HomeMy WebLinkAboutItem 07 Tall Firs Cafe and Events Liquor LicenseAGENDA ITEM SUMMARY
Meeting Date: 11/7/2022
Meeting Type:
Regular Meeting
Staff Contact/Dept.:
Robin Holman - DPW
Staff Phone No:
541-726-3662
Estimated Time:
Consent Calendar
SPRINGFIELD Council Goals:
Mandate
CITY COUNCIL
ITEM TITLE: LIQUOR LICENSE APPLICATION FOR A CHANGE OF OWNERSHIP FOR
TALL FIRS CAFE AND EVENTS LLC, DBA: TALL FIRS CAFE AND
EVENTS.
ACTION Endorsement of OLCC Liquor License Application for Tall Firs Caf6 and Events,
REQUESTED: located at 1486 18' Street Springfield, OR 97477.
ISSUE The owner of Tall Firs Caf6 and Events LLC has requested the City Council to
STATEMENT: endorse its OLCC Liquor License Application.
ATTACHMENTS: Attachment 1: OLCC Liquor License Application.
DISCUSSION/
The license endorsement for Tall Firs Caf6 and Events LLC, DBA: Tall Firs Caf6
FINANCIAL
and Events is for a Change of Ownership with Full On -Premises Sales. The license
IMPACT:
application has been reviewed and approved by the appropriate City Departments.
LIQUOR LICENSE APPLICATION
Page 1 of 3
Check the appropriate license request option:
❑ New Outlet I X Change of Ownership 1 ❑ Greater Privilege I ❑ Lesser Privilege
Select the license type you are applying for.
More information about all license types is available online.
Full On -Premises
❑Commercial
*Caterer ECH-10-14-22
❑Public Passenger Carrier
]Other Public Location
❑For Profit Private Club
❑Nonprofit Private Club
Winery
❑Primary location
Additional locations: [32nd 03rd ❑4th ❑5th
Brewery
❑Primary location
Additional locations: ❑2nd 03rd
Brewery -Public House
[]Primary location
Additional locations: ❑2nd 03rd
Grower Sales Privilege
❑Primary location
Additional locations: 02nd 113rd
Distillery
❑ Primary location
Additional tasting locations: 02nd 03rd 04th 05th 06th
❑ Limited On -Premises
❑ Off Premises
❑ Warehouse
❑ Wholesale Malt Beverage and Wine
INTERNAL USE ONLY
Application received: 07/25/2022
Minimum documents acquired: 07/25/2022
LOCAL GOVERNING BODY USE ONLY
City/County name:
Date application received:
Optional: Date Stamp
❑ Recommend this license be granted
❑ Recommend this license be denied
Printed Name
uate
Return this form to:
Investigator name: Eric.Hildebrand
Email: Eric. Hildebrand@oregon.gov
Attachment 1, Page 1 of 5 OLCC Liquor License Application (Rev. 04.15.22)
LIQUOR LICENSE APPLICATION
Page 2 of 3
APPLICANT INFORMATION
Identify the applicants applying for the license. This is the entity (example: corporation or LLC)
or individual(s) applying for the license. Please add an additional page if more space is needed.
Name of entity or individual applicant #1:
Name of entity or individual applicant #2:
To 11 R✓s Ca4e ad 6vatfs LLC.
C h 9)5 D1`dyrL&y&r
Name of entity or individual applicant #3:
Name of entity or individual applicant #4:
BUSINESS INFORMATION
Trade Name of the Business
�(name customers will see):
` -
Business phone number: Business email:
o 3 Z - --fallf'rs eatea_t,?de
Premises street address (The physical location of the business and where the liquor license will be posted):
1486
City: r l�Zip %Code. County:
L47 12
Business fWailing address (where we will send any items by mail as described in OAR 845-004-0065[11.):
/ q8 P / e`F y.�t
City: State:
Does the bu mess address currently have an OLCC
liquor license?Yes ❑ No
APPLICATION CONTACT INFORMATION
Zip Code:
I ?V]
Does the business address currently have an OLCC
marijuana license? ❑ Yes ,K No
Contact Name:
(' h e� Is
Phone number: Email:
.7 91- 5 I 5 Z 5 7 7at*rs e�vve, ,t6 & grna� 1. «n
Mailing address:
- 151 S_ IIb44--lct.A(
City: Zip Zip Code: County:
9 _7y 0 1
Plaacp nnip: linuor license annliratirins are nuhlir rprnrris
Attachment 1, Page 2 of 5 OLCC Liquor License Application (Rev. 04.15.22)
LIQUOR LICENSE APPLICATION
Page 3 of 3
ATTESTATIONS
By signing this form, you attest that each of the following statements are true. I understand the
Commission may require a licensee to provide proof of any of the below or below referenced
documents at any time.
I understand that marijuana is prohibited 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 un-
waivable 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.
Attachment 1, Page 3 of 5 OLCC Liquor License Application (Rev. 04.15.22)
�_'�dsoA
D, 'Amqw-
g 5 -12 -z -
Print name
Signatur
Date
Atty. Bar Info (if applicable)
Print name
Signature
Date
Atty. Bar Info (if applicable)
Print name
Signature
Date
Atty. Bar Info (if applicable)
Print name
Signature
Date
Atty. Bar Info (if applicable)
Attachment 1, Page 3 of 5 OLCC Liquor License Application (Rev. 04.15.22)
Oregon Liquor Control Commission
9 N LIMITED LIABILITY COMPANY (LLC) QUESTIONNAIR
9 -
LLC Name
PRINT FORM
E RESET FORM
Trade Name of Business (Name Customers Will See) Tat Fir lrQft 'T C—veh
The LLC named in this document is a (see page 1 for definitions): Manager -Managed LLC Member -Managed LLC
Thia aartinn is r1Nl V fnr a mananar-mnnnnari I I C tnirartinns nn nano 1 Ynu may inrluda infnrmntinn nn n senarate sheet.)
Name of Managing Member leaseprint)
Name of Managing Member leaseprint)
CVQASe,o' T) u� 0A V
I o 0?,2
This section is for BOTH a manager -managed LLC and a member -managed LLC. (Directions on page 1. You may include information
nn a cPnarata chaPt )
Name of Member leaseprint)
Percentage of issued membership held
tCk �, "
I o 0?,2
Secretary
Treasurer
Vice president with responsibility over the operation of the business
This section is ONLY for an LLC with the listed nffir_ars_ mirertinns nn nane 1 You may include information on a senarate sheet.)
Title
Name leaseprint)
President
Secretary
Treasurer
Vice president with responsibility over the operation of the business
SERVER EDUCATION DESIGNEE Directions on page 1
Name leaseprint)
SIGNATURE (Directions on page 1) C [
NAME pI"¢igningjPersonA*rhVse type or print) 7 1
SIG TU of NgKng kers (may electronically sign)
This box for OLCC use ONLY exp 7 -
Only for an applicant of record: SOS Number 1989124-96
Does the entity hold, or has it ever held, an OLCC-issued liquor license?
Rev: 10.7.20
Page 2 of 2
ate of Birth
or
DATE
ZZ Z�-
Current at time of issuing license (yes/no)
N
Attachment 1, Page 4 of 5
e�GON LfQ`O
OREGON LIQUOR CONTROL COMMISSIONNOV
BUSINESS INFORMATION
Please Print or Type
TALL FIRS CAFE AND EVENTS LLC
Applicant Name:
Trade Name (dba): �TC(I EA Cafe
Phone: 5c-1 I ' 5115 2-5 7
.1460 1
Business Location Address: / 10 � sl12eil YI
City: _, JX01_lgf oPJc r 0 ZIP Code: 17'177
JAYS AND HOLIRS OF OPERATIC'.
Business Hours:"`
Outdoor Area Hours:
The outdoor area is used for:
Sunday � to �v �1/�
Sunday
to
❑ Food service Hours: to
Monday 7 �n to 2P,
Monday
to
LJAlcohol service Hours: to
Tuesday ento �
Tuesday
to
Ll Enclosed, how
�:U
Wednesday 1Aleyl to 7 J2 /n
Wednesday
to
Thursday 7 rLm to -_2 :7 M
Thursday
to
The exterior area is adequately viewed and/or
Friday %M,to i2 %Yt—
Friday
to
supervised by Service Permittees.
Saturday fi to
Saturday
to
(Investigator's Initials)
Seasonal Variations: ❑ Yes ❑ No If yes, explain:
❑
-
Live Music
Check all that apply:
❑ Karaoke
' 'V Me •
❑
Recorded Music
❑
Coin-operated Games
Sunday to
Monday to
❑
DJ Music
1�j
Video Lottery Machines
Tuesday to
Wednesday to
❑
Dancing
❑
Social Gaming
Thursday to
❑
❑
Friday to
Nude Entertainers
Pool Tables
Saturday to
❑
Other:
Restaurant: 5 r Outdoor:
Lounge: Other (explain):
Banquet: I S0 Total Seating:
OLCC USE ONLY
Investigator Verified Seating:_(Y) _(N)
Investigator Initials:
Date:
I understand if my answer a no ru d mplete, the OLCC may deny my license application.
Applicant Signature: Date:• ZZ • Z�
1-8 0-452-OWC (6522)
www.oregon.gov/olcc (rev. 12/07)
Attachment 1, Page 5 of 5