Colorado > Statewide > Dept Of Revenue > Liquor Enforcement Division
Colorado Liquor Retail License Application DR 8404 - Colorado
| Colorado Liquor Retail License Application Form. This is a Colorado form and can be used in Liquor Enforcement Division Dept Of Revenue Statewide . |
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DR 8404 (05/07/09) Page 1 COLORADO DEPARTMENT OF REVENUE LIQUOR ENFORCEMENT DIVISION DENVER CO 80261 21 COLORADO LIQUOR RETAIL LICENSE APPLICATION DEPARTMENT USE ONLY NEW LICENSE TRANSFER OF OWNERSHIP LICENSE RENEWAL · · · · ALL ANSWERS MUST BE PRINTED IN BLACK INK OR TYPEWRITTEN APPLICANT MUST CHECK THE APPROPRIATE BOX(ES) LOCAL LICENSE FEE $ __________________________ APPLICANT SHOULD OBTAIN A COPY OF THE COLORADO LIQUOR AND BEER CODE (Call 303-370-2165) Corporation Partnership (includes Limited Liability and Husband and Wife Partnerships) Individual Limited Liability Company Association or Other Fein Number Business Telephone 1. Applicant is applying as a 2. Applicant If an LLC, name of LLC; if partnership, at least 2 partner's names; if corporation, name of corporation 2a. Trade Name of Establishment (DBA) 3. Address of Premises (specify exact location of premises) City 4. Mailing Address (Number and Street) County City or Town State State State Sales Tax No. ZIP Code ZIP Code Present Trade Name of Establishment (DBA) LIAB 2300 2302 2310 SECTION A 5. If the premises currently have a liquor or beer license, you MUST answer the following questions: Present State License No. Present Class of License Present Expiration Date NONREFUNDABLE APPLICATION FEES LIAB 1985 1986 1988 1990 1991 2010 2011 2012 2020 2021 2030 2031 2040 2041 2045 2046 2220 2370 2375 SECTION B (CONT.) LIQUOR LICENSE FEES Application Fee for New License ............................... $1,025.00 Application Fee for New License w/Concurrent Review ................................................. $1,125 00 Application Fee for Transfer ...................................... $1,025.00 LIAB 1905 1906 1940 1941 1950 1951 1960 1961 1970 1971 1975 1976 1980 1981 1983 SECTION B LIQUOR LICENSE FEES $500.00 $500.00 $227.50 $312.50 $227.50 $312.50 $351.25 $436.25 $500.00 $500.00 $750.00 $750.00 $500.00 $500.00 $ 75.00 Retail Gaming Tavern License (City) ............................ Retail Gaming Tavern License (County) ....................... Retail Liquor Store License (City) ................................. Retail Liquor Store License (County) ............................ Liquor Licensed Drugstore (City) .................................. Liquor Licensed Drugstore (County) ............................. Beer and Wine License (City) ....................................... Beer and Wine License (County) .................................. Hotel and Restaurant License (City) ............................. Hotel and Restaurant License (County) ........................ Brew Pub License (City) ............................................... Brew Pub License (County) .......................................... Hotel and Restaurant License w/opt premises (City) .... Hotel and Restaurant License w/opt premises (County) Manager Registration - H & R ....................................... Resort Complex License (City) ................................. $500.00 Resort Complex License (County) ............................ $500.00 Add Related Facility to Resort Complex ... $ 75.00 X ____ Total Club License (City) ................................... $308.75 Club License (County) .............................. $308.75 Tavern License (City) ............................... $500.00 Tavern License (County) .......................... $500.00 Manager Registration - Tavern ................. $ 75.00 Arts License (City) .................................... $308.75 Arts License (County) ............................... $308.75 Racetrack License (City) .......................... $500.00 Racetrack License (County) ..................... $500.00 Optional Premises License (City) ............. $500.00 Optional Premises License (County) ........ $500.00 Vintners Restaurant License (City) ........... $750.00 Vintners Restaurant License (County) ...... $750.00 Add Optional Premises to H & R .............. $100.00 X ____ Total Master File Location Fee .......................... $ 25.00 X ____ Total Master File Background ............................ $250.00 X ____ Total ___ ___ ___ ___ DO NOT WRITE IN THIS SPACE - FOR DEPARTMENT OF REVENUE USE ONLY LIABILITY INFORMATION County City Industry Type License Account Number Liability Date FROM State City County Managers Reg 3210987654321098765432121098765432109876543210987654321 321098765432109876543212109876543210987654321098765432 3210987654321098765432121098765432109876543210987654321 3210987654321098765432121098765432109876543210987654321 3210987654321098765432121098765432109876543210987654321 3210987654321098765432121098765432109876543210987654321 1 3210987654321098765432121098765432109876543210987654321 License Issued Through (Expiration Date) TO _____-750 (999) 2180-100 (999) 2190-100 (999) ______-750 (999) Cash Fund New License Cash Fund Transfer License 2300-100 (999) 2310-100 (999) TOTAL $ · American LegalNet, Inc. www.FormsWorkFlow.com DR 8404 (05/07/09) Page 2 APPLICATION DOCUMENTS CHECKLIST AND WORKSHEET Instructions: This check list should be utilized to assist applicants with filing all required documents for licensure. All documents must be properly signed and correspond with the name of the applicant exactly. All documents must be typed or legibly printed. Upon final State approval the license will be mailed to the local licensing authority. Application fees are nonrefundable. ITEMS SUBMITTED, PLEASE CHECK ALL APPROPRIATE BOXES COMPLETED OR DOCUMENTS SUBMITTED I. APPLICANT INFORMATION A. Applicant/Licensee identified. B. State sales tax license number listed or applied for at time of application. C. License type or other transaction identified. D. Return originals to local authority. E. Additional information may be required by the local licensing authority. II. DIAGRAM OF THE PREMISES A. No larger than 8 1/2" X 11". B. Dimensions included (doesn't have to be to scale). Exterior areas should show control (fences, walls, etc.). C. Separate diagram for each floor (if multiple levels). D. Kitchen - identified if Hotel and Restaurant. III. PROOF OF PROPERTY POSSESSION A. Deed in name of the Applicant ONLY (or) B. Lease in the name of the Applicant ONLY. C. Lease Assignment in the name of the Applicant (ONLY) with proper consent from the Landlord and acceptance by the Applicant. D. Other Agreement if not deed or lease. BACKGROUND INFORMATION AND FINANCIAL DOCUMENTS A. Individual History Record(s) (Form DR 8404-I). B. Fingerprints taken and submitted to local authority. (State authority for master file a
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