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Home My WebLink AboutItem 06 Round Table Pizza Liquor License AGENDA ITEM SUMMARY Meeting Date: 6/7/2021 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 ADDITIONAL PRIVILEGES FOR WESTGATE INC, DBA: ROUND TABLE PIZZA #250. ACTION REQUESTED: Endorsement of OLCC Liquor License Application for Round Table Pizza #250, located at 5547 Main St. Springfield, OR 97478. ISSUE STATEMENT: The owner of Westgate Inc. 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 Westgate Inc., DBA: Round Table Pizza #250 is for additional privileges of 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: Nal'i1e Of Cit/ Or COunt/: € Brewery 1" Location Brewery Additional location (2"d) € (3') € II] Brewery-PublicHouse(BPH)l'Jocation BPH Additional location (2'd) [J (3") [] € Distillery € Full On-Premises. Commercial € Full On-Premises, Caterer Recommends this license be: € Granted € Denied BV: € Full On-Premises, Passenger Carrier € Full On-Premises, Other Public Location € Full On-Premises, For Profit Private Club Date:[1] Fllll On-Prpmisps. Nonnrofit Prlvatp Cluh n ('::rniaigr Q:iloc 9riiiilt>op /(Qgl I " Irir:i+irin- %J u V V (l j ta I t_ J I I - V I I 1_ 51. } %l--l I & Ilj[(l & 1111 I OLCC USE ONLY Dale application received: 3/j5/:,1GSP Additional location (2'd) [1] (3'd) € TT * - a - . I #. _ . . ._ I _u cimitea un+'remises Date application accepted: 31'l'E'lllID Off-Premises [_J- Warehouse € Wholesale Malt Beverage & Wine License Action(s): AtFriv € Winery 1" Location Winery Additional location (2'd) € (3'd) € (zith) (zl (5th) 0 2.ldentifytheapplicant(s)applyingforthelicense(s). ENTITY(example:corporationorLLC)orlNDMDUAL(S)1 applying for the license(s): Westgate, Inc. App #1: NAME OF ENTITY OR INDIVIDUAL APPLICANT App #2: NAME OF ENTITY OR INDMDUAL APPLICANT App #3: NAME OF ENTI1Y OR INDIVIDUAL APPLICANT App#4: NAME OF ENTITY OR INDIVIDUAL APPLICANT 3. Trade Name of the Business (Name Customers Will See) Round Tabie Pizza #250 4. Business Address (Number and Street Address of the Location that will have the liquor license) 5547 Main St. City Springfield County Lane Zip Code 97478 ' Read the instructions on page I carefully. If an e33 is applying for the license, list the name of the as an applicant. If an individual is applying as a sole proprietor (no entity), list the as an applicant. OtCC Liquoi License Application (Rev 9 28.20) Attachment 1, Page 1 of 3 OREGON LIQUOR CONTROL COMMISSION LIQUOR LICENSE APPLICATION 5. Trade Name of the Business (Name Customers Will See) Round Table Pizza #250 6. Does the business address currently have an OLCC liquor license?[g iYES []NO 7.DoesthebusinessaddresscurrentlyhaveanOLCCmarijuanalicense? nYES r;01NO 8. MailingAddress/Pa Box, Number, Street, Rural Route (where the OLCC will send yourlicense certificate, renewal application and other mailings as described in OAR 845-004-0065plj.) 728 Scolts Valley Rd. c"'l Yancalla State oregOn Zip Code g74gg 9. Phone Number of the Business Location 541-741-2165 10. Email Contact for this Application and for the Business LesleyNish@msn.com 11. Contact Person for this Application Lesley Nishiguchi Phone Number 541-954-8335 Contact Person's MailingAddress (if different) 728 Scoffs Valley Rd. City Yoncalla State OR Zip Code 97499 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:"JIEADCAREFuLLY ANDMAKESUREYOuUNDERSTANDBEFORESIGNINGTHISFOR?/l" I understand that marijuana Is on the licensed premises. This includes marijuana use, consumption, ingestion, inhalation, samples,give-away,sale,etc. lattestthatallanswersonallformsanddocuments,andallinformationprovldedtotheOLCCasapartof this application are true and complete. I affirm thatlhave read OAR 845-005-0311 and all individuals (sole proprietors) or entitles 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 intersst 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 Each individual (sole proprietor) listed as an appllcant must sign the application below. If an applicant Is an entity, such as a corporation or LLC, at least one INDMDuAL who /s authorized to sign for the entity must sign the application. An individual with the authority to sign on behalf of the applicant (such as the applicant's attorney or an Individual with power of attorney) may sign the application. If an individual other than an applicant signs the application, please provide written proofof 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 forallinformation on this form. Lesley Nishiguchi App. #1: (PRINT NAME) sj) s i ! a KpJ#l:(SlqNA'TURE) J App#l:SlgnatureDate Atty. Bar Information (if applicable) App. #2: (PRINT NAME)App #2: (SIGNATURE)App #2i Signature Date Atty. Barlnformation (if applicable) App. #3: (PRINT NAME)App #3: (SIGNATURE)App #3: Signature Date Atty. Bar Information (if applicablel App. #4: (PRINT NAME)App #4: ISIGNATURE)App #4: Signature Date Atty. Barlnformation (if applicable) OLCC Liqux Llcense Applicatiiin (Rev 9 28 20) Attachment 1, Page 2 of 3 OREGON LIQUOR CONTROL COMMISSION BUSINESS INFORMATION Please Print or Type Applicant Name.' Wes,tgate, Inc. Trade Name (dba): Round Table Pizza #250 Business Location Address: 5547 Matn S!- City: Springfield Phone: 541-849-2465 ZIP Code: 97478 Business Hours: Sunday llam Monday ham Tuesday Wednesday llam Thursday 'lTam Friday ham Saturday ham to 9pm (0 9pni OutdoorArea Hours: Sunday Monday Tuesday Wednesday Thursday Friday Saturday The outdoor area is used for: 0 Food service Hours: € Alcohol service Hours: CI Enclosed, how The exterior area is adequately viewed and/or supervised by Service Permittees. (lnvestigatoras Initials) Seasonal Variations: € Yes EI No If yes, explain: Reskaurant: Outdoor: Lounge: Banquet: Other (explain): No dine in right nOW Total Seating: OLCC L18E ONLY Investigator Verified Sealing:(Y) (N) Inves(igaior Initials: Date: www.oregon.govtoxcc (rev.l2/07) Attachment 1, Page 3 of 3