HomeMy WebLinkAboutItem 04 Lee's Mongolian Grill Liquor LicenseAGENDA ITEM SUMMARY Meeting Date: 3/6/2023
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 NEW OUTLET FOR HILDA SOTO
DUARTE, DBA: LEE'S MONGOLIAN GRILL.
ACTION
Endorsement of OLCC Liquor License Application for Lee's Mongolian Grill,
REQUESTED:
located at 215 Main Street Springfield, OR 97477.
ISSUE
The owner Hilda Soto Duarte has requested the City Council to endorse its OLCC
STATEMENT:
Liquor License Application.
ATTACHMENTS:
1: OLCC Liquor License Application.
DISCUSSION/
The license endorsement for Hilda Soto Duarte, DBA: Lee's Mongolian Grill is for
FINANCIAL
a New Outlet with Limited On -Premises Sales. The license application has been
IMPACT:
reviewed and approved by the appropriate City Departments.
LIQUOR LICENSE APPLICATION
Page 1 of 3
Check the appropriate license request option:
�lew Outlet I ❑ Change of Ownership I ❑ 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
.jmmercial
❑Caterer
❑Public Passenger Carrier
❑Other Public Location
❑For Profit Private Club
❑Nonprofit Private Club
Winery
❑Primary location
Additional locations: ❑2nd 03rd ❑4th 05th
Brewery
❑Primary location
Additional locations: ❑2nd ❑3rd
Brewery -Public House
❑Primary location
Additional locations: 02nd ❑3rd
Grower Sales Privilege
❑Primary location
Additional locations: ❑2nd 03rd
Distillery
❑ Primary location
Additional tasting locations: 02nd 03rd 04th 05th 06th
® Limited On -Premises per 01/31/23 email LG
❑ Off Premises
❑ Warehouse
❑ Wholesale Malt Beverage and Wine
INTERNAL USE ONLY
Application received:
10/27/2022
Minimum documents acquired:
10/27/2022
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 Date
Return this form to:
Investigator name:
Leah Gessel
Email:
leah.gessel@oregon.gov
Attachment 1, Page 1 of 4 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:
sod(-) -buz"At
I lesw5 Sv+ o
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):
. �0- e- 1 5 M6V 0U0 -n Gy -Al
Business phone number:
Business email:
Premises street address (The physical location of the business
and where the liquor license will be posted):
_ l 5 ("" �n S+- • - -
,- -- -- - ---- - - --
City: . Zip Code:
�I ev 'TWI-7
j County:
! Law
Business mailing address (where we will send any items by mail as described in OAR 845-004-0065[11.):
aVAclle W(L
City:
State:
Zip Code:
9-7 Ll
Does the business address currently have an OLCC
Does the business address currently have an OLCC
liquor license? ❑ Yes ILNo
marijuana license? ❑ Yes Wr No
APPLICATION CONTACT INFORMATION
Contact Name:
tt.o,,�-fie-
Phone number:
Sq(r 33-7— o VQ9
Mailing address:
_ ),l;7(& Scelle WQq
City:
uqc
Email:
Zip Code: County:
cpLI o Lj LGt�,
�
f lease nose: liquor license applications are punllc recoras.
Attachment 1, Page 2 of 4 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.
i 1 c� a 5 y J��u►-�� /u/z 2
Print name Signature Date Atty. Bar Info (if applicable)
J ..J
J25 ',C9 San�-arl4 Svt70 T�esys
Print name Signature Date Atty. Bar Info (if applicable)
Print name
Signature
Date
Print name Signature Date
Attachment 1, Page 3 of 4
Atty. Bar Info (if applicable)
Atty. Bar Info (if applicable)
OLCC Liquor License Application (Rev. 04.15.22)
' « OREGON LIQUOR CONTROL COMMISSION
BUSINESS INFORMATION
Please Print or Type
A j j C
Applicant Name: 144 ck � 0, _C �iC:t►-�2 S
pP Phone: t�� l � ��7 � ��
Trade Name (dba):_ ( p>? j Ogoano h) An &V,11
Business Location Address: 0[� Maw) S+
City: so w r, Q 1, d ZIP Code: L 7 Y 7%
Seasonal Variations: ❑ Yes ❑ No If yes, explain:
Check all that apply:
1 • •
Business
Hours:
Outdoor Area Hours:
The outdoor area is used for:
Sunday
� ty`
`A'l:�#e toy%
Sunday
to
Ll Food service Hours: to
Monday
Tuesday
11. `Y' to G cx0 -)" I
11.003 ylo p�; M
Monday
to
LI Alcohol service Hours: to
Wednesday
1100 AtINto G' th
Wednesday
to
to
❑ Enclosed, how
Thursday
0:00-10'%to O, 0
Thursday
to
The exterior area is adequately viewed and/or
Friday
11 Q0;4% to q 0
—WW
Friday
to
supervised by Service Permittees.
Saturday
11 to G CO 9
Saturday
to
N/A (Investigator's Initials)
Seasonal Variations: ❑ Yes ❑ No If yes, explain:
Restaurant:
Lounge:
Banquet:
Outdoor:
Other (explain):
Total Seating: ;;L�
OLCC USE ONLY
Investigator Verified Seating:_(Y) X (N)
Investigator Initials: LG
01/04/2023
I understand if my answers are not true and complete, the OLCC may deny my license application.
Applicant Signature: � Date:/e7l Z,Vf L Z-
1-800-452-OLCC (6522)
www. oregon.gov/olcc (rev. 12/07)
Attachment 1, Page 4 of 4
Check all that apply:
1 • •
❑
Live Music
❑ Karaoke
❑
Recorded Music
❑ Coin-operated Games
Sunday
toMonday
to
❑
DJ Music
❑ Video Lottery Machines
Tuesday
to
❑
❑
Wednesday
to
Dancing
Social Gaming
Thursday
to
❑
Nude Entertainers
❑ Pool Tables
Friday
Saturday
to
to
❑ Other:
Restaurant:
Lounge:
Banquet:
Outdoor:
Other (explain):
Total Seating: ;;L�
OLCC USE ONLY
Investigator Verified Seating:_(Y) X (N)
Investigator Initials: LG
01/04/2023
I understand if my answers are not true and complete, the OLCC may deny my license application.
Applicant Signature: � Date:/e7l Z,Vf L Z-
1-800-452-OLCC (6522)
www. oregon.gov/olcc (rev. 12/07)
Attachment 1, Page 4 of 4