HomeMy WebLinkAbout2001.0809.TCSM.PacketNOTICE OF SPECIAL SESSION
OF THE
FOUNTAIN HILLS TOWN COUNCIL
Mayor Morgan
Councilman McNeill
Vice Mayor Wyman
Councilwoman Fraverd
Councilwoman Hutcheson
Councilman Kavanagh
Councilwoman Ralphe
WHEN: THURSDAY, AUGUST 9, 2001
TIME: 12:00 P.M.
WHERE: TOWN HALL TELECONFERENCE ROOM
16836 E. Palisades, Building A
• CALL TO ORDER — Mayor Morgan
• ROLL CALL
1.) Consideration of the LIQUOR LICENSE APPLICATION submitted by Jim Willers for the Fountain Hills
Community Center located at 13001 North La Montana Drive. The application is for a new Class 5
Government license.
2.) ADJOURNMENT.
DATED this 8t'day of August, 2001.
M.
Cassie B. Hansen, Director of Administration/Town Clerk
The Town of Fountain Hills endeavors to make all public meetings accessible to persons with disabilities. Please call 837-2003 (voice) or 1-
800-367-8939 (TDD) 48 hours prior to the meeting to request a reasonable accommodation to participate in this meeting.
Supporting documentation and staff reports furnished the council with this agenda are available for review in the Clerk's office.
Memo
To: Cassie Hansen, Administration Director
From: Steve Gendler, Public Safety Director
Date: 7/20/2001
Re: Liquor License Application — Community Center
The purpose of this memorandum is to endorse the attached liquor license
application for the new community center.
Background:
The application is for a new, class 5 license, under the provisions of ARS 4-205.03.
IL This classification is reserved for government use and permits the sale and
consumption of all types of alcoholic beverages on premise. Off premise, or "to go"
liquor sales are prohibited under this license class.
In the course of investigation and discussions with the state liquor department, it was
determined that this form of license is common among municipalities with civic
facilities. The license holder will be the town, not the applicant Jim Willers. However,
as applicant, he will be empowered to act on behalf of the municipality under this
license and will be the responsible party.
As agent for the municipal license, a background investigation was initiated on the
applicant that confirmed residential status as well as no current wants or warrants.
Under the provisions of ARS 4-202.D, a comprehensive criminal history investigation
will be maintained under DR#20011293.
Council approval of the license application is required by the state liquor department.
The local governing body has an obligation to determine whether this license, or any
other, represents a proliferation of liquor permits in the community.
Recommendations:
Based on the fact that this represents the only class 5 liquor license in Fountain Hills,
that its intended use is consistent with community expectations regarding the civic
center, and that the applicant as agent for the municipality meets all requirements
under ARS 4-202.D, I recommend approval by the Council.
L L J e -1- I:-
RIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL
800 W Washington 5th Floor 400 W Congress #150
Phoenix AZ 85007-2934 Tucson AZ 85701-1352
;, 1
(602) 542-5141 � F' ��' �'' " ~i � (520) 628-6595
APPLICATION FOR LJQ161Z
TYPE OR PRINT WITH BLACK INK
1-4� OSS�
Notice: Effective Nov. 1, 1997, All Owners, Agents, Partners, Stockholders, Officers, or Managers actively involved in the day to day
operations of the business must attend a Department approved liquor law training course or provide proof of attendance within the last
five years. See page 5 of the Liquor Licensing requirements. ;:)J - ba�f- -7 -17- O
SECTION 1 This application is for a: SECTION 2 Type of ownershipp,- J) aA L- �r - is - C
❑ INTERIM PERMIT Complete Section 5
X NEW LICENSE Complete Sections 2, 3, 4, 13, 14, 15, 16, 17
❑ PERSON TRANSFER (Bars & Liquor Stores ONLY)
Complete Sections 2, 3, 4, 11, 13, 15, 16, 17
❑ LOCATION TRANSFER (Bars and Liquor Stores ONLY)
Complete Sections 2, 3, 4, 12, 13, 15, 16, 17
❑ PROBATE/WILL ASSIGNMENT/DIVORCE DECREE
Complete Sections 2, 3, 4, 9, 13, 15, 17 (fee not required)
❑ GOVERNMENT Complete Sections 2, 3, 4, 10, 13, 15, 16, 17
❑ J.T.W.R.O.S. Complete Section 6-T-' , I
❑ INDIVIDUAL Complete Section 6
❑ PARTNERSHIP Complete Section 6
❑ CORPORATION Complete Section 7
❑ LIMITED LIABILITY CO. Complete Section 7
❑ CLUB Complete Section 8
%GOVERNMENT Complete Section 10
❑ TRUST Complete Section 6
❑ OTHER Explain
�-Ito -b t
SECTION 3 Type of license and fees: LICENSE #:
1. Type of License: (7. 2. Total fees attached: $ d-4 c50
--
APPLICATION FEE AND INTERIM PERMIT FEES (IF APPLICABLE) ARE NOT REFUNDABLE.
LA service fee of $25.00 will be charged for all dishonored checks (A.R.S. 44.6852)
SECTION 4 Applicant: (All applicants must complete this section)
Mr. ,
1. Applicant/Agent's Name -Nis. L L.1EC-Z.J-
(Insert one name ONLY to appear on license) Last First Middle
2. Corp. /Partnership/L. L. C.: -79t� UE EKYIHI�A` UlWtL
(Exactly as it appears on Articles of Inc. or Articles of Org.)
3. Business Name: ,/awmo ,
(Exactly as it appears on the exterior of premises)
4. Business Address: I �?2001 �A ,, Lk-, aZ )4 DL ,Kl �WL-j, MAPIC01PA 652
(Do not use PO Box Number) City COUNTY Zip
5. Business Phone: (,) Residence Phone: (480)
6. Is the business located within the incorporated limits of the above city or town? AYES ❑NO
7. Mailing Address: 1
City state Zip
8. Enter the amount paid for a 06, 07, or 09 license: $ �4 /A (Price of License ONLY)
Accepted by
V\n P
DEPARTMENT USE ONLY
Date: IA00 /
Fees: 160,
Application Interim Permit Agent Change Club
Lic. # 0& /0
a14.. $ia�
F. Prints TOTAL
PROCESSING APPLICATIONS TADS APPROXIMATELY 90 DAYS, AND CIRCUMSTANCES OFTEN RESULT IN A LONGER WAITING PERIOD.
YOU ARE CAUTIONED REGARDING PLANS FOR A GRAND OPENING, ETC., BEFORE FINAL APPROVAL AND ISSUANCE OF THE LICENSE.
• r,
LIC 0100 11/2000 *Disabled individuals requiring special accommodation, please call (602) 542-9027.
w •
SECTION 5 Interim Permit:
AZ LIQ L10
1. If you intend to operate business while your application is pending you will need an Interim Permit pursuant to A.R.S. 4-203.01.
2. There MUST be a valid license of the same type you are applyl fo urr 1 snedE e location.
3. Enter the license number currently at the location.
4. Is the license currently in use? ❑ YES ❑ NO If no, how long has it been out of use?
ATTACH THE LICENSE CURRENTLY ISSUED AT THE LOCATION TO THIS APPLICATION.
1, (Print full name) , declare that I am the CURRENT LICENSEE of the stated license and
location . I have read this application and the contents and all statements are true, correct and complete.
M
(Signature)
My commission expires on:
State of County of
The foregoing instrument was acknowledged before me this
day of
Day of Month Month Year
(Signature of NOTARY PUBLIC)
SECTION 6 Individual or Partnership Owners:
EACH PERSON LISTED MUST SUBMIT A COMPLETED FORM "LIC0101", AN "APPLICANT" TYPE FINGERPRINT CARD, AND $24 FEE FOR EACH CARD.
1. Individual:
_ast T;;—
iu uwucu Restaence Aaaress City State Zip
Partnership Name: (Only the first partner listed will appear on license)
General -Limited r ..r n:-- XX:aal_
❑ ❑
❑ ❑
Ej-
%
tt+l ir+i n rwutiivrrAl JHEE1' 114 NECESSARY)
2. Is any person, other than the above, going to share in the profits/losses of the business? ❑ YES ❑ NO
r
SECTION 7 Corporation/Limited Liability Co.:
EACH PERSON LISTED MUST SUBMPT A COMPLETED FORM "LIC0101", AN "APPI;IP;AIt FINGERPRINT CARD, AND $24 FEE FOR EACH CARD.
❑ CORPORATION Complete questions 1, 2, 3, 5, 6, 7, 8.
❑ L.L.C. Complete questions 1, 2, 4, S, 6, 7 Attd ch {c�oRrl f4�yi�Is of Org. and Operation Agreement.
1. Name of Corporation/L.L.C.: i "# 7 [j
(Exactly as it appears on Articles of Inc. or Articles of Org.)
2. Date Incorporated/Organized:
3. AZ Corporation Commission File No.:
4. AZ L.L.C. File No:
State where Incorporated/Organized:
Date authorized to do business in AZ:
Date authorized to do business in AZ:
5. Is Corp./L.L.C. non-profit? ❑ YES ONO If yes, give IRS tax exempt number:
6. List all directors/officers in Corporation/L.L.C.:
LASE First Middle Tide Residence Address City State Zip
(ATTACH ADDITIONAL SHEET IF NECESSARY)
7. List stockholders or controlling members owning 10% or more:
-�t First Middle % Owned Residence Address City State
%
%
GA
%
(ATTACH ADDITIONAL SHEET IF NECESSARY)
8. If the corporation/L.L.C. is owned by another entity, attach an ownership, and director/officer/members disclosure for the parent
entity. Attach additional sheets as necessary in order to disclose real people.
SECTION 8 Club Applicants:
EACH PERSON LISTED MUST SUBMIT A COMPLETED FORM "LIC0101", AN "APPLICANT" TYPE FINGERPRINT CARD, AND $24 FEE FOR EACH CARD.
1. Name of Club: Date Chartered:
(Exactly as it appears on Club Charter) (Attach a copy of Club Chatter)
2. Is club non-profit? ❑ YES ❑ NO If yes, give IRS tax exempt number:
3. List officer and directors:
Last First Middle Title Residence Address City State Zip
(ATTACH ADDITIONAL SHEET IF NECESSARY)
3
� � J
SECTION 9 Probate, Will Assignment or Divorce Decree of an eadsting Bar or Liquor Store:
1. Current Licensee's Name:
(Exactly as it appears on license) Last
7 ��!�! First Middle
2. Assignee's Name:'
Last );' s� Middle
3. License Type: License Number: ��4'
Date of Last Renewal:
4. ATTACH TO THIS APPLICATION A CERTIFIED COPY OF THE WILL, PROBATE DISTRIBUTION INSTRUMENT, OR
DIVORCE DECREE THAT SPECIFICALLY DISTRIBUTES THE LIQUOR LICENSE TO THE ASSIGNEE TO THIS
APPLICATION.
SECTION 10 Government: (for cities, towns, or counties only)
I. Person to administer this license: E j15Q-7 \ IWT 7
Last First Middle
2. Assignee's Name: W t �1 1AMa5 E
Last First Middle
A SEPARATE LICENSE MUST BE OBTAINED FOR EACH PREMISES FROM WHICH SPIRITUOUS LIQUOR IS SERVED.
SECTION 11 Person to Person Transfer:
Questions to be completed by CURRENT LICENSEE (Bars and Liquor Stores ONLY).
L Current Licensee's Name: Entity:
(Exactly as it appears on license) Last First Middle (Indiv., Agent, etc.)
2. Corporation/L.L.C. Name:
(Exactly as it appears on license)
3. Current Business Name:
(Exactly as it appears on license)
4. Current Business Address:
5. License Type: License Number: Last Renewal Date:
6. Current Mailing Address (other than business):
7. Have all creditors, lien holders, interest holders, etc. been notified of this transfer? ❑ YES ❑ NO
8. Does the applicant intend to operate the business while this application is pending? ❑ YES ❑ NO If yes, complete section 5, attach
fee, and current license to this application.
9. I hereby relinquish my rights to the above described license to the applicant named in this application and hereby declare that the statements
made in this section are true, correct and complete.
1> (Print full name) , declare that I am the CURRENT LICENSEE of the stated license. I have read this
application and the contents and all statements are true, correct and complete.
State of County of
X The foregoing instrument was acknowledged before me ,
(Signature of CURRENT LICENSEE) day of
Day of Month Month Year
My commission expires on:
(Signature of NOTARY PUBLIC)
SECTION 12 Location to Location Transfer: (Bars an&'—!-iquo?Stores ONLY)
APPLICANTS CANNOT OPERATE UNDER A LOCATION TRANSFER UNTIL IT IS APPROVED BY THE STATE.
Current Business Name and Address:
xactly as it appears on license)
2. New Business Name and Address: o
(Do not use PO Box Number)
3. License Type:
4. What date do you plan to move?
License Number:
SECTION 13 Questions for all in -state applicants:
Last Renewal Date:
What date do you plan to open?
1. Distance to nearest school: �_Z 2 j ft. Name/Address of school: FOONMNI 44t 6 WC� ! `_
(Regardless of distance)
000 GN=KL4ff2 a- D-
2. Distance to nearest church: 2 ,21 I ft. Name/Address of church:
(Regardless of distance)
tun the: ❑ LESSEE ❑ SUBLESSEE ', OWNER ❑ PURCHASER (of premises)
4. If the premises is leased give lessors name and address:
4a. Monthly rental/lease rate $ m/A What is the remaining length of the lease? yrs. mos.
4b. What is the penalty if the lease is not fulfilled? $
or other
(give details - attach additional sheet if necessary)
5. What is the total business indebtedness of the applicant for this license/location excluding lease? $
Does any one creditor represent more than 10% of that sum? ❑ YES ❑ NO If yes, list below. Total must equal 100%.
Last First Middle % Owed Residence Address City State Zip
(ATTACH ADDITIONAL SHEET IF NECESSARY)
6. What type of business will this license be used for? (BE SPECIFIC) 122ur—�_ )2 MEUC2L, J (�,�
7 . Has a license, or a transfer license for the premises on this application been denied by the state within the past one (1) year?
❑ YES X NO If yes, attach explanation.
�Wooes any spirituous liquor manufacturer, wholesaler, or employee , have any interest in your business? DYES XNO
9. Is the premises currently licensed with a liquor license? ❑ YES X NO If yes, give license number and licensee's name:
License # (Exactly as it appears on license) Name
5
SECTION 14 Restaurant, or Hotel -Motel Applicants:
1. Is there a valid restaurant or hotel -motel license at the proposed location? ❑ YES ❑ NO If yes, give -licensee's name:
H ' 1 l ap license #:
Last First Middle zIc
-
2. If the answer to Question 1 is YES, you may qualify for an I r# eT operate while your application is pending; consult
A.R.S. Section 4-203.01; and complete Section 5 of this applicatiol F i l 3 to A3 DO
3. All restaurant applicants must complete a Restaurant Operation Plan (Form LIC0114) provided by the Department of Liquor.
4. Do you understand that 40% of your annual gross revenue must be from food sales? ❑ YES ❑ NO
SECTION 15 Diagram of Premises: (Blueprints not accepted, diagram must be on this form)
Check ALL boxes that apply to your licensed premises:
XEntrances/Exits X Liquor storage areas
❑ Drive-in windows ❑ Patio enclosures
❑ Service windows Under construction: estimated completion date
2. Restaurants and Hotel/Motel applicants must explicitly depict kitchen equipment and dining facilities.
The diagram below is the only area where spirituous liquor is to be sold, served, consumed, dispensed, possessed, or stored.
Give the square footage or outside dimensions of the licensed premises. ;� (' a� L ('4 ,
g
DO NOT INCLUDE PARKING LOTS, LIVING QUARTERS, ETC. �L� '�
YOU MUST NOTIFY THE DEPARTMENT OF LIQUOR OF ANY CHANGES OF BOUNDARIES,
ENTRANCES, EXITS, OR SERVICE WINDOWS MADE AFTER SUBMISSION OF THIS DIAGRAM.
9
FOUNTAIN HILLS-
COMMIlNI�YCENTER
0
MAIN LNIKT
I
I
SECTION 16 Geographical Data: A SAMPLE FOR THIS SECTION IS PROVIDED ON THE BACK OF THIS PAGE.
List below the exact names of all churches, schools, and spirituous liquor outlets within a one half mile radius of your proposed location.
3. (Cltp
L
4.
5. L '1 5 [ -0w�
6.�1�ii�1C"?
JUL
8.�1 1 /2 Mi.
9. 1�27- 1
10.
i
11.
12. ' 5 j)Pa cMr6--
13. sic Ph"Ap P t%Rln` --
14.
- 15.LSIG V
(ATTACH ADDITIONAL SHEET IF NECESSARY)
- SECTION 17 Signature Block:
4,? lr7 1 /2 Mi.
1 /2 Mi.
A = FOUNTAIN HILLS COMMUNITY CENTER
1 /2 Mi.
declare that: 1) I am the APPLICANTO(AgentClub Member/Partner), making this
(Print name of APPLICANT/AGENT listed in Section 4 Question I)
application; 2) I have read the application and the contents and all statements are true, correct and complete; 3) that this application is not
being made to defraud or injure any creditor, taxing authority, regulatory authority, or transferor; 4) that no other person, firm, or
corporation, except as indicated, has an interest in the spirituous liquor license for which these statements are made; and 5) that none of the
owners, partners, members, officers, directors or stockholders listed have been convicted of a felony in the past five (5) years.
State of County of I
X The foregoi4 instrument was acknowledged before rre this
(Signature)
day of
OFFICIAL SEAL Day of Month Mo th Year
WBEVELYN J. BENDEMy commission expires ootary Public . State of Arizonay comm. expires Aug. 28, 200
(S' cure TARY PUBLIC)
7
800 W Washington Sth Floor ARiZONA DEPARTMgN-. OF LIQUOR LICENSES &CONTROL
W Congress #150 v��yPhoenix AZ 85007-2934 TucsonP/0
AZ 85701-1352
(602)542-5141 (520)628-6595
LhWESTIONNAIRE
L SECURITY ANIQ B RTHDATE INFORMATION IS CONFIDENTIAL BY LAW
AND A NdT"'$' 4 t1.�SEMINATED TO THE PUBLIC
Read Carefully, this instrument is a sworn document. Type or print with black ink
An extensive investigation of your background will be conducted. False or incomplete answers could result
in criminal prosecution and the denial or subsequent revocation of a license or permit.
TO BE COMPLETED BY EACH OWNER, AGENT, PARTNER, STOCKHOLDER (1007o OR MORE), MEMBER, OFFICER OR MANAGER. ALSO EACH PERSON
COMPLETING TMS FORM MUST SUBMIT AN "APPLICANT' TYPE FINGERPRINT CARD WHICH MAY BE OBTAINED AT THE DEPT. FINGERPRINTING MUST BE
DONE BY A BONA FIDE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVICE APPROVED BY THE DEPARTMENT OF LIQUOR. THE DEPARTMENT
DOES NOT PROVIDE THIS SERVICE.
1. Check
appropriate
box —,
There is a $24.(X) processing fee for each fingerprint card submitted.
A service fee of $25.00 will be charged for all dishonored checks (A.RS. 44.6852)
Downer []Partner ❑Stockholder ❑Member 00ftice4VAgent I ❑ Manager(Only)
`( Other Lk- "A")h V4220 (Complete Questions 1-46 & ) (Complete All Questions e-rcept # 14, 14a & 25)
Licensee or Agent must complete # 25 for a Manager I Licensee or Agent must complete # 25
2. Name: C`7 �7�[ tT'hK•lJ l Date of Birth:
Last First Middle (Thu Will Not Become a Part of Public Records)
3. Social Security Nu mber — Drivers License #: 76>LI State: �_��f�_
// (Thu W' No Become a Part of Public Records) / .-,�
4. Place of Birth: 6 a, �� — �I !!//'' C� Height: —�- Weight: 2 Eyes: I Hair: t (1
City State Country
Marital Status ❑ Single ❑ Mamed f Divorced El Widowed Residence (Home) Phone) �-
6. Name of Current or Most Recent Spouse: p Date of Both:
(List all for last 5 years - Use additional sheet if necessary) Last First Muddle Maiden
7. You are a bona fide resident of what state? A`" Ill o If Arizona, date of residency: Z Q d
8 Telephone number to contact you during business hours for any questions regarding this document. ( c4-- I ED -_t1
9. If you have been a resident less than three (3) months, Submit a copy of driver's license or voter registration card.
WILL Fle CSC 4 6 t
10. Name of Licensed Premises, 6 n Premises Phone: (GL ) E'M(r�- r22CX>
11. Licensed Premises Address: 15 Co f K,, LA Ata M-A1A �e ��' � RI L L5 Liquor License W
Street Address (Do not use PO Box #) City County, NXA�2I CZip6'Q4 SSZLg (If this location iscurrently licensed)
12. List your employment or type of business during the past five (5) years, if unemployed part of the time, list those dates. List most gent 1st.
FROM
Month/Yeaz
TO
Month/Year
DESCRIBE POSITION
OR BUSINESS
EMPLOYER'S NAME OR NAME OF BUSINESS
(Give street address, city, state & zip)
�(
L�
CURRENT
�yt� `h 4 s
1(1(
`fcc+�, rCEitn lug I6F,36, �I Erg
rf
�71/C )1
tse> al t-1o1'en02-
v on 1,45 6t.
c% �Rc)MACQ
25la o17(2ko- Or n '�3741, )
�Z LCn
I N r, rz c -2 9-M
5 tl"W
j H M /Vk95 is C
d 9 l l CGl I cCl lc3 1h Fl Z iscC (5a
ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION
13. Indicate your residence address for the last five (5) years:
. •
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RESIDENCEStreet Address
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