HomeMy WebLinkAboutItem 09 Cheesesteak NW Liquor License AGENDA ITEM SUMMARY Meeting Date: 10/1/2018
Meeting Type: Regular Meeting
Staff Contact/Dept.: Robin Holman - DPW
Staff Phone No: 541-726-3662
Estimated Time: Consent Calendar
S P R I N G F I E L D
C I T Y C O U N C I L
Council Goals: Mandate
ITEM TITLE: LIQUOR LICENSE APPLICATION FOR A NEW OUTLET FOR
CHEESESTEAK NW LLC, DBA: CHEESESTEAK NW.
ACTION
REQUESTED:
Endorsement of OLCC Liquor License Application for Cheesesteak NW, located at
521 Main Street Springfield, OR 97477.
ISSUE
STATEMENT:
The owner of Cheesesteak NW LLC has requested the City Council to endorse its
OLCC Liquor License Application.
ATTACHMENTS: Attachment 1. OLCC Liquor License Application.
DISCUSSION/
FINANCIAL
IMPACT:
The license endorsement for Cheesesteak NW LLC DBA: Cheesesteak NW is for a
New Outlet with Limited on-Premises Sales. The license application has been
reviewed and approved by the appropriate City Departments.
ffi OREGON LIQUOR CONTROL COMMISSION
LIQUOR LICENSE APPLICATION
IICENSE FEE: Do not include the license fee with the
application (the license fee will be collected at a later
time).
APPIICATION: Application is being made for:
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Brewery
Brewery-Public House
Distillery
Full On-Premises, Commercial
Full On-Premises, Caterer
Full On-Premises, Passenger Carrier
Full On-Premises, Other Public Location
Full On-Premises, Nonprofit Private Club
Full On-Premises, For-Profit Private Club
Grower Sales Privilege
Limited On-Premises
Off-Premises
Off-Premises with Fuel Pumps
Warehouse
Wholesale Malt Beverage & Wine (WMBW)
Winery
CIW AND COUNW USE ONLY
Date application received
Recommends this license be Granted Denied
By
Date
OLCC USE
Application received by
Date
LicenseAction: NgrO CU*\UA
1. LEGAL ENTIW (example: corporation or LLC) or INDIVIDUAL(S) applying for the license:
Applicant #1
Cheesesteak NW LLC
Applicant #2
eicnncnJ!'fu+ne-
Applicant #3Erirt{oruenaurns Applicant #4
2. Trade Name of the Business (the name customers will see):
Cheesesteak NW
3. Business Location: Number and Street 521 Maln Street
city Springtlelo County Lane 71p97477
4. ls the business at this location licensed the oLcc?Yes No
5. Mailing Address (where the OLCC will send your moil):
pO Box, Number, Street, Rural Route 2240 El Bonlta Place
city springfield State oB 71p 97477
6. Phone Number of the Buslness Location:
7. Contact Person for this
Name Phone Number
Mailing Address, City, State, ZIP
2240El Bonlta Place, Sprlngfleld, OR,97477
g,ns; ; cheesesteaknw@ gmall.com
I understand that marijuana (such as use, consumption, ingestion, inhalation, samples, give-away, sale, etc.) is
prohibited on the licensed premises.
Signature of Applicant Signature of Applicant #2Stepnqrm+mr
signaFuie ;fAFETtoLnt+*!.e*Horrc'rr8unrs Signature of Applicant #4
q
OLCC Liquor License Application (Rev. 06/2017)
Name of City or County
'l tc"
Attachment 1, Page 1 of 3
OREGON LIQUOR CONTROL COMMISSION
LIMITED LIABILITY COMPANY QUESTIONNAIRE
Please Print or Type
LLC Na Cheesesteak NW , LLC
Cheesesteak NW
.2017Year Filed
frade Name (dba):
Business Location Address:521 Main Street
Springfield ZIP Code 97477
List Members of LLC:
.,. Stephen M. Burns
Percentage of Membership lnterest:
50Yo
50o/o
(managing member)
Teri Lowen Burns2.
3.
4.
5.
6.
(members)
(Note: lf any LLC member is another legal entity, that entity musf a/so complete an LLC, Limited
Parlnership or Corporation Questionnaire. lf the LLC has officers, please list them on a separate
sheef of paper with their titles.)
Seruer Education Desig Teri Lowen Bums DOB .
3V6D:
I understand that if answers not true and complete, the OLCC may deny my license application
a
1-800452-OLCC (65221
(title)
Signatu
www.olcc.state.or.us
Date:
(rev. )
Attachment 1, Page 2 of 3
OREGON LIQUOR CONTROL COMMISSION
BUSINESS INFORMATION
Please Print or Type e
Applicant Name
he<t<e;te>V N \^/LLC-,9t 6s'z z?dq
Trade Name (dba):e,Sr-Z'k Ntv
Business Location Address fzt M*tu%
City D ZIP Code:7
DAYS AND HOURS OF OPERATION
Business Hours:
Sunday
Monday /2-2Lho T
Outdoor Area Hours:
Tuesday
Thursday
Friday
Saturday
outdoor area is used for:
tr
tr Alcohol
0 Enclosed,
The exterior area is
supervised by Service Perm
Hours: _to _
Hours: _to _
viewed and/or
Tuesday /tt 30lp
Wednesday
Thursday
Friday
Saturday
.7?
T_q?
7?
to
to
to
to
to
to
Wednesday
lnitials)
Seasonal Variations: D Yes !o-"
tr
tr
tr
Restaurant:
Lounge:
Banquet:
Live Music
Recorded Music
DJ
Dancing
Nude Entertainers
Check all that apply:
E xaraoxe
EI coin-op"rated Games
E UO.o Lottery Machines
E SociatGaming
EI otn"r,
Outdoor:
Other (explain):
Totarseatins, 40
Sunday-
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
to
to
to
to
to
to
I understand if my answers a true plete,
1-800-452-OLCC (6s221
Date:--
may deny my license a
ENTERTAINMENT DAYS & HOURS OF LIVE OR DJ MUSIC
SEATING COUNT
Applicant Sig
wmt.oregon.gov/olcc (rev. 1U07)
lf yes, explain:
tr
OLCC USE ONLY
lnvestigator Verified Seating:_(Y) _(N)
lnvestigator lnitials:_
Attachment 1, Page 3 of 3