City and County of Denver
Department of Excise and Licenses
201 W. Colfax Ave. Dept. 206
Denver, CO 80202
720-865-2740
www.denvergov.org/businesslicensing
BUSINESS QUESTIONNAIRE
To obtain a business license in the City and County of Denver, the following must be answered in full as part of the
application. Additional documents may be required depending on type of license.
BFN #: 922477688 License type: Lodging Facility
(to be filled out by EXL licensing technician)
EIN #: 922477688
Questions for tiered licenses only (leave blank if you do not have a tiered license): These include child care, food,
restaurants, motor vehicle repair garages, lodging facilities, kennels, swimming pools, emergency and non-emergency
vehicles, and companies offering tree care, vehicle immobilization, wrecking and towing, or pedal cab services.
Tier: Retail Food Establishment: Restaurant (Over 500 Capacity)
Food retail/wholesale - Number of employees: 350 Motor vehicle repair garages - Number of stalls: 152
Emergency vehicle, non-emergency vehicle, pedal cab, Swimming pool - Number of pools/spas/jacuzzis:
vehicle immobilization, wrecking and towing services - Open date: 01/10/2013 Close date: 07/30/2024
Number of vehicles: 40
Kennel – Type: ✔ Kennel Pet grooming Pet hospital Pet shop
Entity name: Victoria Shantrall Nelson
Legal entity name – as registered with the Secretary of State
Trade name/DBA: Fairview investment Fund Vii ,LP
As registered with the Secretary of State
Business physical address: 707 E Harrison st
City: Seattle State: WA Zip: 98102
Business mailing address: 300 s lehmberg rd apt 137
City: Columbus State: MS Zip: 39702
Type of ownership:
✔ Sole proprietor Partnership Corporation LLC Nonprofit
Page 1
PRIMARY, ON-SITE INFORMATION Please provide the following information for one responsible party, on-site contact for the business. The on-site contact must
have the authority to make decisions regarding the licensed establishment and must have access to and control over the licensed establishment at all times.
Name:
V Date of birth (mm/dd/yyyy):
Home address: Phone number:
City: Email:
State: Zip: Position:
ASSET OWNERSHIP INFORMATION Please provide the following information for anyone who owns 10% or more of the entity, either directly or indirectly
through another entity. You must list all officers, directors, general partners, managing members, stockholders, partners, and members. If a holding company
has an ownership interest in the licensed business, list that company and its ownership percentage as well. Please attach additional pages if necessary.
Owner details: (If no natural owners, please provide name and details of corporation/company)
Victoria Shantrall Nelson 04/10/1991
Owner 1 - Name: Date of birth (mm/dd/yyyy):
300 s lehmberg rd CEO
Address: Position:
Columbus 6625708332
City: Phone number:
MS [email protected]
State: Zip: Email:
100
% owned:
Owner 2 - Name: Date of birth (mm/dd/yyyy):
[Select One]
Address: Position:
City: Phone number:
State: Zip: Email:
% owned:
Page 2
Entity owner details (provide corporate officer details):
Officer 1 - Name: Victoria Shantrall Nelson Phone number: 6625708332
300 s lehmberg rd
[email protected]Contact address: Email:
Columbus CEO
City: Position:
MS 39702
State: Zip:
Officer 2 - Name: Phone number:
Contact address: Email:
[Select One]
City: Position:
State: Zip:
Officer 3 - Name: Phone number:
Contact address: Email:
[Select One]
City: Position:
State: Zip:
Officer 4 - Name: Phone number:
Contact address: Email:
[Select One]
City: Position:
State: Zip:
Page 3
CRIMINAL OR ORDINANCE VIOLATION HISTORY
Has the applicant or any partner, member, officer, director, or stockholder of the application ever been convicted of a
crime or ordinance violation (other than a traffic violation) in any federal, state, or city court?
Yes ✔ No
If yes, explain in detail:
VEHICLE DETAILS (if applicable to license)
Make of vehicle:
VIN: License plate #:
**Attach additional vehicle information if needed**
OATH OF APPLICANT
I declare under penalty of perjury in the second degree that this application and all attachments are true, correct, and
complete to the best of my knowledge. I further acknowledge that it is my responsibility and the responsibility of my
agents and employees to comply with the provisions of the Denver Revised Municipal Code and all Rules and
Regulations which govern my Business Questionnaire Application:
Authorized signature:
Printed name:
Victoria Nelson
Title:
MS Date:
07/30/2024
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