HomeMy WebLinkAbout4G - Wilds Liquor License
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STAFF AGENDA REPORT
DATE:
4-G
LAURIE DAVIS FRIEDGES/LICENSE CLERK
APPLICATION FOR NEW ON-SALE LIQUOR
LICENSE FOR REDHDS, INC. (THE WILDS)
MAY 20,1996
AGENDA #
PREPARED BY:
SUBJECT:
INTRODUCTION:
Michael O. Regan of Redhds, Inc. is applying for an on-
sale liquor license in order to sell liquor at the Wilds in
Prior Lake. He is requesting that the new license be
granted now and that his fee be' prorated from May 20,
1996 to June 30, 1996. Prior Lake City Code 3-1-9(B)
provides that, "...a license may be issued for the remainder
of the year for a pro rata fee. In computing such fee, any
unexpired fraction of a month shall be computed as one
month. "
BACKGROUND:
The Prior Lake Police Department has conducted a
background check on Redhds, Inc. and all partners
involved, and agrees that the application meets the criteria
for granting the liquor license.
DISCUSSION:
Mr. Regan has asked that the Prior Lake City Council
consider prorating the liquor license fee for the period of
May 20,1996 to July 1, 1996 (when the new license period
begins), in order to that his corporation will not need to use
the old icense under the name of The Wilds Management
Group. The prorated amount for the above suggested dates '
is $917.00.
ISSUES:
Mr. Regan of Redhds, Inc. would like not to be associated
with the Wilds Management Group of which the old
license is named. There is not an affiliation between Wilds
Management Group and Redhds, Inc.
ALTERNATIVES:
The Prior Lake City Council has the following alternatives:
1. Approve the pro-rated amount of $917.00 and the
16200 ~~t~e~~k Ave. S.E., Prior Lake, Minnesota 55372-1714 / Ph. (612) 447-4230 / Fax (612) 447-4245
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<.~~ ~~~~..~;z~~^ t~ N"'~~ ~ .
~ Minnesota Department of Public Safety <1jU;~' .
,},~..~*
LIQUOR CONTROL DIVISION ~~ dg,:,
~~ ,~~
444 Cedar St., Suite 100 L, St. Paul, MN 55101-2156 1~~~~
~~-~ Fax (612)297-5259 ~'ii!t~'
(612)296-6430 TTY (612)282-6555
CERTIFICA TION OF AN ON SALE AND/OR SUNDAY LIQUOR LICENSE
No Bcense will be approved or released until the $20 Retailer ID Card fee is received by MNl.iquor Control
Workers Compensation Insurance Company G ~ ~ ~ l^l CeA..$Uo..t '-"j Policy# eWe. 02Z.17"3
LICENSEE'S SALES & USE TAX ill # 1 Gt I i () 8 '" To apply for sales tax number, call 296-6181 or 1-800-657-3777
CITY OF r~\O l\ (", ~t.. ISSUING AUTIlORITY $ Lb-tJ-
COUNTY OF
Licensee Name (Corporation, Partnership, Individual) DaB TradcN~h~Blu; Id~ - ~ {;?SfCL I') LL(
~~YS . :r""c. ,
Business Address ~q, I(w~ City Zip Code
~ S' 00 w.\cis SS37z.
~~\oCl. l Q 'Kt, M l'J ~ S 372- \>~'()~ ll.\\(~
License Type (Check one or both) License Period Count.
\l( On Sale )d' Sunday From To 510
On Sale License Number I On Sale Fee l
Sunday License Number Sunday Fee I Business Phone
6/Z-4J.1S-3Soo
If a oartnenbio. state the name and address of each oartner; If a corporation. state the na:ne and address of each offICer.
Partner/Officer Name (First, middle and last) DaB Title Address b'2.NA Sr.
Ml,-ht>.~.L I 0 ~QN Ptot s,~....+ I oS 10 N.
.5+, II \WtI,-k,,.. fYIrV -:>S'O~2-
Partner/Officer Name (First, middle and last) DaB Titlc Address
Partner/Officer Name (First, middle and last) DaB Titlc Address
The Licensee must have one of the following:
(A IT ACH CERTIFICATE OF INSURANCE TO THIS FORM.)
Check one
>>- Liquor Liability Insurance (Dram Shop) - $50,000 per person; $100,000 more than one person; $10,000 Property Destruction;
$50,000 and $100,000 for loss of means of support.
or
DB. A bond of a surety company with minimum coverage as specified above in A.
or
DC. A certificate from the State Treasurer that the licensee has deposited with the State, Trust Funds having a market value of
S I 00.000 in cash or securities.
DYes lINo During the past license year has a summons been issued under the Liquor Civil Liability Law (Dram Shop)?
If yes, attach a cop" of the summons.
Check those items that apply Circle one
Transaction Type <<'New o Revoke/Cancel SuspendlRevoke/Cancelled
o Transfer o Suspension From To
Transfer of ownership from (Name and Address)
I certify that this license was approved in an official meeting by the governing body of the city or county.
Cil't Clerk's Signature Date
IMPORT ANT NOTICE
All retail liquor licensees must have a current Federal Special Occupational Stamp. This stamp is issued by the Bureau of
Alcobol, Tobacco and Firearms. For information call (612)290-3496 PS 9011-94
,\
o
'AC.'RIt.
f?I~!!~.~':l;'.~:
'€;3/ ,25' ,199'
":~'riiiS1;t~iii'~1Et~?;~EJ)if~S~~MA~fOF1:tNFORMA'ntiNS~::'
'ONLY~~: ,'CONFERS:,-;NO';'flUGHTS~UPON;~THE ~CERnFICAlE ';'"
Hcx.DER~"'1TH1S;"CER1IFlCATE'~'DOES~'NOr~'~lIENDi",exn:ND~OR (
AL'I1!R THE! COYERAGE!AFFORDED BY THI!:POUClESIELOW.
COMPANIES AFFORDING COVERAGE
PIIOIlUC.
Harris-Homeyer Company
P. O. BOX 24030
Edina, !IN 55424 _
(612) '922-0301
C(NWft
A General Casualty
INlIUIlED
Rec!lbds, Inc.
Restan, LLC dba The wilds
2500 Wilds Parkway
prior Lalfen. __H' u , HH55372
~>>lf
8
CCM'AH'r
C
CtJfIiIINf
D
::I; ... . II
11-119 IS TO C8mfY mAT n1E POUClES OF INSUAANCE US1ED BBmI HAVE BEEN JSS(J8J TO .1HE INSURED NAMED ABCIE FOR 1HE POUC't' PERIOD
INOICAlED, N01Wl1HSTANOING ~ ..eoulRaAENT, 'TaW OR CClNDmON OF JH( coti'rIU.cT,OAO'IHERDOCUPAENT Wffii RESPECT TO WHICH 11iIS
CERTlFlCATl; MA.Y BE'ISSUED OFlMAV PERTAIN. lliE INSUFWlCE AFFOROeO BY THEPOUCles't!ESCFllBED HElWN IS SUeJECT TO ALL niE TEAMS,
EXCLUSIONS AND CONDITIONS OF SUCH POUClEs. UMI1'S SHCM'N MAY HAVE BeEN RSl:lOceoirfPAlDClAl~
co
Lm
ftPE OF IN8UIWICE
POUCY NIAI8Sl
POucy IIRC11WE I'OUC'Y EIftV&'I1ON
DATE ~ ....1a (UIIIDDtT'I)
UIml
03/20/96
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CBA 0221763
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QENERAL. LI.lIi&ITT
COMMEllClAl aasw.. UABLl1Y
~MADeD<X:ClEI
~ & CON"IilACTORs f'FlOT
AIITOtIOIlILE UAIlILITY
A X mr Al,ITO
.IU OYfNEO AIJTOS
SCHEDUlED .wTOS
HlAED MiTOS
NON-OWNED AVTOS
, 1.000.000
_/'/
$
I BOOIL Y IN.AJAY
i (f'll t a.:eldatlQ
I
I
I PROPERTY DAMACl E
i
MiTO ONlY - Ell ACCIDeNT $
I cmt81 ntAN AlITO ONLY:
~ ACCII;lENT S
AGGFl&GATi S
EACH OCCUME:NCf ,
AOGRE<lAlE $
$
,----
ANY AUTO
EllCallII UAIlI&.m'
UMBREllA FOR.II
011181 1)1Nl UMIlREllJ'. FORM
WORlWlS COMPelSAllON AHD
A I!JIIII,O~S' Ul81llTY
srJ.TUTORY LIMITS
ewe 0221763
03/20196
03/20/97
EAD1 ACC1Derr
lHI1 PROPRIETORI
P~CUTIVE
OFFICERS ARE:
OTI1at
XINO.
EXCL
OtS6A& ' PO~ICY I.I"'IT
DSEAst: ' EACH EMf'lO'rEE
$
S
,
, 00,000
500,000
100.000
DliSCRIIfT10IC OF OPelATlOIC9/l.DCA TlONSNlHI:~W. rrem
~ULD ANY OF Tttf: AIIO'ff: DESCRI8ED P'OUCID If: CAJlCf1..I.m IIEPOlU ncl.
DJIIlRATON DAnt THIIRIl:lII, THE 5lIUINO COUPAHT WLL !:HDlAVOR TO ~
30
DAn nma IlOTlCE TO THE CEm'1FICATi HOLDER lWEI TO ll1E l.EFT,
city of prior Lake IIUT FAJUmIl TO MAL SUCH NoncE SHAU IIoIPOSIl NO OIUQATON OR LWlIUTY
4629 Dakota street BE "'<J~'" OR REPRWKfA1'1'rt3.
Prior Lake, MN 55372 AlITliOAl%ED :A'T1YE .If1 ./ ;
X~~'Y~$~~$iilijtMH'f~:~~'mi::tr}7:~~~'~~tt$.:~f&J:M?[~g@~#~~WWt~w~~~ ;~;ii1 KW<./.ftd%. nZ't ~ ~!~ : ~ m]~i]%:;g'~~~~ij'~~'. . ~~'JfQ~~~~~
.~
/
f
LtC!HSt QUIST1OHMAll1
IW1E or ISTAJLISlOOT 7?C.D -H ~ $/ 'r/1 c.
nPI or LICDSZ &/). S"A~..e.. ~;p.c.,,.t11 S~>?JA.1.f ,-z..,. Sa/-<..
m! OF OWNElS1tl1 S - ~ ~__.,().~".e-~*",...,
.
!MOll or !)lpt.Ol!!S ~
~
tw1!S OF t>4PLOY!!S
/I?~e." tot.. I <::!). RcJ ~A/'
. IRni DA 1'!S
? /':3ttP /~7
~ OF lWfAGZ~
/>>..'~t.z.4" I <!:J. R~ )'I d
XAJ1ES 01 O'wll!lS
,m/~It. It -4 ( 4. ~.qA"/
Plea.. n tum to:
.~~
Cl t1 of Pnor t..&b
462' Dakota Street 51
P.O. lox 359
PTiol' l.a.kl, lUnnesota
55372
form SP: C 1
~ICENSt APP~ICANT:
Pur,uant to ~inne~ota ~tatute 270.12 lax Clearance: Issuance of ~Icen'e'.
t~e licensing autnorlty Is re~ulrec to crovice to t~e "inne,ota
Commissioner of Revenue your ~Innesota business tax fdentlflcatlon numcer
and t~e social security numoer of eacn license acellcant.
Under tne ~innesota Government Data Practices Act anc t~e receral Privacy
Act of 197., \lte are reQulrec to acvlse you of t~e follO\ltlng re94rdlng t~e
use of this Information:
I. This Information may be used to deny t~e Issuance, rene~al or
transfer of your license In t~e event you o\lte t~e "Innesota
Dee.ar't;nent of Revenue ce H nQuent taxes. cena I ties or Interest:
2. Ucon recelvfng tnls Information, t~e licensing aut~orlty \ltfll
supely It only to t~e "innesota Department of Revenue. HO\ltever.
under t~e Feoeral Exc~ange of Informatfon AQreement t~e
Decartment of Revenue may sucply t~ls Information to tne'Internal
Revenue Service:
3. FaIlure to succly tnls InformatIon may jeocardlze or celay tne
crocessing of your licensing Insuance or rene~al acel icatlon.
Please succly tne forlo~lng Information anc return along \ltlt~ y~ur
accl ic~tion to tne agency Issuing tne I icen,e. 00 HOT RETURN TO THE
OEPARTl'IENT Ck REVENUE.
~ICENS~ BEING APPLIED FOR OR RENE~ED:
L. 'Jill_it 1.- ,. (. ~ /"')~~
~/-r~"P p,cJ ~A L.o..k.e..
fssuln; license)
LICENSING AUTHORITY:
(~me of city. coun~y or state agency
- Ll CENSC: RENE'"AL OA TE:
~ PERSONAL I NfOR~ iI c..
Acel Ican~'s Accress:
(If applicable):
;//I":c.1, 4..../ ~ ~9A",v
/cS"/O ~ h ~ ..>~
51-. 'IItud'e~ /11;1.
. Ace 1 i can't I 5 Name:
So~fal Se:~:-f":y
BUSINESS IHf'CRMTICH (If eQlleable):
Bus f nes s Name: ~ ~ d. H t::J oS ~ :::C tv G.
Business Accz-ess: -z,.5.,o ~:IJ.~ A.A!./<.~4.tt
".' ~/-t<. I~ /)1/2.
City State
CI~y
NUi:".:e:-: '1-'77- 7-z... - t'1cf't:'
S~a~e
~!i'~ g2.-
Zle Cooe
11S'~'i"-z,-
Zlg Coc:e
"fnnesota Tax Ioentlflcatlon No.:
Federal Tax Identification No.:
1 f a "i nne,ota Tax Ident I f I cat Ion numoer t s not reQul rea. P tease exp taln
on tne reverse side.
SIQnature Position (OfFicer. Partner. etc.) :
.Oat!
Mio.n~sot:l SC:HUCe. S~c.tian 176.182 requires every state :lnd lu~::lllicen:)ing J.gency rc
w;" .bold the issu~nct: or n:newal of a license or permit to oper:lte :l business or .:ng:lge in
!.hl activit:. in L\1innesota until the applicant presentj acceptabie ~..idence of compliance
with th.: worklers' compeIU4Stion insurance co'\'erage requirement of::'.155 Ch3pce....176.
The information required is: the name of the insurance comp:lny, the policy number, :md
dates of co,",era~e or the p~rmi{ to self-insure. This information will he collected b'; the
licensin~ agenc'\' and ret:lined in their files.
This information is required by law~ and licenses and permits to operate :1 business ma~'
not be issued or renewed if it is not proyided and/or is falsely reported. Furthermore, if
this information is not pro....ided or falsely stated, it may result in a 51,000 penalty ;lssl::$sed
against the applicant by the Commissioner ofrh.c Di:partment of Labor and Ind...::;tr:o.
Insuranc~ Company Nar::e: e~;"e,,';tne:.fi. -:z::".s-r,~,,'" ~e ?-.
iliQI the insurance ag~:lt)
Policy ~urnb~::-:
~pp
d#7
1:'379
Dates \Jf Co'\:er:lge:
~/'Z..b/9~
to '5/-z.e> /97
(or)
I am not required ~o ha...";: worke!'s' compensation EabiEty CQv,;:rage b~"::iu:::c:
( ) I hJse no employees
( ) I am sdf insured (include pc::-rrJ.lt to sel.f-insur~)
( ) I have: no ~mproyee~ .......ho are cove:ed 0;: the work~rs' compc:1$.:!.ticnl:::....... (~hc~s~ inch:.de:
Spouse, Parcnts, Chilc:ren and c;::'tain far::1 e:nploye~s)
I certit:" that tile information pro""ided. acove is :iCC1.lI'ate and comple~e :md ttat a valid worke=s'
compensation policy "",ill be kept in effec,: at all times as n:::rilie-:i DY la...,".
Name:
i':?'~"N, /JIlt; ~~ ~ 10# (J..
(l<b"l, ~ middle)
Doing Busin~ss As:
J<E I;) ,.I D..s / .:c ,./ v .
(busin~ss name if difIerem than your name)
Busine'S5 Address: Z S~P ~,'/,'r J&b,..Jc. vua y
City. State. Zip: ~ .t/<. #I'L. 5~--r1'Z--
Phone::6',.z )4~S- - <3 S"41(!7
Signature:: ~~~~
Dat~: -S/7." /,?