RES 2014-1302 - Appoint John P Webb manager of Granite City Food & Brewery �tsn'N.to` , .1t
j � ° , RECEIVED
y
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¢�. sSTATE OF NEBRASKA
u\ .." Y fi, Dave Heineman 9A1I SEP 24 Pti I- 1115BRASKA LIQUOR CONTROL COMMISSION
Governor LtJi [ Ili
yR �i%b1__ Hobert B.Rupe
Executive Director
301 Centennial Mall South,5th Floor
CITY CLERK P.O.Box 95046
OMAHA Lincoln,Nebraska 68509-5046
E B R A S�t Phone(402)471-2571
Fax(402)471-2814 or{402)471 2374
September 24, 2014 TRS USER 800 833-7352(TTY)
web address:http://www.lcc.ne.gov/
OMAHA CITY CLERK
1819 FARNAM STREET LC-1
OMAHA NE 68183
RE: Manager Application John Webb
LICENSE C-74411 L-74412
Dear Clerk:
Enclosed is a co of a manager application for John Webb in connection with Granite City licenses C-
74411 an L-744 2, both located in Omaha.
Please present this application for manager to your CityNillage Council or County Commissioners and
send us the results of their action.
Sincerely,
1 o(1.2czeerp.41/ 6,72Z-71-CtIALT,Lek.f/1
Jacqueline Rodriguez
Licensing Division
NEBRASKA LIQUOR CONTROL COMMISSION
402-471-2571
encl.
Janice M.Wiebusch Robert Batt William F.Austin
Commissioner Chairman
Commissioner
An Equal Opportunity Employer
Printed with soy ink on recycled paper
MANAGER APPLICATION Office Use
INSERT-FORM 3c
NEBRASKA LIQUOR CONTROL COMMISSION
301 CENTENNIAL MALL SOUTH
PO BOX 95046
LINCOLN,NE 68509-5046 s $s . =U O
PHONE:(402)471-2571 C ,9N"=`€ _
FAX: (402)471-2814
Website: www.lcc.ne.gov
Corporate manager,including their spouse,are required to adhere to the following requirements
1) Must be a citizen of the United States
2) Must be a Nebraska resident(Chapter 2—006) and must provide proof of voter registration in the
State of Nebraska
3) Must provide a copy of one of the following: state issued US birth certificate,naturalization
paper or US passport
4) Must submit their fingerprints(2 card r person)and fees of S38 per per n,made payable to
the Nebraska State Patrol — D v\ .4, /. ((f S S vc 2—
5) Must be 21 years of age or older
6) Applicant may be required to take a training course
r ,;u,�
_ ,-
Name of Corporation/LLC: n}r l ( '2L 7 k,u l,- 1 �. j� vc.
•
Premise License Number:
(if new applicati leave blan)).,
Premise Trade Name/DBA: ra,,v -- -,sue L. f--c d "
y--/7
Premise Street Address: it)0 1 / J 1/r -
City: 0 ,f
U �S/tate: � �,,— Zip Code: �
Premise Phone Number: `1 — '5'1 '2 — �j�0?t,,�'
The individual whose name is listed as a corporate officer or managing member as reported on insert form 3a
or 3b must sign their name below
CO RATE ANAGING MEMBER SIGNATURE
(Faxed signatures are acceptable)
Form 103
Rev 1/2011
Page 2 of 5
140 0021923
.._. „�.....`'r=r 4t4 i ;et' { "` 'a �`' fr}k l„ a 0
Gender: v'7";MALE OFEMALE '
Last Name: iiiit45 First Name: JtSi/A/ it` l(4
CONTROL COtvIMISION
Home Address(include PO Box if applicable): 78 5. CZA.a do, 1 ,$T
City: F�;'E%,4 t»,ni r County: e: Lc Zip Code:
Home Phone Number: 4 -707-37/.3 Business Phone Number: 9 - 37;-5-6pc
Social Security Number:_ Drivers License Number&State:_
f /
Date Of Birth: Place Of Birth: ,.Sri/7A4r1` 4 A)
3 � �atiaYr�aw �+ 4 ,a : ai ��sf!} a ..ems � s x,r
' *,4�y$..,k ,. 5�.• '9'•�'1a r ' � ara ,-(,.�. a- ,�q-1`'. ` �w m a i'C ¢i F` �i �s�r ' i)
OYES NO
)Teb€‘ sa },;io1
" �
a
Spouses Last Name: First Name: MI:
Social Security Number: Drivers License Number&State:
Date Of Birth: Place Of Birth:
� ',� JI`�X7��fig a t r{ F S4• 4y1:**1-b 2 ! 11C 6 c�.Y'�. � 4'r, �*•_:.-, I 4
�
21
CITY&STATE YEAR YEAR CITY&STATE YEAR YEAR
FROM TO FROM TO
fxemeNr n/� ACz7 0, y
, Nc Ci.7' o2bb 7
Form 103
Rev I1/2012
Page3 or5
N
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE
FROM TO
NUMBER
, cj �r� � �r .t &,CF X71A'?" o.i S
?902 (3 r1 eAirmai., 70A7 /i7t�Sin/
1. READ CAREFULLY. ANSWER COMPLETELY AND ACCURATELY. Must be completed
by both applicant and spouse,unless spouse has filed an affidavit of non-participation.
Has anyone who is a party to this application,or their spouse,EVER been convicted of or plead guilty to any charge.
Charge means any charge alleging a felony,misdemeanor,violation of a federal or state law;a violation of a local law,
ordinance or resolution. List the nature of the charge,where the charge occurred and the year and month of the
conviction or plea. Also list any charges pending at the time of this application. If more than one party,please list
c arges by each individua's name.
YES NO
I yes,please explain be ow or attach a separate page.
Name of Applicant Date of Where Description of Charge Disposition
Conviction Convicted
(mm/yyyy) ((city&state)
d 07/ZPo L,M4PA AIC
biZA C'e.04/h2<'
•
2. Have you or your spouse ever en approved r made application for a liquor license in Nebraska or
any other state? ES 010
IF YES,list the name of the premise. y}
17(/,✓'is 64,1F
3. Do you,as a manager,qualify under Nebraska Liquor Control Act(§53-13 1 01)and do you intend to
supervise, in person,the management of the business? SVES (>10
4. Have you enclosed the required fingerprint cards and PROPER FEES with this application?
heck or move order made payable to the Nebraska State Patrol for$38.00 per person)
Es
47
S. List
any alcohol related training and/or experience(when and where).
c /JZcv SSW- A/ L/ t/a.A r %•ti6+Ut/ /V6- 6,4line,
RECEIVED Form 103
Rev 1 1/2012
Paged of s
NEBRASKA '_I£ UOR
•
4t"'
F s
The above individual(s), being first duly sworn upon oath, deposes and states that the undersigned is the
applicant and/or spouse of applicant who makes the above and foregoing application that said application has
been read and that the contents thereof and all statements contained therein are true. If any false statement is
made in any part of this application, the applicant(s) shall be deemed guilty of perjury and subject to
penalties provided by law. (Sec §53-131.01)Nebraska Liquor Control Act.
The undersigned applicant hereby consents to an investigation of his/her background including all records of
every kind and description including police records, tax records (State and Federal), and bank or lending
institution records, and said applicant and spouse waive any rights or causes of action that said applicant or
spouse may have against the Nebraska Liquor Control Commission and any other individual disclosing or
releasing said information to the Nebraska Liquor Control Commission. If spouse has NO interest directly or
indirectly,a spousal affidavit of non participation may be attached.
The undersigned understand and acknowledge that any license issued, based on the information submitted in
this application, is subject to cancellation if the information contained herein is incomplete, inaccurate, or
fraudulent.
Z7./11,71—
tgnature of Manager Applicant Signature of Spouse
ACKNOWLEDGEMENT
State of Nebfakka
County of UV 441,5 The foregoing instrument was acknowledged before me this
VittioTtV1lkR.i..i( It C date
L f by � n \N t b b
none of person acknowledged
Affix Seal
othry Public signature rew, 6EriERALNOTARY-Stetete4ebraeka
c.k\f\l‘AAL''." JESSICA A NELSON
My Comm.Eltp,May B,2017
In compliance with the ADA,this application is available in other formats for persons with disabilities.
A ten day advance period is required in writing to produce the alternate format.
RECEIVED
Fonn l03
Rev 11/2012
SE
P Page 5of5
NEBRASKA UQUOR
iè
7,1111111; 311111
CityofOmaha, fAlebras&a
1819 Farnam—Suite LC 1 2*likt! �t K
Omaha, Nebraska 68183-0112 o'� & ',`; G'
Buster Brown (402) 444-5550 �A
City Clerk FAX (402) 444-5263 o 4�
TFD FEBit
October 8, 2014
Granite City Restaurant Operations, Inc. Application to appoint John P. Webb
Dba"Granite City Food &Brewery" manager of your present Class "C" and
1001 North 102nd Street Class "L" Brew Pub"Liquor License
Omaha, NE 68114 Location
Dear Liquor License Applicant:
This letter is notification that a hearing before the Omaha City Council on your application to
appoint a manager to the liquor license has been set for October 21, 2014 . The City
Council Meeting begins at 2:00 P.M. in the Legislative Chamber, (LC-4), Omaha/Douglas Civic
Center, 1819 Farnam Street, Omaha, Nebraska. City Council Liquor Rule No. 6 states, "Each
applicant or his/her representative for any type of license shall be personally present in the
Council Chambers, in order that the Council may make inquiries, on the date of public hearing
of the application for said license". Failure to be present at this Council Meeting is grounds to
recommend denial of your application to the Nebraska Liquor Control Commission.
Sincerely yours,
,e4e6I rio'.
Buster Brown
City Clerk
BJB:clj
Cityof Nebras Fe 4:
1819 Farnam—Suite LC 1 z i`
moo
Omaha, Nebraska 68183-0112 ® ��► �
Buster Brown (402) 444-5550 o dry,
City ClerkFAX (402) 444-5263 4, r4
Fo FEBR
October 8, 2014
John ' Webb Application to be appointed manager of
78 S Clarkson Street the present Class "C" and Class "L"Brew
Fremont, NE 68025 Pub Liquor License location for Granite City
Restaurant Operations, Inc., dba"Granite City
Food& Brewery", 1001 North 102"d Street
Dear Liquor License Manager Applicant:
This letter is notification that a hearing before the Omaha City Council on your application to be
appointed manager of the liquor license has been set for October 21, 2014 . The City
Council Meeting begins at 2:00 P.M. in the Legislative Chamber, (LC-4), Omaha/Douglas Civic
Center, 1819 Farnam Street, Omaha, Nebraska. City Council Liquor Rule No. 6 states, "Each
applicant or his/her representative for any type of license shall be personally present in the
Council Chambers, in order that the Council may make inquiries, on the date of public hearing
of the application for said license". Failure to be present at this Council Meeting is grounds to
recommend denial of your application to the Nebraska Liquor Control Commission.
Sincerely yours,
idezte
grie
Buster Brown
City Clerk
BJB:clj
_.5
No. /3(7,2
Granite City Restaurant Operations, Inc., dba
"Granite City Food & Brewery", 1001 North
102nd Street, requests permission to appoint
John P. Webb manager of their present Class
"L" Brew Pub License location.
10-21-14;cj
CA\
RECEIVED
Presented to Council:
October 21, 2014 - Approved c7
Buster Brown
City Clerk