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DR 8432(0924/09) Page 4 <br /> 1 1 8.Change of Manager or to Register the Manager of a Tavern or a Hotel and Restaurant liquor license. <br /> w_; (a)Change of Manager(attach Individual History DR 8414-I H/R and Tavern only) <br /> 0 .i <br /> ¢ Former manager's name <br /> iz <br /> • 2 ! New manager's name <br /> .p 1 (b) Date of Employment <br /> • w 1 Has manager ever managed a liquor licensed establishment? Yes❑ No❑ <br /> z' Does manager have a financial interest in any other liquor licensed establishment? Yes❑ No❑ <br /> • <br /> s i If yes, give name and location of establishment <br /> 0 • <br /> 9. Modification of Premises,Addition of an Optional Premises,or Addition of Related Facility <br /> . _.i NOTE:Licensees may not modify or add to their licensed premises until approved by state and local authorities. <br /> °t ' (a) Describe change proposed Modification of oremises to include a portion of the barking lot to allow the sale and <br /> 0 . consumption of alcoholic beverages.The changes will be made on August 4.2012 to 10:00 P.m. Live amplified music <br /> ;:o. 2 will be play from 12:00 am.to 10:00 D.M. <br /> O'er. <br /> O a j (b ) If the modification is temporary,when will the proposed change: <br /> z u-I Start August 4.2012 (mo/day/year) End August 4,2012 (mo/day/year) <br /> io 0 <br /> s H-�; NOTE:THE TOTAL STATE FEE FOR TEMPORARY MODIFICATION IS$300.00 <br /> o.�; (c)Will the proposed change result in the licensed premises now being located within 500 feet of any public or <br /> ce re` private school that meets compulsory education requirements of Colorado law, or the principal campus of any <br /> o o college, university or seminary? <br /> rn 0: <br /> L co! (If yes, explain in detail and describe any exemptions that apply) Yes❑ No Cpl <br /> .m- i (d) Is the proposed change in compliance with local building and zoning laws? Yes C+' No❑ <br /> ■ w, (e) If this modification is for an additional Hotel and Restaurant Optional Premises or Resort Complex Related <br /> p .re <br /> i a 1:1-1 Facility, has the local authority authorized by resolution or ordinance the issuance of optional premises? <br /> o ' Yes No <br /> ,o <br /> •n , (f)Attach a diagram of the current licensed premises and a diagram of the proposed changes for the <br /> licensed premises. <br /> (g)Attach any existing lease that is revised due to the modification. <br /> < . � OATH OF APPLICANT .. <br /> i • I declere under-penalty of'perjury in the second degree that-I have read the foregoing application and-all attachments <br /> _ ,__ thereto,and:that alliinformation therein latrue correct and complete'toahe best;of wmy'knowledge _,._ <br /> _ ._._...�_.__�.. die Date .__ <br /> Signat _,W...______—_—__,-..—_._ ___ _ ... <br /> 1 Member 6/21/2012 <br /> N i4 REPORT.AND APPROVAL OF LOCAL LICENSING AUTHORITY(CITY/COUNTY) '` <br /> _-The foregoing application has:been examined and:the premises,business conducted and character of the iapplicant is-- <br /> satisfactory, and we do report'that.such permit if granted .will comply with the applicable'provisions of Title 12,Articles ' <br /> 461and47,c.R S>�as'ainended :THEREFORE THISAPPLICATIONISAPP.ROVED - -=` <br /> Local Licensing Authority(City or County) Date filed with Local Authority <br /> Signature Title Date <br /> F7-77—.. <br /> 7:777-77—..- d :i .REPORTOs F wSiiATE LICENSING AUT OY. am_ . 77 <br /> .The foregomgzhas been exammed and,completh the filng equirements of Title 12 Article47,C R S , as amended:; <br /> Signature _ <br /> Title Date <br />