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Home My WebLink AboutItem 10 US Market Liquor License AGENDA ITEM SUMMARY Meeting Date: 3/1/2021 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 US MARKET 222 LLC, DBA: US MARKET. ACTION REQUESTED: Endorsement of OLCC Liquor License Application for US Market, located at 4213 Main St. Springfield, OR 97478. ISSUE STATEMENT: The owner of US Market 222 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 US Market 222 LLC, DBA: US Market is for a New Outlet with Off-Premises Sales. The license application has been reviewed and approved by the appropriate City Departments. OREGON LIQUOR CONTROL COMMISSION LIQUOR LICENSE APPLICATION 1. Application. Do not include any OLCC fees with your application packet (the license fee will be collected at a later time). Application is being made for: License Applied For:CITY AND COUNTY USE ONLY Date application received and/or date stamp: Nome of City or County: € Brewery 1" Location Brewery Additional location (2"d) € (3'd) € € Brewery-Public House (BPH) 1" location BPH Additional location (2"d) € (3'd) € € Distillery € Full On-Premises, Commercial € Full On-Premises, Caterer Recommends this license be: € Granted € Denied BV: € Full On-Premises, PassengerCarrier € Full On-Premises, Other Public Location € Full On-Premises, For Profit Private Club Date:€ Full On-Premises. Nonorofit Private Club € (;rriwer S;ilps Privilpgp ((i5J)1 1 " Inr.,:itinn- - a - a - - a - - a - - a a a o a a - e) - I- - a I - a - -% - a - a a D.iteapplicationreceiove"dc: UsEl79NllYl'2( Date application accepted: GSP Additional location (2'd) € (3'd) € € Limited On-Premises [Z Off-Premises LJ Warehouse LJ Wholesale Malt Beverage & Wine License Action(s): ,€ Winery 1" Location Winery Additional location (2"d) € (3'd) € (,ith) @ (sth) @ 2.ldentifytheapplicant(s)applyingforthelicense(s). ENTITY(example:corporationorLLC)orlNDMDUAL(S)1 3pplying for the license(s): US Market 222, LLC App #1: NAME OF ENTITY OR INDIVIDUAL APPLICANT App #2: NAME OF ENTIT/ OR INDIVIDUAL APPLICANT App #3: NAME OF ENTITY OR INDMDUAL APPLICANT App #4: NAME OF ENTITY OR INDMDUAL APPLICANT 3. Trade Name of the Business (Name Customers Will See) USMarket 4. Business Address (Number and Street Address of the Location that will have the liquor license) 4213 Main St City SpringTield County Lane Zip Code 97478 Attachment 1, Page 1 of 3 OREGON LIQUOR CONTROL COMMISSION LIQUOR LICENSE APPLICATION 5. Trade Name of the Business (Name Customers Will See) US Market %g,- 6.DoesthebusinessaddresscurrentlyhaveanOLCCIiquorlicense? € YES [NO 7. Does the business address currently have an OLCC marijuana license? jlYES jNO 8. Mailing Address/Pa Box, Number, Street, Rural Route (where the OLCC will send yourlicense certificate, renewal application and other mailings as described in OAR 845-004-0065(11) 1038 Broadway St a'y Salem State OR ZipCOdegzao* 9. Phone Number of the Business Location '15D 10. Email Contact for this Applicat.on and for the Business usmktent@gmail.com 11. Contact Person for this Application Jennifer Babine Phone Number 503-391-8889 ext 101 Contact Person"s Mailing Address (if different)City State Zip Code Please note that liquor license applications are public records. A copy of the application will be posted on the OLCC website for a period of several weeks. ATTESTATION: "READ CAREFULLY AND MAKE SURE YOU UNDERSTAND BEFORE SIGNING THIS FORM" I understand that marijuana is on the licensed premises. This includes marijuana use, consumption, ingestion, inhalation, samples, give-away, sale, etc. I attest that all answers on all forms and documents, and all information provided to the OLCC as a part of this application are true and complete. I affirm that I have read OAR 845-005-0311 and all individuals (sole proprietors) or entities with an ownership interest (other than waivable ownership interest per OAR 845-005-0311[6]) are listed as license applicants in #2 above. I understand that failure to list an individual or entity who has an unwaivable ownership interest in the business may result in denial of my license or the OLCC taking action against my license in the event that an undisclosed ownership interest is discovered after license issuance. Applicant(s) Signature Mehar Sidhu App. #1: (PRINT NAME) * Each individual (sole proprietor) listed as an applicant must sign the application below. * If an applicant is an entity, such as a corporation or LLC, at least one INDMDUAL who is authorized to sign for the entity must sign the application. * Anindividualwiththeauthoritytosignonbehalfoftheapplicant(suchastheapplicant'sattorneyoranindividualwith power of attorney) may sign the application. If an individual other than an applicant signs the application, please provide written proof of signature authority. Attorneys signing on behalf of applicants may list the state of bar licensure and bar number in lieu of written proof of authority from an applicant. Applicants are still responsible for all information on this form. App #1: (SIGNATUR!) App #1: Signature Date Atty. Barlnformation (if applicable) Fli I+R Sangha App. #2: (PRINT NAME) 1Xa'\\ / App #2: (SIGNATURE:App #2: Signature Date Atty. Bar Information (if applicable) Atty. Bar Information (if applicable) Atty. Bar Information (if applicable) ""%cy5< " Sy oAA's\<coaJ icy5e, OLCC Liquor License Application (Rev. 9.28.20) Attachment 1, Page 2 of 3 OREGON LIQUOR CONTROL COMMISSION BUSINESS INFORMATION Please Print or Type 4pplj(,3110 Name: US Market 222, LLC TradeName(dba): Ui% Hgq'@e-'v Business Location Address: 4213 Main St Oj(y; Springfield TE5C) pl 101 1B,QC 510 0(10S2- ZIP Code: 97478 Seasonal Variations: € Yes q No If yes, explain: =*u4- ai 44 € Live Music Cl Recorded Music € DJ Music € Dancing € Nude AIupnpdieicrsatnatndsi.ifgmnyataunrseweyrSyarenot ftrueandco7LCC may "eDnaytem:y IicSense,ap\plica2tiaon, I 1 -800-452-OLCC (6522) urww.oregon.gov/olcc (rev. 12/07) Attachment 1, Page 3 of 3