Liquor Store (City) ....................................................................... $227.50
Retail Liquor Store (County) .................................................................$312.50
Tavern License (City) .......................................................................... $500.00
Tavern License (County) ....................................................................$500.00
Vintners Restaurant License (City) ......................................................$750.00
Vintners Restaurant License (County) .................................................$750.00
Section B Liquor License Fees
Add Optional Premises to H & R ......... $100.00 X ________ Total ________
Add Related Facility to Resort Complex $75.00 X ________ Total ________
Arts License (City) ................................................................................ $308.75
Arts License (County) .......................................................................... $308.75
Beer and Wine License (City) .............................................................. $351.25
Beer and Wine License (County) ........................................................ $436.25
Brew Pub License (City) .................................................................... $750.00
Brew Pub License (County) ................................................................. $750.00
Campus Liquor Complex (City) ........................................................... $500.00
Campus Liquor Complex (County) ..................................................... $500.00
Campus Liquor Complex (State) ......................................................... $500.00
Club License (City) ............................................................................... $308.75
Club License (County) ........................................................................ $308.75
Distillery Pub License (City) ................................................................. $750.00
Distillery Pub License (County) ........................................................... $750.00
Hotel and Restaurant License (City) ................................................... $500.00
Hotel and Restaurant License (County) ............................................ $500.00
Hotel and Restaurant License w/one opt premises (City) ................. $600.00
Hotel and Restaurant License w/one opt premises (County) ............ $600.00
Liquor–Licensed Drugstore (City) ....................................................... $227.50
Liquor–Licensed Drugstore (County) ................................................. $312.50
Lodging & Entertainment - L&E (City) ................................................ $500.00
Questions? Visit: www.colorado.gov/enforcement/liquor for more information
Do not write in this space - For Department of Revenue use only
Liability Information
License Account Number Liability Date License Issued Through (Expiration Date)
Total
$
DR 8404 (12/21/18)
COLORADO DEPARTMENT OF REVENUE
Liquor Enforcement Division
(303) 205-2300
2
Application Documents Checklist and Worksheet
Instructions: This checklist should be utilized to assist applicants with ling all required documents for licensure. All
documents must be properly signed and correspond with the name of the applicant exactly. All documents must be typed
or legibly printed. Upon nal State approval the license will be mailed to the local licensing authority. Application fees are
nonrefundable. Questions? Visit: www.colorado.gov/enforcement/liquor for more information
Items submitted, please check all appropriate boxes completed or documents submitted
I. Applicant information
A. Applicant/Licensee identied
B. State sales tax license number listed or applied for at time of application
C. License type or other transaction identied
D. Return originals to local authority
E. Additional information may be required by the local licensing authority
F. All sections of the application need to be completed
II. Diagram of the premises
A. No larger than 8 1/2" X 11"
B. Dimensions included (does not have to be to scale). Exterior areas should show type of control (fences,
walls, entry/exit points, etc.)
C. Separate diagram for each oor (if multiple levels)
D. Kitchen - identied if Hotel and Restaurant
E. Bold/Outlined Licensed Premises
III. Proof of property possession (One Year Needed)
A. Deed in name of the applicant (or) (matching question #2) date stamped / led with County Clerk
B. Lease in the name of the applicant (or) (matching question #2)
C.
Lease assignment in the name of the applicant with proper consent from the Landlord and acceptance by the Applicant
D. Other agreement if not deed or lease. (matching question #2) (Attach prior lease to show right to assumption)
IV. Background information and nancial documents
A. Individual History Records(s) (Form DR 8404-I)
B. Fingerprints taken and submitted to the appropriate Local Licensing Authority through an approved State
Vendor. Master File applicants submit results to the State using code 25YQHT with IdentoGO.
The Vendors are as follows:
IdentoGO - https://uenroll.identogo.com/ Phone: (844)539-5539 (toll-free)
IdentoGO FAQs: https://www.colorado.gov/pacific/cbi/identification-faqs
Colorado Fingerprinting by American BioIdentity – Details to be announced
C. Purchase agreement, stock transfer agreement, and/or authorization to transfer license
D. List of all notes and loans (Copies to also be attached)
V. Sole proprietor/husband and wife partnership (if applicable)
A. Form DR 4679
B. Copy of State issued Driver’s License or Colorado Identication Card for each applicant
VI. Corporate applicant information (if applicable)
A. Certicate of Incorporation date stamped by the Colorado Secretary of State's Ofce
B. Certicate of Good Standing
C. Certicate of Authorization if foreign corporation
D. List of ofcers, directors and stockholders of applying corporation (If wholly owned, designate a minimum of
one person as principal ofcer of parent)
VII. Partnership applicant information (if applicable)
A. Partnership Agreement (general or limited). Not needed if husband and wife
B. Certicate of Good Standing (If formed after 2009)
VIII. Limited Liability Company applicant information (if applicable)
A. Copy of articles of organization (date stamped by Colorado Secretary of State's Ofce)
B. Certicate of Good Standing
C. Copy of operating agreement
D. Certicate of Authority if foreign company
IX. Manager registration for Hotel and Restaurant, Tavern, Lodging & Entertainment, and Campus Liquor
Complex licenses when included with this application
A. $75.00 fee
B. Individual History Record (DR 8404-I)
C. If owner is managing, no fee required
DR 8404 (12/21/18)
3
Name Type of License Account Number
7. Is the applicant (including any of the partners if a partnership; members or managers if a limited liability company; or ofcers,
stockholders or directors if a corporation) or managers under the age of twenty-one years?
Yes No
8. Has the applicant (including any of the partners if a partnership; members or managers if a limited liability company; or ofcers,
stockholders or directors if a corporation) or managers ever (in Colorado or any other state):
(a) Been denied an alcohol beverage license?
(b) Had an alcohol beverage license suspended or revoked?
(c) Had interest in another entity that had an alcohol beverage license suspended or revoked?
If you answered yes to 8a, b or c, explain in detail on a separate sheet.
9. Has a liquor license application (same license class), that was located within 500 feet of the proposed premises, been denied within the
preceding two years? If "yes", explain in detail. ______________________________________________________________________
10. Are the premises to be licensed 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?
Waiver by local ordinance?
Other: ________________
or
11. Is your Liquor Licensed Drugstore (LLDS) or Retail Liquor Store (RLS) within 1500 feet of another retail liquor license for off-premises
sales in a jurisdiction with a population of greater than (>) 10,0000? NOTE: The distance shall be determined by a radius measure-
ment that begins at the principal doorway of the LLDS/RLS premises for which the application is being made and ends at the principal
doorway of the Licensed LLDS/RLS.
12. Is your Liquor Licensed Drugstore (LLDS) or Retail Liquor Store (RLS) within 3000 feet of another retail liquor license for off-premises
sales in a jurisdiction with a population of less than (<) 10,0000? NOTE: The distance shall be determined by a radius measurement
that begins at the principal doorway of the LLDS/RLS premises for which the application is being made and ends at the principal
doorway of the Licensed LLDS/RLS.
13a. For additional Retail Liquor Store only. Was your Retail Liquor Store License issued on or before January 1, 2016?
13b. Are you a Colorado resident?
14. Has a liquor or beer license ever been issued to the applicant (including any of the partners, if a partnership; members or manager if a
Limited Liability Company; or ofcers, stockholders or directors if a corporation)? If yes, identify the name of the business and list any
current nancial interest in said business including any loans to or from a licensee.
15. Does the applicant, as listed on line 2 of this application, have legal possession of the premises by ownership, lease or other
arrangement?
Ownership Lease Other (Explain in Detail) _______________________________________________________________________
a. If leased, list name of landlord and tenant, and date of expiration, exactly as they appear on the lease:
Landlord Tenant Expires
b. Is a percentage of alcohol sales included as compensation to the landlord? If yes, complete question 16.
c. Attach a diagram that designates the area to be licensed in black bold outline (including dimensions) which shows the bars, brewery, walls, partitions,
entrances, exits and what each room shall be utilized for in this business. This diagram should be no larger than 8 1/2" X 11".
16. Who, besides the owners listed in this application (including persons, rms, partnerships, corporations, limited liability companies) will loan or give
money, inventory, furniture or equipment to or for use in this business; or who will receive money from this business? Attach a separate sheet if
necessary.
Last Name First Name Date of Birth FEIN or SSN Interest/Percentage
Last Name First Name Date of Birth FEIN or SSN Interest/Percentage
Attach copies of all notes and security instruments and any written agreement or details of any oral agreement, by which any person (including
partnerships, corporations, limited liability companies, etc.) will share in the prot or gross proceeds of this establishment, and any agreement
relating to the business which is contingent or conditional in any way by volume, prot, sales, giving of advice or consultation.
17. Optional Premises or Hotel and Restaurant Licenses with Optional Premises:
Has a local ordinance or resolution authorizing optional premises been adopted?
Number of additional Optional Premise areas requested. (See license fee chart)
18. Liquor Licensed Drugstore (LLDS) applicants, answer the following:
(a) Is there a pharmacy, licensed by the Colorado Board of Pharmacy, located within the applicant's LLDS premise?
If "yes" a copy of license must be attached.
19. Club Liquor License applicants answer the following: Attach a copy of applicable documentation
(a) Is the applicant organization operated solely for a national, social, fraternal, patriotic, political or athletic purpose and not for pecuniary gain?
(b) Is the applicant organization a regularly chartered branch, lodge or chapter of a national organization which is operated solely for
the object of a patriotic or fraternal organization or society, but not for pecuniary gain?
(c) How long has the club been incorporated?
(d) Has applicant occupied an establishment for three years (three years required) that was operated solely for the reasons stated above?
20. Brew-Pub, Distillery Pub or Vintner's Restaurant applicants answer the following:
(a) Has the applicant received or applied for a Federal Permit? (Copy of permit or application must be attached)
DR 8404 (12/21/18)
4
Name Type of License Account Number
21. Campus Liquor Complex applicants answer the following:
(a) Is the applicant an institution of higher education?
Yes No
(b) Is the applicant a person who contracts with the institution of higher education to provide food services?
If "yes" please provide a copy of the contract with the institution of higher education to provide food services.
22. For all on-premises applicants.
a. Hotel and Restaurant, Lodging and Entertainment, Tavern License and Campus Liquor Complex, the Registered Manager must also submit an
Individual History Record
- DR 8404-I and ngerprint submitted to approved State Vendor through the Vendor's website. See application checklist, Section IV, for details.
b. For all Liquor Licensed Drugstores (LLDS) the Permitted Manager must also submit an Manager Permit Application
- DR 8000 and ngerprints.
Last Name of Manager First Name of Manager
23. Does this manager act as the manager of, or have a nancial interest in, any other liquor licensed establishment in the State of
Colorado? If yes, provide name, type of license and account number.
24. Related Facility - Campus Liquor Complex applicants answer the following:
a. Is the related facility located within the boundaries of the Campus Liquor Complex?
If yes, please provide a map of the geographical location within the Campus Liquor Complex.
If no, this license type is not available for issues outside the geographical location of the Campus Liquor Complex.
b. Designated Manager for Related Facility- Campus Liquor Complex
Yes No
Last Name of Manager First Name of Manager
25. Tax Distraint Information. Does the applicant or any other person listed on this application including its partners, ofcers, directors,
stockholders, members (LLC) or managing members (LLC) and any other persons with a 10% or greater nancial interest in the
applicant currently have an outstanding tax distraint issued to them by the Colorado Department of Revenue?
If yes, provide an explanation and include copies of any payment agreements.
26. If applicant is a corporation, partnership, association or limited liability company, applicant must list all Ofcers, Directors, General Partners,
and Managing Members. In addition, applicant must list any stockholders, partners, or members with ownership of 10% or more in the
applicant. All persons listed below must also attach form DR 8404-I (Individual History Record), and make an appointment with an approved
State Vendor through their website. See application checklist, Section IV, for details.
Name Home Address, City & State DOB Position %Owned
Name Home Address, City & State DOB Position %Owned
Name Home Address, City & State DOB Position %Owned
Name Home Address, City & State DOB Position %Owned
Name Home Address, City & State DOB Position %Owned
** If applicant is owned 100% by a parent company, please list the designated principal ofcer on above.
** Corporations - the President, Vice-President, Secretary and Treasurer must be accounted for above (Include ownership percentage if applicable)
** If total ownership percentage disclosed here does not total 100%, applicant must check this box:
Applicant afrms that no individual other than these disclosed herein owns 10% or more of the applicant and does not have nancial interest in a
prohibited liquor license pursuant to Article 3 or 5, C.R.S.
Name Type of License Account Number
Oath Of Applicant
I declare under penalty of perjury in the second degree that this application and all attachments are true, correct, and complete to the best of my
knowledge. I also acknowledge that it is my responsibility and the responsibility of my agents and employees to comply with the provisions of the
Colorado Liquor or Beer Code which affect my license.
Authorized Signature Printed Name and Title Date
Report and Approval of Local Licensing Authority (City/County)
Date application led with local authority Date of local authority hearing (for new license applicants; cannot be less than 30 days from date of application)
DR 8404 (12/21/18)
5
The Local Licensing Authority Hereby Afrms that each person required to le DR 8404-I (Individual History Record) or a DR 8000 (Manager Permit) has
been:
Fingerprinted
Subject to background investigation, including NCIC/CCIC check for outstanding warrants
That the local authority has conducted, or intends to conduct, an inspection of the proposed premises to ensure that the applicant is in compliance with
and aware of, liquor code provisions affecting their class of license
(Check One)
Date of inspection or anticipated date _____________________
Will conduct inspection upon approval of state licensing authority
Is the Liquor Licensed Drugstore (LLDS) or Retail Liquor Store (RLS) within 1,500 feet of another retail liquor license for off-
premises sales in a jurisdiction with a population of > 10,0000?
Yes No
Is the Liquor Licensed Drugstore(LLDS) or Retail Liquor Store (RLS) within 3,000 feet of another retail liquor license for off-
premises sales in a jurisdiction with a population of < 10,0000?
NOTE: The distance shall be determined by a radius measurement that begins at the principal doorway of the LLDS/RLS premises
for which the application is being made and ends at the principal doorway of the Licensed LLDS/RLS.
Does the Liquor-Licensed Drugstore (LLDS) have at least twenty percent (20%) of the applicant's gross annual income derived
from the sale of food, during the prior twelve (12) month period?
The foregoing application has been examined; and the premises, business to be conducted, and character of the applicant are satisfactory. We do
report that such license, if granted, will meet the reasonable requirements of the neighborhood and the desires of the adult inhabitants, and will comply
with the provisions of Title 44, Article 4 or 3, C.R.S., and Liquor Rules. Therefore, this application is approved.
Local Licensing Authority for Telephone Number
Town, City
County
Signature Print Title Date
Signature Print Title Date
DR 8404 (12/21/18)
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Liquor Retail License Application

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 12 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document