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RES 2014-0826 - Class C liq lic to Omaha Mining Company C-25A CITY OF OMAHA LEGISLATIVE CHAMBER Omaha, Nebraska RESOLVED BY THE CITY COUNICL OF THE CITY OF OMAHA: THAT, in accordance with the provisions of the Nebraska Liquor Control Act, as amended, after a hearing held within 45 days after receiving notice and a copy of the license application and upon due consideration of all standards and criteria provided by law, this Council hereby recommends that the following application for a Class "C" Liquor License be granted. Allen Enterprises, Inc., dba"Omaha Mining Company", 1715 Leavenworth Street. That,the cost of publication of notice of the hearing was $26.00. July 1, 2014 - Resolution No. 826 -Motion to adopt. Carried 7-0. Christopher Jerram By July 1, 2014 7-0 Councilmember Adopted City Clerk Wia, Approv . jaj_, Mayor '719 NO. t5= .. .,,.,...., Resolution by Res. to grant Class "C" Liquor License to Allen Enterprises, Inc., dba"Omaha Mining Company", 1715 Leavenworth Street. 07/01/2014 - Res. #826 - Motion to adopt. Carried 7-0. Presented to City Council July 1, 2014 Adopted 7-0 gaoler grown City Clerk y5c/ (,) CCID TYPE OF LICENSE: CLASS "C"LIQUOR LICENSE NAME &ADDRESS: ALLEN ENTERPRIS ES, INC. DBA "OMAHA MINING COMPANY" 1715 LEAVENWORTH STREET RECEIVED: JUNE 9, 2014 45TH DAY: THURSDAY, JULY 24, 2014 HEARING DATE: JULY 1, 2014-22ND DAY AND/OR PERSONS CONTACTED: JOSEPH ALLEN /.F t 402-681-0089 POSTED: N/A NOTIFIED: N/A NEW APPLICATION, OLD LOCATION. PRESENT LICEN TIPP-IT,IS TIPP IT, INC., DBA "OMAHA MINING COMPANY", 1713-15 LEAVENWORTH ST REET, WHO HAS A CLASS "C"LIQUOR LICENSE TEMPORARY OPERATING PERMIT EXPIRES SEPTEMBER 8, 2014 LIQUOR LICENSED ESTABLISHMENT HISTORY LICENSE #C 29342 TIPP-IT INC 1713-15 LEAVENWORTH ST 68102 449-8703 DBA OMAHA MINING COMPANY NLCC ORDERS 04-01-03-SHOW CAUSE HRG *04-17-03- 10 DAYS SUSP RE: SELLING TO A MINOR 01-16- 03"05-09-03-PYMNT OF FINE*01-30-13- LETTER OF PERSONAL REPRESENTAIVE FOR TERRY E TIPPIT DECEASED GRANTED TO CATHERINE ANN WEST*05-23-13- DELETION APPROVED *06-14-13-MGR (JOSEPH L ALLEN, JR) APPROVED OTHER ACTIVITIES 11-21-95-DANCE PERMIT-RES#3034 *01-16-03-TAVERN REPORT RE: SELLING TO A MINOR *01-06-04-AFTER HOUR DANCE PERMIT -RES#1616 *07-02-06-TAVERN REPORT RE: AFTER HOURS VIOLATION UNDER 18*01-07-07-TAVERN REPORT RE: MINOR IN POSSESSION & UNCOOPERATIVE WITH OFFICERS * 12-23-08-RENEWAL AFTER-HOURS DANCE PERMIT*01-12-10-RENEWAL AFTER-HOUR DANCE PERMIT*02- 09-10-LAW COMM MTG *07-22-12 -TAVERN REPORT RE: DISORDERLY CONDUCT AND HIT AND RUN OUTSIDE THE ESTABLISHMENT*05-07-13- REQ DELETION OF L-SHAPED DECK APPROX 26'X 48'TO THE SOUTHWEST; FENCED L-SHAPED VOLLEYBALL COURT APPROX 85'X 95'TO THE SOUTHEAST AND BEER GARDEN AREA APPROX 24'X 68' CCID #601 APPROVED *05-21-13-MGR APP (JOSEPH L ALLEN, JR) CCID#655 APPROVED 07-01-14-TRANSFER TO ALLEN ENTERPRISES, INC * LICENSED PREMISES MAIN FLOOR APPROX 34'X 55'; LOFT APPROX 17'X 25'; BASEMENT INCLUDES COOLER TO WEST APPROX 35'X 55'; L-SHAPED DECK TO THE SW APPROX 26'X 98'; & FENCED L- SHAPED VOLLEYBALL COURT APPROX 85'X 94'TO SW INCLUDES 24'X 68' BEER GARDEN OFFICERS: MGR-JOSEPH L ALLEN, JR, 3815 WIRT STREET, 68111 (H)402-681-0089 *PRES/SEC- CHARLOTTE TIPPIT(H)405-672-2739* POWER OF ATTY-CATHERINE WEST-405-761- 6462 * *****(2013-OLD-MGR-JAMES PERKINS, 1902 SO 15TH STR, 68108 (H) 341-4467) (2012-DECEASED -VP/TREAS-TERRY TIPPIT, 1715 LEAVENWORTH ST SUITE A 68102 (C) 679-7782) 5 1 w 3 RECEIPT _ t , From: NLCC Randy.Seybert@nebraska.gov Phone: 402/471-4885 Fax: 402/471-2814 To: CLERK-OF OMAHA Subject: ALLEN ENTERPRISES INC dba OMAHA MINING COMPANY C-108506 NEW APPLICATION PLEASE COMPLETE THE BOTTOM SECTION IMMEDIATELY UPON RECEIPT OF THIS APPLICATION AND FAX OR EMAIL THIS FORM BACK ACKNOWLEDGING THE RECEIPT OF THIS APPLICATION. PLEASE DATE STAMP IF THAT OPTION IS AVAILABLE. THANK YOU. VN-Q el 9 �. DATE OF RECEIPT Ca SIGNATURE ® Urgent El For Review Please Please ® Com ❑ Please Recycle ment Reply STATE OF NEBRASKA _. 4 + Dave Heineman NEBRASKA LIQUOR CONTROL COMMISSION Governor Hobert B. Rupe Executive Director 301 Centennial Mall South, 5th Floor P.O. Box 95046 Lincoln, Nebraska 68509-5046 Phone(402)471-2571 r _ Fax(402)471-2814 TRS USER 800 833-7252 (TY) June 8, 2014 OMAHA CITY CLERK 1819 FARNAM STREET OMAHA NE 68183 RE: ALLEN ENTERPRISES INC dba OMAHA MINING COMPANY C-108506 Dear Local Governing Body: Attached is the form to be used on all retail liquor license applications. Local clerks must collect proper license fees and occupation tax per ordinance, if any, before delivering the license at time of issuance. TWO KEY TIME FRAMES TO KEEP IN MIND ARE: 1) Publicize one time not less than 7 days, not more than 14 days prior to date of hearing. 2) You have 45 days to conduct a hearing after the date of receipt of the notice from this Commission (§53-134). You may choose NOT to make a recommendation of approval or denial to our Commission. PER §53-133, THE LIQUOR CONTROL COMMISSION SHALL SET FOR HEARING ANY APPLICATION WHEREIN: 1) There is a recommendation of denial from the local governing body. 2) A citizens protest; or 3) Statutory problems that the Commission discovers. PLEASE NOTE...A LICENSEE MUST BE PROPERLY LICENSED IN ORDER TO PURCHASE FROM WHOLESALERS; AND, A LICENSE IS EFFECTIVE: 1) Upon payment of the license fees; 2) Physical possession of the license; 3) Effective date on the license. Sincerely, -;'14•KA LIQUOR CONTROL • 'ISSION Ra dy Seyb:. Li.. nsing Division Enclosures Janice Wiebusch Bob Batt William F.Austin Commissioner Chairman Commissioner An Equal Opportunity/Affirmative Action Employer FORM 35-4001 REV. 12/99 APPLICATION FOR LIQUOR LICENSE RETAIL NEBRASKA LIQUOR CONTROL COMMISSION RECEIVED 301 CENTENNIAL MALL SOUTH PO BOX 95046 LINCOLN,NE 68509-5046 PHONE:(402)471-2571 JUN 5 2014 FAX:(402)471-2814 Website:www.lcc.ne.gov/ ` COIVEB�gS�A LIQUOR :,,.]...3.-.::,_.0 f : !lSStt�� 7 u•• w . :,-..-...‘'.'. 4P;)' t;I: 7.:19 k." ':I) :: !�'Y�•Y L'y :`:�.. Ar..-1,M1 • 1. r. k. •.(•' .'MMr'. {�'..- • :•ram.!':`41.1:s'I''' a, tri, (p`, �.1 •;fat n E' adµ , t 1.� . -.., ,ttt..4,' + ;_rt-. ::r :;;" �r c ;.' •'i -r 4. t 4'�:- -}k. 1 ?..f.:... RETAIL LICENSES) Submit$400 Non Refundable Application Fee EJ A BEER,ON SALE ONLY fl B BEER, OFF SALE ONLY { C BEER,WINE,DISTILLED SPIRTS,ON AND OFF SALE fl D BEER,WINE,DISTILLED SPIRITS,OFF SALE ONLY O I BEER, WINE, DISTILLED SPIRITS,ON SALE ONLY El AB BEER,ON AND OFF SALE O AD BEER ON SALE ONLY,BEER,WINE,DISTILLED SPIRITS OFF SALE O IB BEER,WINE,DISTILLED SPIRITS ON SALE,BEER OFF SALE ONLY El ID BEER,WINE,DISTILLED SPIRITS ON AND OFF SALE O Class K Catering license(requires catering application form 106) $100.00 Additional fees will be assessed at city/village or county level when license is issued t ( _.. •-. a.a• .�yya, .', •..a �� > ' �.: Kwt t •, 3.A,,:'S •.,‘'' •7;, i�� I ,: }` 1;. yy 14 1 <:J- 7 ; • ,� 7i �? i.�.Y. „.: ..„ . ;�f'v . .Fi .:.a.S :i. ,� . ?3. ^^ -: ^ .x14f�. -f - , j '{N , t -N a,� Y . Y , r f1 Class C license term runs from November 1 —October 31 All other licenses run from May 1 —April 30 Catering license(K)expires same as underlying retail license CHECK TYPE OF LICENSE FOR WHICH YOU ARE APPLYING (CHECK ONLY ONE) El Individual License(requires insert form 1-form number 104) El Partnership License(requires insert form 2-form number 105) El Corporate License(requires insert form 3a& 3c-form number 101 and 103) bid Limited Liability Company(LLC)(requires form 3b&3c-form number 102 and 103) ,NAgg..py 1► i OR FIRMA SIST'IN - , ,, -0,110.140 1,,,, ..,,,, ., Vim' Sjla,�� . . .. �-35'- .. .. r.. ommission tl erson with any.qu.es iiis we miy have oit l pp � '-1 til Name_ Phone number: Firm Name FORM 100 REV 12/2013 PAGE 3 PRESh E INFORMATION , ,. .. , � - ";t w(. , Trade Name(doing business as) 0Ma Ji ct' ffOnitij 1#Ai Street Address#1 i —I I 5- - 1-C A 1IiQ el R t-P> 5-1: , Street Address#2 City0 a b ck. County o v,j/ c Zip Code 6 6 2.. Premise Telephone number ' ,-- LT(+9 o RECEIVED Business e-mail address Is this location inside the city/village corporate limits: YES 0 N ,JU 5 2014 Mailing address(where you want to receive mail from the Commission) .... NEBRASKA LIQUOR Name c. 1ph Lr A•1 I e- A -Tn._ CONTROL. COMMISSION Street Address#1 c..-+. Street Address#2 City C.) rvl c y,� State All , Zip Code (00'i 1 i . -—.. .. .. ,.._.. ;. ,.<or - r.. .-rwhpY. Reit ir• .. .^v.�taw;: ,,.n.J• .•MrS+...a,. .,� .4;t - y-. ..�r(wr . q� , DES .R IO.. L'.. 71� _,, ,t)` t, k+ ' . 4. • ! r• w�D� .y .a....:. Y..• .•......�., .:.�ti. .1.5 i :1Yt 1. � o�r -M C '1' w ZI t is .. .. :.�- •:.:'.' .r. .:.'...: .�_-'...N c .. .., `� d �{; '.t It.,��♦ y i +� i iZ�`1 u 'h "i:. . �.ix_ .0............:1 ....�_'•:•:. .:.:.1.. l �+.- a.N »] . 'V'. 5 �.}q,: t.. <,.'r � L �.� a@''p7:r�� ... .. � . .3S. .'�1:{ram�` Y �`�!lid�^M{1 :. �.�y�.: ct , �}r_{�4+k:.-+ :{' �..+n,:... � ?0�1�, .f.is`�t��+:. In the space provided or on an attachment draw the area to be licensed. This should include storage areas,basement, outdoor area, sales areas and areas where consumption or sales of alcohol will take place. If only a portion of the building is to be covered by the license,you must still include dimensions(length x width)of the licensed area as well as the dimensions of the entire building. No blue prints please. Be sure to indicate the direction north and number of floors of the building. **For on premise consumption liquor licenses minimum standards must be met by providing at least two restrooms Building: length 3 x width e'5 in feet Is there abasement to be licensed? Yes )+. No If yes, length 8 4 x width 5'5 in feet Is there an outdoor area?Yes No X If yes,length x width in feet PROVIDE DIAGRAM OF AREA TO BE LICENSED BELOW OR ATTACH SEPARATE SHEET FORM 100 REV 12/2013 PAGE 4 RECEIVED JUN 5 2014 NEBRASKA LIQUOR CONTROL COMMISSION ci j 2 f ot el - a.--- z 4.) N T No f r. ;1:0 D 4=1 D, , ;et ) N. -7 7 \ \ \\ \ \\\ Y. 1 ..,4 , \ \\\ \ .N \. i 1 .\\\ 4,\ N i co 41 lil t ) g i F: z 1 0 i (4- ' C F.- a. Wo � z W i... Q RT J m � 1 A • "NOTICE TO PUBLIC" THE DAILY RECORD Notice is hereby given that Allen Enterprises, Inc., dba "Omaha Mining OF OMAhA Company",has filed application of a license to sell beer,wine and liquor for consumption On and Off the premises at 1715 LYNDA K. HENNINGSEN, Publisher Leavenworth Street, legally described as fol- lows: PROOF OF PUBLICATION LOT 3,BLOCK 8, KOUNTZE &RUTHS ADDITION, 1/2 VACATED ALLEY ADJACENT AND EAST 1/2 OF LOTS 2 UNITED STATES OF AMERICA, & 3, CITY OF OMAHA, DOUGLAS COUNTY,NEBRASKA The State of Nebraska, That in accordance with provisions of Sec- SS. District of Nebraska, tion 53-1311,Nebraska Liquor Control Act,as amended, hearing upon said application will County of Douglas, be held in the Legislative Chamber, Om- City of Omaha, aha/Douglas Civic Center, 1819 Farnam Street,Omaha,Nebraska,on Tuesday,July 1,2014,at 2:00 o'clock P.M.,at which time J.BOYD the City Council shall receive evidence either orally or by affidavit from any person bearing beingdulysworn deposes and says upon the propriety of the issuance of said p that she is license. BUSTER BROWN, LEGAL EDITOR City Clerk 6-23-14 of THE DAILY RECORD, of Omaha, a legal newspaper, printed and published daily in the English language, having a bona fide paid circulation in Douglas County in excess of 300 copies, printed in Omaha,in said County of Douglas,for more than fifty-two weeks last past; that the printed notice hereto attached was published in THE DAILY RECORD,of Omaha,on June 23, 2014 That said Newspaper during that time was re,: : ly dub.:hed and neral circulation in the County of Douglas, : . . to : Nebraska. �II' GENERAL NOTARY-��IU��,i��'�G`•r k { ELLEN F ^,rttit I .; Subscribed in my pres and sworn to before �• t�:n, �, Publisher's Fee._...__-_e, '1)..-�..0,.0_...m �.,.. . $ me this 3 r• day of Additional Copies $ A A . 1- 2d 4 Total $26.00 All ,Iti Not! Public in and for Douglas County, State of Nebraska DAILY RECORD: Charge to General Ordinance Order NO. 2447 H. CLASS "C" LIQUOR LICENSE Please publish: June 23, 2014 Notice is hereby given that Allen Enterprises, Inc., dba"Omaha Mining Company", has filed application of a license to sell beer, wine and liquor for consumption On and Off the premises at 1715 Leavenworth Street, legally described as follows: LOT 3, BLOCK 8, KOUNTZE & RUTHS ADDITION, 1/2 VACATED ALLEY ADJACANT AND EAST 1/2 OF LOTS 2 & 3, CITY OF OMAHA, DOUGLAS COUNTY, NEBRASKA That in accordance with provisions of Section 5 3-1311, Nebraska Liquor Control Act, as amended, hearing upon said application will be held in the Legislative Chamber, Omaha/Douglas Civic Center, 1819 Farnam Street, Omaha,Nebraska, on Tuesday, July 1, 2014, at 2:00 o'clock P.M., at which time the City Council shall receive evidence either orally or by affidavit from any person bearing upon the propriety of the issuance of said license. Buster Brown "NOTICE TO PUBLIC" Notice is hereby given that Allen City erk Enterprises, Inc., dba "Omaha Mining Company;has filed application of a license JUL - 12014 , �� ,1 - .�,,, ,y - �J to sell beer,wine and liquor for consumption On and Off the premi ses ses at 1715 . Leavenworth Street, legally described as fol- (-fecr4c7/e 67e/v2Q41/ /'/'/ / lows: LOT 3,BLOCK 8,KOUNTZE&RUTHS ADDITION, 1/2 VACATED ALLEY ADJACENT AND EAST 1/2 OF LOTS 2 & 3, CITY OF OMAHA, DOUGLAS COUNTY,NEBRASKA That in accordance with provisions of Sec- tion 53-1311,Nebraska Liquor Control Act,as amended, hearing upon said application will be held in the Legislative Chamber, Om- aha/Douglas Civic Center, 1819 Farnam Street,Omaha,Nebraska,on Tuesday,July 1,2014,at 2:00 o'clock P.M.,at which time the City Council shall receive evidence either orally or by affidavit from any person bearing upon the propriety of the issuance of said license. BUSTER BROWN, City Clerk 6-23-14 Douglas Co u n , Nebraska Property er Record R1532400000 �/ P r`tY Print Report Information is valid as of 2014-06-13 Treasurer's Tax Report New Feature Subdivision Sales Search Owner r e . TIPP-IT INC P 0 BOX 8074 SOMA HA NE 68108-0000 Pr n rm i n o e at o p rtY 0 ..... . ............. ... ..... ...::.:..':.::.'. .. .......... ......K... e....y.........N..... mn e...::...:.:......... 3240 0000 15 . . . ... .: ... . Account Type: Commercial Parcel Number: ` 1532400000 Parcel Address 1715 LEAV E NWORTH ST ........... OMAHA NE 68102-0000 Legal Descriptions KOUNTZE & RUTHS ADD LOT 3 BLOCK 8 1/2 VAC ALLEY ADJ & E 1/2 LTS 2 & .... . .......... ... .... ....:..... r:V slue Information . :::::...:::..:......::.. ...Total....: Land'''. �Improvement........... .............. .......... ... ... 2014 $13,900.00 $111,700.00 $125,600.00 2013 $13,900.00 $111,700.00 $125,600.00 2012 $13,900.00 $111,700.00 $125,600.00 2011 $13,900.00 $111,700.00 $125,600.00 2010 $13,900.00 $111,700.00 $125,600.00 2009 $13,900.00 $111,700.00 $125,600.00 Sales nformation . Sales Date: 1994-08-24 . ...: ... :. Deed pD Sock: 1145 Page: 446 rice: . $75,000.00 Grantor: rantee Valid/Invalid; Valid :.:'. :.:..:.':.:. ..."....'::. :....:.:..::::''.:.::..:..':. Exclusion Reason: Show All Transactions Land Informs ioon t —Acres SF Units De th Width Vacant .w 0.16 7200.0 1.0 0.0 0.0 No `I- Improvement-Information .......... ... . ... ................... ...............:.... [luuidingi___________...... .. . .............. ..... . . . . ....... 1 1 $ ii Bar/Tavern '' ': i: :::::z:^:::.::,:>::>` 1713 LEAVEMWORm ST.• Bufk 1997 .,i0:i...!E'•:i . ''' . ' .:,..: ' .1:::: 36,rir .'',! ::.!':.':::',:'!:!''.':'.'7::7:::::: . if i ;:;:>: • 22 :lititi:::1:::: ,..:,,2' ,i:::::....,:.i ::..: - 1:::,.::ig ..!,..,,, , . I-—i'-iv, << '`> First Floor Jiri €: Y ?? 5420.0 sf a x $ Second F6or h 61' ' ''''' '-': "if:4" '''.1F"..........:''''. . ...:.''''''''''''.'''''':. . '''''''''''':::''''''''''.'''''''''..:H ''''''''''''''':::.....''''''''.'':' ':',''''.i.:. } 2684. 0 sf ' ' .P:.....i.itiii...':.-:... .,',' '' x: ¢¢'pp s : :`�,;- .. -44' NN�� S'�< J? ':}::?•}: ._. ):(:�,,�,,,:ti}{.:,:i: i i ive}::;g ..'4 f:y w'�''..mow$�•?>; ..:.-1111;: NOVEMBER 2010 DOUGL.A S COUNTY ASSESSOR :::::: CLICK TO ENLARGE IMAGE CLICK TO ENLARGE IMAGE uare Foota e: 8104.0 q g Percent Complete: • 100.0/o Perimeter 346.0 Quality: Average Unit Type: Condition: Average Built As: Bar/Tavern Condo Square Footage: 0.0 HVAC: Complete HVAC Rooms: 0.0 Exterior: Units: 2.0 Interior: Baths: 0.0 • Roof Cover: Bedrooms: ' 0.0 Roof Type: Flat Stories: 2.0 Floorcover: Foundation: Sprinkler Square Footage: 0.0 --- ..... ear I ercen# A Y d c�sted'_ ear r .. rB 1 . ea u�r _ _ Ph s�cal� e Remodeled er»odeea► • Bruit t 1900 199� 0% 1924 88 Detail Type tat D0esc!Pt ors • Units Basement Storage 2684.0 Inc INFORMATION ;�� Y: • . t� ry 1.. READ CAREFULLY. ANSWER COMPLETELY AND ACCURATELY 53-125(5) • 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. Include traffic violations. 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 charges by each individual's name. The commission must be notified of any arrests and/or convictiorRECEIVE ,er the date of signing this application. [5( YES ❑ NO JUN 5 2014 If yes,please explain below or attach a separate page KA Name of Applicant Date of Where Descriptionof*r_ii__PAS pp � Ti o n GIN Conviction Convicted CONTROL COMMISSION (mm/yyyy) (city&state) /1/-C-1- 1/k. -)//ha-) /1/2//9Cle+ 2. Are you buying the business of a current retail liquor license? 15i YES NO q '4 If es give name of business and liquor license number L._.- V'`t�- 1 c,: Y\11t�' • yes, q �1 � a) Submit a copy of the sales agreement b)Include a list of alcohol being purchased,list the name brand,container size and how many c) Submit a list of the furniture,fixtures and equipment 3. Was this premise licensed as liquor licensed business within the last two(2)years? 5-11 YES ❑ NO If yes,give name and license number 4. Are you filing a temporary operating permit to operate during the application process? [ YES El NO If yes: a) Attach temporary operating permit(TOP)(form 125) b) TOP will only be accepted at a location that currently holds a valid liquor license. FORM 100 REV 12/2013 PAGE 5 RECEIVED QUESTION NO.1: MANAGER APPLICATION INSERT--FORM 3c JUN 5 2014 NEBRASKA LIQUOR JOSEPH L.ALLEN,JR. CONTROL COMMISSION 1. 12-07-1983 Omaha, NE Speeding Fine 2. 02-28-1984 Omaha, NE Negligent Driving Fine&TS 3. 02-28-1984 Omaha, NE Speeding Fine 4. 06-06-1984 Omaha, NE Negligent Driving Fine 5. 02-21-1992 Omaha,NE Unlawful Display of Plates,renewal tabs Fine 6. 10-28-1994 Omaha, NE No Helmet Fine 7. 10-31-1994 Omaha, NE Unlawful Display of Plates,renewal tabs Fine 8. 05-04-1999 Omaha,NE No Proof of Insurance Dismissed 9. 02-27-2003 Omaha, NE Speeding Fine 10. 05-26-2004 Lincoln, NE Speeding Fine 11. 2008 Council bluffs, IA Speeding Fine 5. Are you borrowing any money from any source, including family or friends,to establish and/or operate the business? ❑ YES t NO If yes,list the lender(s) 6. Will any person or entity,other than applicant,be entitled to a share of the profits of this business? o YES ►`'4 NO RECEIVED� If yes,explain. (All involved persons must be disclosed on application) JUN 5 ?O1 No silent partners N E B RAS KA L 7. Will anythe andequipment to be used in thisbusiness be owne b NoTiRePs: - COMM«SSON of h furniture,fixtures equ p s y YES ❑ NO 5L> jbo .1RIf yes,list such items)and the owner. �,� �,��}� �� w�� "� 1 8. Is premise to be licensed within 150 feet of a church,school,hospital,home for the aged or indigent persons or for veterans,their wives, and children,or within 300 feet of a college or university campus? ❑ YES f NO If yes,provide name and address of such institution and where it is located in relation to the premises(Neb.Rev. Stat. §53-177)(1) 9. Is anyone listed on this application a law enforcement officer? ❑ YES NO If yes,list the person,the law enforcement agency involved and the person's exact duties 10. List the primary bank and/or financial institution(branch if applicable)to be utilized by the business a)List the individual(s)who will be authorized to write checks and/or withdrawals on accounts at this institution. tt ' �1 (-4*-1 o y„ 3A�k- . L A1I J 11. List all past and present liquor licenses held in Nebraska or any other state by any person named in this application. Include license holder name,location of license and license number. Also list reason for termination of any license(s) previously held. Pi A. FORM 100 REV 12/2013 PAGE 6 12. List the alcohol related training and/or experience(when and where)of the person(s)making application. Those persons required are listed as followed: a)Individual,applicant only(no spouse) Lift y rn 43,v\-18-r b)Partnership,all partners(no spouses) c)Corporation,manager only(no spouse)as listed on form 3c d)Limited Liability Company,manager only(no spouse)as listed on form 3c NLCC certified training program completed: Applicant Name Date Name of program(attach copy of course completion certificate) (mmlyyyy) RECEIVED JUN5 2f4 For list of NLCC certified training programs see: www.lcc.ne.gov/traininginfo.html Experience: Applicant Name/Job Title Date of Name&Location of Business NEBRASKA LIQUOR Employment: coMMLS ON CONTROL 13. If the property for which this license is sought is owned, submit a copy of the deed,or proof of ownership. If leased, submit a copy of the lease covering the entire license year. Documents must show title or lease held in name of applicant as owner or lessee in the individual(s)or corporate name for which the application is being filed. ❑ Lease: expiration date ❑ Deed Purchase Agreement 14. When do you intend to open for business? - r 15. What will be the main nature of business? aTA U e A NC C f 16. What are the anticipated hours of operation? 01 SG *- M. -'p . SL;/, o " 2,4 .4,\ 17. List the principal residence(s)for the past 10 years for all persons required to sign on page 8,including spouses. RESIDENCES FOR THE PAST 10 YEARS,APPLICANT AND SPOUSE MUST COMPLETE APPLICANT:CITY&STATE YEAR SPOUSE:CITY&STATE YEAR FROM TO FROM TO NICSNr\ct, 2-009 Picse,ca- O'c. .2ot%r If necessary attach a separate sheet. FORM 100 REV 12/2013 PAGE 7 The undersigned applicant(s) hereby consent(s) to an investigation of his/her background and release present and future records of every kind and description including police records,tax records(State and Federal),and bank or lending institution records,and said applicant(s)and spouse(s)waive(s) any right or causes of action that said applicant(s)or spouse(s)may have against the Nebraska Liquor Control Commission,the Nebraska State Patrol,and any other individual disclosing or releasing said information. Any documents or records for the proposed business or for any partner or stockholder that are needed in furtherance of the application investigation of any other investigation shall be supplied immediately upon demand to the Nebraska Liquor Control Commission or the Nebraska State Patrol. 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. Individual applicants agree to supervise in person the management and operation of the business and that they will operate the business authorized by the license for themselves and not as an agent for any other person or entity. Corporate applicants agree the approved manager will superintend in person the management and operation of the business. Partnership applicants agree one partner shall superintend the management and operation of the business. All applicants agree to operate the licensed business within all applicable laws,rules,regulations,and ordinances and to cooperate fully with any authorized agent of the Nebraska Liquor Control Commission. Must be signed in the presence of a notary public by applicant(s) and spouse(s). See guideline for required signatures RECEIVED Signature Signature ,UN 5 2014 p L tit Ni�fN QfJ..��SKA LIQUOR Print Name ame CONTROL COMMISSION Signature of Spouse Signature of Spouse Print Name Print Name ACKNOWLEDGEMENT State of Nebraska County of The foregoing instrument was acknowledged before me this — /`T b �-c- date name of person(s)acknowledged(individual(s)signing) Notary Pu Si na NINO•ale d Nebraska FRANK X.HAVERKAMP 1 .11041111U1N. flae�iaira Goes New 1,2015 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. FORM 100 REV 1212013 PAGE 8 APPLICATION FOR LIQUOR LICENSE Office Use RECEIVED CORPORATION INSERT-FORM 3a JUN 5 ,?1•14 NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH PO BOX 95046 N E�RAC KA LIQUOR LINCOLN,NE 68509-5046 PHONE:(402)471-2571 FAX:(402)471-2814 Wcbsitc: www.lcc.ne.gov Officers,directors and stockholders holding over 25%shares of stock,including spouses,are required to adhere to the following requirements: 1) All officers,directors and stockholders must be listed 2) President/CEO and stockholders holding over 25%and their spouse(s)(if applicable)must submit fingerprints(2 cards per person) 3) Officers,directors and stockholders holding over 25%shares of stock and their spouse(if applicable)must sign the signature page of the Application for License form 100(even if a spousal affidavit has been submitted) .:,: .. ....: .,... '.:,.:...: c.., :. :Nf 1 x .d ��o: ?:. W 1 Aftiiiie0ifI.is q:.t.. .k.. � :5.1 � �, 4�f. ti G�. r1 I: tx 1`9 t�f� I�: � �. ��' e� �� a �A ach co I�co ,��r � s � � � �� /�3A� Name of Registered Agent: I h vv‘ --5I L. i I .f: .,f t C: ..., it ...: Sid ::. :: ,.. . .: .� `r ,.� 'till a..E. ti. p Nave of�Cor or a�� fiat Ii oil its ., � :they Ar� �es r r a �..j..A - .. ..,,..:...� ':.......... ..: ,, xlx..'..... �,.'� nh�. 4� M k. 4' :'!4[Ei ...:��,• ,fix M;1.:'C ! r EEWG� 0 /citi 3 2.‘C \ v‘ Corporation Address: 7: \ 4.Th � t Ci : ti' State: ` L Zi Code: / f tY P � , �f Corporation Phone Number: `I L;Z C' , ` a q-ciFax Number Total Number of Corporation Shares Issued: C.)C) Name and nA redsi nature of P residiii1C' fl:(Information of prOdevihnutiiin ixoedon,fo11o40tg 04g e Last Name: \ First Name: MI: Home Address: City: C .\'•. State: f\) Zip Code: d l Home Phone Number: C> COrct S' nature of President/CEO ACKNOWLEDGEMENT State of Nebras County of 40,,0• -c� The foregoing instrument was acknowledg d before me this 1 byOLS'e /4. / ate name of person acknowledge Affix Sm1 GENERAL.NOTARY•State of Nebraska MICHELLE R.PORTER My Comm Exp.March 21,2011 FORM 101 REV 12/2010 Page 1 of 4 i ' F $ :'S e {i. a' V V ,. w r: Y.:1 �d r �. � �s� a. PP' 1t ha List n es � _ c � ,. tors: d c � s�tnc •been submitted; ,.'.,.:...<..- S e ...1..w..:_.::.«......:...`-Ji'.rF...�}..:.:...£..5:k:.4:.i...G.+,3..•:.p...+b 1aa,, '!:...1:'.,.. .$•,!E'dv a'' xv i: d:p iarY4:!h:4 .°a Ink -f•4I Last Name: First Name: 6 s •_p MI• Social Security Number: _ Date of Birth: - - Title: r� �' Number of Shares �;C Spouse Full Name (indicate N/A if single): /Li 4- Spouse Social Security Number: Date of Birth: R!CEIVED Last Name: First Name: MI: UN 5 tr.)..01 Social Security Number: • Date of Birth: J 4 Title: Number of Shares NEBRASKA LIQUOR CONTROL COMMISSION Spouse Full Name(indicate N/A if single): Spouse Social Security Number: Date of Birth: Last Name: First Name: MI: Social Security Number: Date of Birth: Title: Number of Shares Spouse Full Name(indicate N/A if single): Spouse Social Security Number: Date of Birth: Last Name: First Name: MI: Social Security Number: Date of Birth: - Title: Number of Shares Spouse Full Name (indicate N/A if single): Spouse Social Security Number: Date of Birth: FORM 101 REV 12/2010 Page 3 of 4 € '.A:"i}�. .r a :.i �;, 3 -..1:. 1:.•t 'C1S i yy F 5• \ ,t s nam:es ti Y ntl �L V.rl# 3 #. d ....... :.' . • ... tt b. 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JUN 0 t - Spouse Full Name(indica N/A if single): := � NEBRASXft _ Spouse Social Security Num er: Date of Birth: CONTRA Last Name: First Name: MI: Social Security Number: Date of Birth: Title: Number of Shares Spouse Full Name(indicate N/A if singl ): Spouse Social Security Number: Date of Birth: Last Name: First Name: MI: Social Security Number: Date of Birth: Title: Number of Shares Spouse Full Name(indicate N/A if single): Spouse Social Security Number: Date of Birth: Last Name: First N. e: MI: Social Security Number: Date • Birth: Title: Number of Sh.h es Spouse Full Name (indicate N/A if single): Spouse Social Security Number: Date of Bi h: \. FORM 101 REV 12/2010 Page 2 of 4 • ££a .a n- a F o € U i a.l • .:; I,'':a.,. i�,sr.:f<'r�;�„r, ...;€ ..., +,..., •. ,r .. t..r >..�4....,,,.. �...,... <, .. EYES NINO If yes,provide the following: 1) Name of corporation 2) Supply an organizational chart of the controlling corporation named above 3) Controlling corporation MUST be registered with the Nebraska Secretary of State,copy of articles must be submitted with application §53-126 . ,..: ,..,' _ _... ..,.., ....,I..,. ....,: *tjtftfe;-'1: . _P" , A .•.a. E. .S1' .�EA 1 N'. y y�.tay...i:. .. ..E ..:.. -a (.. .:i .e,. .. ,r-:.:,:. , ....,.< ,. :1. ... '. 3,... :..4 I. • ... 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Y .s. !f...gg .�h t.� ,�a �5 .Z �..� �:,... >e#�• ,�7< � ...�..,',: Y : .....ae. ,.-......�A.. ., .<. :..�... ,.f...w .. a.. .'.. .:. f!t!{� ... _ M A::a... ,P�: P f!A..•., ,.Y h'_ y '..AI': r.�.:.. .... ... ::.,- ............... :. ,4.s7.::-: .. :. '�... .,..fy.�. ,...I...a........4. .. .,8Nt5 !.f*� r ..I •t„:. :,k,..fglA �r C-��k. :I. .(kl ft f .:.' :.... ::, x..s ,.: :.._., n, ,r ,�.� }. .:..,....'�3,. r;.. •,. I .. .+.cG ."�., ,b @. gg,� � �:�a' 44,N,P.. 'taF�R P,u: h, N.. r1YES ricNO If yes,provide the Federal ID##. R E ,,E I VE D JUN 5 2014 NEBRASKA LIQUOR CONTROL COMMISSION In compliance with the ADA,this corporation insert form 3a is available in other formats for persons with disabilities. A ten day advance period is requested in writing to produce the alternate format. FORM 102 REV 12/2010 Page 4 of 4 6/5/2014 Corporation Inquiry RECEIVED Page 1 JUN 5 2014 NEBRASKA LIQUOR CONTROL COMMISSION HE Sec o7 SEele John A Coin - COAP Ar ARTICLES OF INCORPORATION ALLEN2ENTERPRISES,7884 INC. Poe: Filed: 06/02/2014 02:36 PM OF ALLEN ENTERPRISES,INC. TO: THE SECRETARY OF STATE OF THE STATE OF NEBRASKA: THE UNDERSIGNED,a natural person of the age of twenty one(21)years or more,acting as Incorporator of a corporation under the Nebraska Business Corporation Act, hereby adopts the following Articles of Incorporation for the Corporation: 1. The name of the Corporation is ALLEN ENTERPRISES,INC. 2. The Corporation shall have perpetual existence. 3. The Corporation is organized to engage in any lawful business within the State of Nebraska or elsewhere. / 4. The Corporation shall have and exercise all powers and rights conferred upon corporations by the Nebraska Business Corporation Act and any enlargement of such powers conferred by subsequent legislative acts, and in addition thereto, the Corporation shall have and exercise all powers and rights not otherwise denied corporations by the laws of the State of. Nebraska,such as are necessary,suitable, proper, convenient,or expedient to the attainment of the purposes set forth in Article 3 above. 5. The aggregate number of shares which the Corporation shall have authority to issue is 10,000 shares of common stock and the par value shall be$1.00. 6. The address of the initial registered office of the Corporation is 6910 Pacific Street, Suite 305, Omaha, Nebraska 68106-1046, and the name of the initial registered agent at such address is Thomas H.Penke. 7. The name and address of the Incorporator is Thomas H. Penke,6910 Pacific Street, Suite 305,Omaha,Nebraska 68106-1 046. DATED this 27th day of May,2014. C _ . Thomas H. enke Incorporator https://w►new.nebraska.govlsos/ccorp/corpsearch.cg i?document-number=1001287884 1/2 RECEIVED DURABLE GENERAL POWER OF ATTORNEY .JUN 5 2014 STATE OF OKLAHOMA NEBRASKA LIQUOR KNOW ALL MEN BY THEMINPlegtOMMISSiON COUNTY OF OKLAHOMA That I, Charlotte Ann Tippit, of 808 S. Scott Street, Oklahoma City, Oklahoma County, Oklahoma, 73115-0000, have made, constituted and appointed, by these presents do make, constitute and appoint Catherine Ann West or Patrick Anthony Tippit, or Martha Jean Mercer as my true and lawful attorneys-in-fact. It is my intent that this instrument shall constitute a durable power of attorney under the Uniform Durable Power of Attorney Act (Title 58 Okla. Stat. 1071). This power of attorney shall be effective immediately and shall not be revoked or in any way affected by my subsequent disability or incapacity or lapse of time. My attorneys-in-fact shall be authorized to act for me and in my name, place and stead to the Terry Eugene Tippit Estate (may be referred to herein as simply the estate)and Tippit Inc.: • • For the purpose of handling the personal and business affairs of my deceased son Terry Eugene Tippit, of 1715 % Leavenworth Street, Douglas County, Omaha, Nebraska. 68102-0000 and his and my corporation ownership of Tipp-it Inc. dba Omaha Mining Company of 1713-1715 Leavenworth Street,Douglas County, Omaha NE 68102-0000; • To evaluate the business, it's needs, the possible lease of such business or business property or to facilitate the sale of such business, corporation, business/corporation property or personal property of Terry Eugene Tippit and his estate if and when we determine it to be necessary; • To handle all financial affairs business and personal with any lending institutions necessary and to pay any accumulated or future bills or obligations necessaryto run said business, and finalize the personal and 1 g business needs of the Terry Eugene Tippit estate and Tipp-it Inc.; RECEIVED JUN )011 NEBRASKA L QUOR • To abide by the perpetual articles of incorporatioe040dEscb boN Articles XI. of Tipp-it, Inc. as dictated by the Incorporator Jeffrey i ver and signedduplicate in du licate the 25th day April ril 1994 and that was received p and filed for record and recorded April 27, 1994 on film roil 94.8 at page 720 by the Secretary of State for the state of Nebraska; ■ To ask, demand, sue for, collect, recover and receive all and any sum or sums of money, debts rights, property, effects or demands whatsoever due, payable or belonging to The Terry Eugene Tippit estate or Tipp-it Inc. from any person or persons whatsoever and to execute any and all necessary or proper receipts, releases and discharges therefore; • To deposit in any national or state bank or any loan association or other depository deemed proper by said attorneys all monies of the estate or Tipp-it Inc. which shall come into the hands of my said attorneys and all bills of exchange, draft checks, promissory notes and other securities for money payable or belonging to The Estate or Tipp-it Inc. for that purpose to sign my name and endorse the same, either for deposit for collection, and to at any time or times withdraw from any bank, loan association or other depository any and all monies now or hereafter belonging and payable to The Estate or Tipp-it Inc. as well as bills of exchange, drafts, checks, promissory notes and other securities, and for that purpose to draw checks in The estate or Tipp-it Inc.; • To invest all monies of The Estate or Tipp-it Inc. which shall come into the hands of my said attorneys in such manner and in such assets as my attorneys may deem proper; ■ To sell, assign and transfer any portion of the shares of common stock of Tipp-it Inc. now standing in the name of Charlotte Ann Tippit or Terry Eugene Tippit's name which I as the nearest living relative stand to inherit from his Estate or any other shares of stock which has been sold after the date of the original date of incorporation as Tipp-it Inc; • To give notice, make proofs of loss, demand and collect money, sue, compromise, arbitrate, carry on or consummate any other negotiation whatever with any insurance company whatever with any insurance company and do everything else necessary or proper in connection with the collection of the amount in whole or in part due upon any insurance company and do everything else necessary or proper in connection with the • RECEIVED JUN 5 NEBRASKA LIQUOR collection of the amount in whole or in part due upon a t€18 ISSION or policies , by reason of fire or damage or destruction by fire or any property belonging to me, the Terry Tippit estate or Tipp-it Inc., empowering my Attorneys-in-fact in my name, place and stead, to execute any papers that are proper and particularly to receive, receipt for and release any insurance company from further liability for any amounts due any policy; • To effect insurance on ail or any portion of the property, real personal or mixed, now owned or hereafter owned by me, the Estate, or Tipp-it Inc. in such amounts and to cover such risks as said attorneys considers proper; • To have access to remove the contents from any safe deposit box which Terry Eugene Tippit or Tipp-it Inc. may maintain in any bank,savings and loan association or other financial institution, and to open in the name of The Estate of Terry Eugene Tippit or Tipp-it Inc.; • To execute and file tax returns, closing agreements, compromises, and other settlements with the Internal Revenue Service and any state regulatory authority and to defend the Estate of Terry Eugene Tippit, any personal returns or business returns for Tipp-it Inc.. To deal with any actions ,suits,or legal proceedings that maybe instituted against the Estate, Tipp-it Inc.,or myself,and for that purpose my attorneys are authorized to employ counsel to arbitrate, compromise, to submit to judgment, or to prosecute an appeal; • To prosecute or defend any suit and to compromise or arbitrate any claims or litigations; • To execute guaranties of the obligations of third parties or other instruments; • To make inter vivo gifts (1) to charities defined under section 170(b)(1)(A) of the Internal Revenue Code of 1986, as amended or any successor provision thereto (the "Code") in such amount as my attorneys deem advisable and (2) to any descendant or spouse of any descendant of mine, however remote, including my attorneys, if applicable, such amount as my attorneys deem advisable, limited, however, to amounts within either(I) the federal gift tax annual exclusions (currently $13,000 per done per year) or (ii) the amount of taxable gifts which yield a federal transfer tax equal to or RECEIVED JUN 5 ?014 NEBRASKA LIQUOR less than the then current unified credit under Sed itaki LoC i1 ON provided, to the extent that any said done is under legal disability, my attorney shall be authorized to make such transfer in trust , including a spendthrift trust; • To transfer record legal title in any asset to any person or entity to hold such title as nominee on my behalf,and my attorneys shall be authorized to give such instrument of conveyance and sign any other instruments deemed necessary and advisable in my attorneys' sole discretion to create and maintain such nominee relationship; • To herein resolve any matters necessary that need to be resolved as we are aware of now or may become aware of in the future to process the Estate of Terry Eugene Tippit or Tipp-it Inc.; All powers and authorities hereby granted may be exercised by my said attorneys-in-fact acting alone without the joiner of any other person; I recognize that powers of attorney are sometimes strictly construed and it is not the intention by outlining the above powers to in any manner limit the power and authority of the above named attorneys, and in addition to the above outlined powers, said attorneys are authorized and empowered for me and in my name to handle the Estate and Tipp-it Inc issues that may arise; The validity of the power of attorney shall not be affected in any manner by reason of the execution, at any time, of powers of attorneys by the undersigned,other that the ones named herein; The undersigned agrees and represents to those dealing with my said attorneys-in-fact that this power of attorney may be voluntarily revoked only by revocation entered into record in the office of the County Clerk of Oklahoma County,Oklahoma; In making the above appointments of my attorneys-in-fact, I hereby certify that I am of sound mind and am not acting under any duress, menace, fraud or other undue influence; WITNESS THE EXECUTION HERE OF this 18th day of December,2012. GIVEN UNDER MY HAND AND SEAL OF OFFICE this 18TH day of December,2012, f Notary Public I Commission No.: My Commission Expires: t a /2_v i4 RECEIVED JUN 5 201 NEBRASKA LIQUOR CONTROL COMMISSION RECEIVE I) JUN 5 2O1 } CONSENT AND ACCEPTANCE NEBRASKA LIQUOR CONTROL COMMISSION I,Patrick Anthony Tippit, hereby agree to serve as Attorney-In-Fact for Charlotte Ann Tippit, according to the terms and conditions set forth in this durable power of attorney. Patrick Anthony Tippit Subscribed and sworn to before me this 18th day of December 2012. e. tjS dA44..../ !1 Notary Public My Commission Expires: akf$, 4 ss ` 4S,1% /1/If/Initst4►+1 , RECEIVED JUN F CONSENT AND ACCEPTANCE NEBRASKA LIQUOR I,Catherine Ann West, hereby agree to serve as Attor $IRIt.aom MISSION Charlotte Ann Tipp it,accordingto the terms and conditions set forth in this durable power of attorney. 6-1-Z-uxelt4d47e,,21 Catherine Ann West Subscribed and sworn to before me this 186 day of December 2012. _r r- w J. -'� Notary Public My Commission Expires: (SEAL) RECEIVED JUN 5 2014 CONSENT AND ACCEPTANCE NEBRASKA LIQUOR Mercer, herebyagree to serve as Attoz - h ttf� M SSi4N I, Martha Jean g Charlotte Ann Tippit,according to the terms and conditions set forth in this durable power of attorney. /7; "4":e artha Jean Mercer Subscribed and sworn to before me this 1e day of December 2012. Notary Public My Commission Expires: tV 2,-214 (SEAL) t' E f 1 i f t t : gate. .._. . . .. , l 0 tea _..._- -__.. _ . _... re,..__... . .mow cft„..A. ci 01_ GI/NI 6.,57_,‘ 4:---4)1}1 6 m eA) f- 6--c- . . , . ---(--h g 0 C_ z 6' 6' T e a 144 m,v 1,:i 1 _.................... .... _ . . . _ . _ ... .ft- . _ , . . . ... ... ... ....._ . .., . . . . RCED i _ _ .... . . .. _ _ . . ... 3u ....5, ___2.. 1.4. . ... . __ 1 f f, __ ____4.1 - SKPCtieU° NEB [� MQNIiSSIU i I i , I , f , i 4 ..._. .. ......... _ --4 - _____ - __ ___-______-_,__._ -.................-.......... ____. -...... ... .. ... ..••••••...._ _ . .. ..y. 44. _ . ___.......... .. ........._...,• ______. ......... _. . 1 4 r f It 4C X u) ILJ ":0";'::1\,\T;S;(:),\,..,,,.. 1114 'Ct [J. 00 L.- ,,.‘1,; i t. -'• -., O E < fo'. "," !?,1, 1/,‘-',./, . -,... eS1 0 1.- .,,c%,-- ,,:. - ,,, z '� ) ' �4 4.0 .....„ :th.. ILI .`0;,.-; .: E 00 O ir, IA ,h� ,may --� a LE ` 0 J .1 N . all Gil Ca _� i L i r;n. 0 z J Z Q a OULLI W Z > o co•o . . J J 01 71 vi H 4 W .0.4 ..I4)C E J z M I mg E Am li j IA iimi A ON I amo r% u) v-4 m t-4 rt u x IA W CU Fax, � "IISw a c cl. W rwl LA (/) Oa Ui. (1)0 g moo I Z it M 5 ,cr gel 1•• U trdifl,< X u. fa 0LU � o in oc z ( IZo a o tra a. _ ril) I5Iw W V Q o ro o z NQ �� z CA —1 w t 67) 2 W 0 —I . o 0 •= E. W J Mu %ii% 4 1E14 0 Z1-1 z E 0 Q pi 4, o o = 0 u 1- o IC iig cu 4.0 u) * Ill." CD . . X = W0 x c o r� ...toti) W o o o— ne` �u.■ ate•- � N 0 LA 'L.� = - in .. V � J = W 1 z *� Q IA m ra 4.1 o r` WI Imi m W .43 C Ci CI t ealn A e I. a) -- Vo ^ .D kt ri v IN O WO •_ d. = zMJ .,.. RECEIVED APPLICATION FOR TEMPORARY Office Use OPERATING PERMIT (TOP) JUN 5 2014 NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH NEBRASKA LIQUOR Po Box 95046 CONTROL COMMISSION LINCOLN,NE 68509-5046 PHONE:(402)47 I-257 i FAX: 02)471-2814 Application for a temporary operation permit(TOP) must be included with the application for liquor license. TOP will not be considered without the completed application for a liquor license. Enclose documentation showing sale of business; document may be in the form of a purchase agreement/contract, management agreement or promissory note. Sale of business document must include the following: name of business being sold, purchase date or closing date within 2-3 weeks of requesting TOP and must be signed by the seller and buyer. nTOP's are valid for 90 days from date of issuance and cannot be extended past the expiration date(no exceptions). piSeller's liquor license will terminate upon issuance of the TOP. nIf the seller's liquor license is up for renewal during the TOP it will not be necessary for the seller to renew. NAME OF CURRENT LICENSEE(SELLER): SELLER'S LICENSE#: Tit Do Q.. , p ts) CD.:;;\ .3 .1.14 2_, On (date) El Ci I ace i 9 seller and buyer entered into a contract for sale of the business known as (TRADE NAME): 9rn c�h� )'Y\ Ii'? /jic �'O � r�NBu er seeks to obtain a temra operating t (TOP) to allow bu er to o erate the Y P rY P g P Y P business under the same terms and conditions of the current licensee; subject to approval by the Nebraska Liquor Control Commission (NLCC) for a period not to exceed 90 days (no exceptions). Seller hereby declares that they are current on all accounts with all Nebraska licensed wholesalers under section §53-123.02. Any seller who provides false information regarding such accounts is guilty of a Class IV misdemeanor for each offense. � FORM 125 1400013529 � REV 12/2013 Page 1 of 2 /7 ,, / KJ! ,;-,1- 7/,,- ,,,/ ,-•-..ii,p 4', Signature of STLLER .2:..._14-27,_-.-_,,,,I *gnlature of ITY'IF °ICiL4'i /1 •/' ' , , / ;;, ,/ /,, _ _ .%)f-:. 1/7/--;', t-- i---;/ e;,,:L (1.i-Vir-Ycrz. ocz,cif) L A }le t1/4-) 7302- ,,..., Print Name ,;,-, ,--- 7.---,,-- 4--; Print Name State of Nebraska,County of Dougi(1 ,S State of Nebraska,County of 6cA,st6..c The foregoing instrument was acknowledg&I before me The foregoing instrument was acknowledged before me this 0(fi - Oli • 2D li (date) this 6 - 9----i q- (date) byr I A Vi 'U VU..t.b t by '2"'F. Se7° 4 t-t-z---/u Na-1- )of Person Ackn wledged[individual(s)signing document] Name( (s)Acknowledged[individual(s)signing document] " AP fib N$ • P 'flie si ature Notary Public signature —.' ----- --- GEKRAL NOTARY-State of Nebraska IENERCIOTWikalill of*anis FRANK&HAVERKAMP GUADALUPE 9 FABLA it,Commission Fees Not 1,2015 My Coma bp.bur 20111 ......: RECEIVED JUN 5 2014 NEBRASKA LIQUOR ADMINISTRATIVE REVIEW—Office use only Date: (.P 1 LA\DO t q Rep: e5 - Lic.Class: • C.-- — Lic.# 9 VAAISSION liKpproved Denied Reason for Denial: FORM 125 REV 12/2013 Page 2 of 2 zoi fp 4 , 1 I A. H___ ___ A 3 F Li.\ i.iflo_a_A-t-U- Si skim ).__ __SL 1 _ ._____........,......_ ____ 5 - j L Re.CEIVED-- 6 2- _.-.7._ __• . Yl. \-) ii L 7 U1 ---',' . , --- - ------ ll L - 'i --;'1' 7 ._SzA. ._ 1 1 NEBRASKA LIQUOR 4'-ONTROL COMMISSION I Li to ------ ...6 ./), N ), # L 3 , ._ -- I/ 12 1 — k.,..Arz_ Kci V6 40 - icc) 1 L 1 5" IL _ i 6 z-„,.. 7 0 7.-i 'L /7 7. " — ;. (< 0 Azsz, \A 's\ ( .9_, 1 1— 1 g I — L vt 1 ber_. IL 1 y IL 20 na i kii-L. uo ct ko, 26 _ . 7 Gc&Az5"- ( zg 45, -'5. IN.\ Sbv-,-• ) .' Vt._)/ (.2 ,-2_,-( L( 5 -- drNc 1i� �� __ _ � 56. .0 l, ��_ s - S � �2� Y�� s � _ 1 L 31 I _ _ a.._ . � _ k LBsSQs i ._ __1.., f). 1, j 1 ------ - .73._ '"' .._ r ( 1,, (Li.pc Ez-ANJ(., i 2.--- 13 3 '.; e_i_4_Q d Iv\ fst_c.i.).( z.,r , -75 _0. --t- t. '-f i , L.\ .......„_: ...-... ffr A. io (-- k c, / L 3-5' ') .S-Q _„ .=.. .4. cxcp..k...NvS . 7. . _ / 1._ 4 --- _ ,.. ,-. ..9_e.-587.:P P,.Y\S ... ..V. CD . ___ t b 3? .. --- Q 1,....- 3s RECEIVE ._._ 'fr,-.-, __.3._ .4 1_5 c,,e_...__.e..8,--t-E).:,-1-_,I_ _PL.0,...).__ _(.... .) ... . t L . 35 . __, . .__ _ _ _._ 2, ' li 13 gi,i1.(4.,. _{.L.4.4v3 JUN 5 2.014 ( d, q 0 � 3on a.tcz_i_43 i,� NEseasKa uau�L ` / _ . a " - ..L--E CONTROL COMMISIL (2-- .... A n,��< ._ _._ -- _ 2- ^ D1 Sc-,&_ 7 5 0 0 L U3 � �. - __ 1 0 Q -.. -.-L.-3 5 0 ,,,, L, 4/ ,__ 4-t • . . 7 5 0 ;� < �5 a ._.G c,111_�h cti _ --- Occ, ------- 1 -"j"Ci- --0..- -- 1. 0 tkIL_.S_ko.i--:._.5_________________....,________ 71 1-,______ _____ _____ r 4 \ 1 L q.z -. .. ..,- - _i_.__ o,s . - C7‘.2-AA---L. L_ (&_ick_CL &AI , _ c . ...L r\,,4: 1 L (/. , ' `--. 1 a l•-i_P,..a.L. _ IVA.2._,___Tv--_______...I.LS.)._9_ -, _ . j , . . E ../.... „_ 49 ...„_ , --":... -(3. 0:\ 5 _ S__t_;,,,. .k-.4(2 ,t, --- . „ . I ''' i. 6. c rZ-53()" .ckt.S2A I L 5 b .___ .•4• • •- �) t.UD iv 0 T t g 1 L s/ ,. P.-,Q p i .6-- ) L -. Sz ,,,), .._ � — D �� w rc — W In v�. (s2k. i/e.Q._ Ce_-t*c_ii,p— f L ��3 3 - (cc ti.1 �i.e, ., d /c../6.--- IL i L 57 -_ _ _• _ I-A) UF-,v-rmu 6-z-r y (..) . . •'---A.i_.\ Lv_p_s_._... _____ __Y\A_.-A.-_,........__c4e„_,.....AK_____ 5 S (,), .....,...,.. p 1,.,,, ( , s 7 ____..........._ ...L.2 ...A.s Lit,iy V _ .. LI i 3 --‘', 1 1.) _ i ,P___9,0,,, I L a 1, ..,..7 In 4:1 \j„..._ .i,. -a ,_f)) r 4_ S di) J\i A 'IS ___________11-_-____. 6 1 S ......... G , (.„ if..,..,a,,,.._ , A Q c.o. fi..,, _ _ __________________14., ______ _____ o 2 1 — P k It t fi_. 5-1.A.3_. i iJ 1 L -- 63 .... ...... R A, _.)R. , \; s'.\--- _ 1 L 6.._41 _____ ________ _,_ _ _ , - _ t_.w .0 .1._PA,(C _ - [14) t s...K Cit. _,Q„ .,1,,, L--- SOS _a____ --- -- ----------- — � ,�_Lea...9...Q...... ..... RECEIVED _ , . I - C_ ok- 12...., /.* u (1). / / yiti + Adi6L- . .._.- . i id N , .. . t al___R 141(.1A.4,,_/ipp, ho±+4-- ___. _ ....._ �� h n__ NEBRASKALIQUOR � -E��-- ..._2 _____b ar____ _____sy JD ii,''''. /.___ - - P Q.d. ____A,2_4,-16.2.__ _ et--tL _______. _ .. _ '',1( 0, . ..__- 1.- _____LL4._. I lqkt4-- P/6j:_i_o_ ......,___, • \/0. - I)atict/ / 44, 6 c, .ci (.,9 (24,1,___ . , . . a, h,,,,,A4 & 8 si 4 _(_4_,' _ . ......__________________________ . __ , .. _ _Y�-h��. ci • All...d.‘„11,06---• vita -- -- ____________________________ X2, hc,A,NQ ._ M1( (( /i,AF ADDENDUM to OFFER TO PURCHASE The offer to purchase Omaha Mining Company is contingent upon the following: 1. Buyer review& approval of all seller financial statements to include: 2012,& 2013 Tax Returns and YTD income statements. 2. Buyer inspection and approval of equipment. 3. Buyer's ability to obtain a temporary liquor license. 4. Buyer and seller entering into a detailed asset purchase agreement, transition agreement, and non-compete. 5. $225,000 seller carry back to be paid as follows: a. 7% interest rate b. 25 year amortization c. 5 year balloon payment d. Monthly payment to be $1,590.25 e. First payment to be 5 months after closing. 6. If all contingencies are not meet to buyer's satisfaction then the $5,000 deposit will be refunded in full. RECEIVED JUN F: 2014 NEBRASKA LIQUOR CONTROL COMMISSION All other terms and conditions of the Offer to Purchase to remain the same. Receipt of copy of this agreement is acknowledged. Date: B 1 301 L\ Date: .r aeir Cl ' çurchasr Seller Purchaser Seller ..@). SUNBELT. BUSINESS ADVISORS OFFER TO PURCHASE Date 5 Ian/ /4 1. The Buyer agrees to purchase from the Seller the assets of the business described as follows,including all equipment,fixtures,goodwill,inventory, trademarks,trade names,and other intangible assets and of that business known as: Omaha Mining Company Located at: 1715 Leavenworth St.Omaha,NE 68144 2. The purchaseprice of$ 300,000 shall be paid as follows: RECEIVED a. $_5,000 — . Deposit on the date of this agreement,included in down payment. JUN 5 2014 R b. N/A Additional deposit upon acceptance by Seller,included in down payment. Balancedown payment due at the closingin cash or certified check. N ES RAS c. 70 000 of p ym lq, (.��f 0 CONTROL c $ 75 000 Total Down-Payment aM �SStO N d. N/A Assumption of existing obligation payable as follows:$ N/A per month(including N/A %interest), evidenced by a Secured Promissory Note. e. N/A Assumption of existing obligation payable as follows:$ N/A per month(including N/A %interest), evidenced by a Secured Promissory Note. f. $225,000 Balance to be paid to Seller pursuant to a Secured Promissory Note in said amount payable as follows: $_See Addendum or more per month,including %interest for months. g. See Addendum Additional Terms:_See Addendum $ 300,000 Total Purchase Price 3. The closing shall take place on or before 1 o'clock A.M./P.M.on June 13 ,2014,at the office of Sunbelt Business Advisors ; Closing costs shall be shared equally by Buyer and Seller. 4. The full purchase price shall include inventory of$ Working at seller's cost. If the actual amount is more or less,the purchase price and down Payment shall be adjusted accordingly. • However in no event shall the inventory exceed$ Working • At Sellers cost and paid directly to seller in addition to purchase price. • 5. The sales tax on fixtures and equipment,if any,shall be paid for by the buyer. 6. Seller warrants that at the time physical possession is delivered to Buyer,all equipment will be in working order and that the premises will pass all • inspections necessary to conduct such business. 7. The Buyer and Seller agree to execute all documents necessary to consummate this transaction including where applicable,such documents as are necessary to comply with the Bulk Transfer provisions of the Uniform Commercial Code. 8. This document contains the entire understanding of the parties and there are no oral agreements,understandings,or representations relied upon by the parties. Any modifications must be in writing and signed by the parties. 9. The Seller warrants that it has a clear and marketable title to the business being sold except as mentioned above. 10. Seller shall deliver to Buyer a valid lease or assignment of lease for a period of N/A years,at a rental of$ N/A per month. Option of N/A . 11. The following adjustments and pro-rations shall be made at closing:rent, _Pr epays , , 12. In case any litigation is instituted to collect any sum due Broker,the Buyer and Seller,jointly and severally,agree to pay the expense incurred by the Broker in connection with such suit,including attorney's fees. 13. If Seller fails to accept this agreement by 6:00 o'clock P.M. May 29 ,2012,then the buyer may revoke this agreement. 14. Buyer agrees that if he should fail or refuse to complete this transaction after timely acceptance by the seller,then any funds or deposit with the broker will be forfeited and,at the broker's option,shall be.split 50%to Seller,and 50%to the Broker. PURCHASER AND SELLER INDIVIDUALLY ACKNOWLEDGE RECIPET OF A COPY OF THIS AGREEMENT THIS IS A LEGALLY BINDING DOCUMENT. READ IT CAREFULLY.IF YOU DO NOT UNDERSTAND IT,CONSULT AN ATTORNEY. BROKER IS NOT AUTHORIZED TO GIVE LEGAL ADVICE. Purchaser hereby agre s Dated:to buy on the terms set forth above. Seller agrees to l n he erm above.Broke 's Commission as per separate Agreement. Dated: 0 �j� at /c ? '/ i ' ' { PURCHASER: ....\,S,..k Business Name: ne. QAi ni Address: c3 {Z _ SELLER: 40z•...-...r / ,A /S— .-, , Cit 'rnv„(\a, State;Zi ‘g1 t\ Phone qD 2—G gi•66 ddress: / ..3" 6 5 i ve/71th Sunbelt Business Brokers by_Andrew Foxhoven Its Agent City_On4 ak State Zip Phone -�Q /1- *' '2j MANAGER APPLICATION Office Use INSERT-FORM 3c RECEIVED NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH `UN 5 2014 PO BOX 95046 LINCOLN,NE 68509-5046 PHONE:(402)471-2571 �BRASKA IQUOR FAX: 471-2814 of cQmMISSION Website:te:www.lcc.ne.gov CONT MUST BE: ✓ Citizen of the United States. Include copy of US birth certificate, naturalization paper or current US passport ✓ Nebraska resident. Include copy of voter registration in the State of Nebraska ✓ Fingerprinted. Two cardsper person,fees of$38per person, made payable to Nebraska State Patrol. If printed at NSP mail check only. ✓ 21 years of age or older 'f,..,, r-.�..� :. 3 .'. \. a4^' ry,r..,.. >A. 'ti. I � y .': :4 .... , r. .�:r .tl�.�lt a 'A !!. .Ya.:.;N:.hld dap:., �" '4. 4 a.,., e�,.. .f I.,,,.... „(4. - - �,^ „q •n. t' ,. ., '°�a i y. .?' w.lr, pµ 9.,: I '"N p .�' ., of..•.,. d,.� .,: A.',. ,_ ,, .'. ,ry. e=I rk ra' •� ,.,A:....:.:d. :i 5. Name of Corporation/LLC: !/ P w-t 62 e J t;E S ..... .....,..,.:.. ._ .. .... .:..:...: .. ,.. .. :.. .. ........ .... ..-..:.: -_ 'N .ham r.. .,,.. .\ �:�1 --.9 '.,1:.t. .s. \ A:...., 1.+� G ,t 9„. ft`,...q ,. ,:,:I..:. .1,..'�' :..I!. % ...,,.. , ,. .'. f... '"� "7 $1 i.. 't ,w'• i ik S,G�z.. .. ,. � �_,.. �. ��9k ,. i;, :..k :,n::Y,hit .: b. a ,�wrtn. a "di � rp'ti ,•• 4,•, v � k, ;,;; .,•I;}A. » �, ,.y. Liquor License Number: Class Type cri, (if new application leave blank) Premise Trade Name/DBA: 0 nil(), e_ YY\i r Premise Street Address: j \1 t S L LE;;►'4k 'rj1" 1 City: c, Count : ZipCode: (c51 ( I Y w� C.� Y � y C� Premise Phone Number: 1+Q A Email address: Q - 195 tyv The individual whose name is listed as a corporate officer or managing member as reported on insert form 3a or 3b or listed with the Commission. Click on this link to see authorized individuals. http://www.lcc.ne.gov/license search/licsearch.cgi isA 4 too - •_ N w � S GNAT RE UIRED f y '‘' ' ORATE OFFICER/MANAGING MEMBER (Faze..signatures are acceptable) Form 103 Rev 9/2013 Page 2 of 6 t .. .. A .. :.. + .x -. .. .. :.:..r..: : ..:.,.�."'-::. ... .�,� :.w "fix, a•. i '.�a a.,1�r6,� 5,41r r t' .r.�x#:•.~'�a.+tr�'A'.,'":.::�a ,�:�:, ;.,��,...,-:s'» :.'.*At Last Name: ail cIV t2,, First Name: 305if/'1 MI: PO Box if applicable): Home Address (include � Wii24- tY Ci : m C! ��.. County:• t.3 1 St Zip Code: 6 Home Phone Number: 40 d o 5 Business Phone Number: ¶i4 M e Social Security Number: � Drivers License Number& State: . • Date Of Birth: _ Place Of Birth: moo. ,, Email address: REbIVED ... A(�::Ig,.:....:M''r:s,s.::n,:,a,;•'7r,..r�..::,�.......::.�z.�.:�.--..:1�.,.�.t['.,.�' �,t,•.... r..w.,.-+.•�.��.q.;A,.,:,,,.:...Zs r!i-,a�.•..,ra:..1,-t'�•.r}rl�,o'.v,r�at,<,'::..•:;�.,�� aT.*.r..t.::,,�.a.�.{�r.-,r,..-.N..s,,:..a.N.„,-,x..�t:d.-r.r•,.r..:>,h,:,.r,,v»:.i•t ..... ,.:yp.- w�P.,.�i p�s;sz r:e k,•�-�e'. �++k�µ#°,e. .,.an�A"e�.;.��,.I. sit' , ,'. :�� 1 j- M.x•'l E .,rl¢ �.'� • �arr u da� �9 ) R# 'qe ! • % 1 N:f�tw JUN 5 2014 ❑YES NO IU�1�K/-15KA LIQUOfl t , ;....�., ,;:.a ,•s d,,,... -�.,E tR:. w t t _, +.. 1,.::d „':1: Iq..'; ,. i. ..'•��r .., ,:+„... s.. +,.P:i'.79 :,��.: P. �GAag P. a: r:r r p `e ry 2•+'.,ah ,,. P.fir± r�� . ,.r�: k'' „r t. A. .��. r: i } pp tyC: Iµ / ....:.. a�dr,:r. .1,. .. t:(,. ..„ ,.,.. I' � A, u�' -..r.f {,� M f ,�.�f R �t.... H°ert+"' ....,+h_ � a P' G :'X :e:4.:. .� 4 i+ +[, t �:.: '9 `M6 ,,n. `lt,...,. a ,;+ ,{,. rpsr.,..:,.r ,Y.' S�y,.��„:vs ,. ''x.r`. ;.:.` r`� i s.-_ j.� ��?tf•.. � ;'TN• Spouses Last Name: First Name: MI: Social Security Number: N I Drivers License Number&State: Date Of Birth: Place Of Birth: ,7. \ a:•a- j�, a" A -y^ ;Li E t f a r 7 s { ,�7•;:w t '�t'�. a;a i..�c,:! p.,.l.. a s .,•',I��i a�i1�.al�,l•.,. //,e :. ¢.,:l.� .; ,t. _. .. ,• � + .:G A i l�•9 �:: `i � h k, . „ Si ,,..•.. .a.l.._. {.. ".� R" 17.:;ris -{.•. '"k:J; YEAR YEAR YEAR YEAR CITY& STATE CITY& STATE FROM TO FROM TO ç3S-YCL iJ'zZ G Pr - � s cs., t-S, tucc r4s. 2 00e 2 c? Form 103 Rev 9/20 1 3 Page 3 of 6 f; �X- tt �,:t,! yi•.r- b.�:. ,:... .:.n .._ W,dl.Ty�Rw C+... i 'r...... :.........R��., i:a r .: � �: L"� 9'G. A•�' �.. i. sr �W(I' 9 _e ':m ..,.:. ..:1 ..:. .. e._. �... '. r.�..,- .♦� .,.:.::: ..... r c r -,.h.:y :.1 fE;y� v.1p ..J x..b,. L,_.w,,:�;.: 3 1,1iM.. .��' r...d..r, r - e a i✓ �k� 1 z ,.. e a „. C e� �.� ,}. 'a, ;;7 �� ay 9� .r.r ,:.. i �: .�.-: i_...' ... -. � n. ,. ... a. � �. ,.r— r, b ��i}y t 1 !_ a R 'n �.: J.`d. E 5P ..,•a .:..mow..1.. r.r rr✓ we. ..� .�d : Y. S r� � e Via'i 'S:, a.9 �'�t � �.'. ..Y .'�Y �I .C. � R >.:..:1.a ...... .�...... :. - :.: e- �y ,.t 6 F,a'-:+w 3- `€, :r 4e>•.3 vae� :bey `W ... ii..e.;. �-' YEAR TELEPHONE NAME OF EMPLOYER NAME OF SUPERVISOR FROM TO NUMBER \c'A) 2-0i 3 141/6k) pz 6 er6ei-cro8F 1I1 2 "c G..' 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 IREUEIMED, please list charges by each individual's name. Di: YES LJ NO .wJ U N 5 2014 If yes,please explain below or attach a separate page. N E B RAS KA LIQUOR C QNTR4-L ASS f Date of Where Description Name of Applicant Conviction Convicted of Disposition (mm/yyyy) (City&State) Charge 2. Have you or your spouse ever been approved or made application for a liquor license in Nebraska or any other state? JYES IF YES, list the name of the premise(s): 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? UYES LINO Form 103 Rev 9/2013 Page 4 of 6 4. List the alcohol related training and/or experience(when and where)of the person i &Mini *NLCC Training Certificate Issued: Name on Certificate: jUN ?014- NEBRASKA LIQUOR Date CONTROL COMM1SSiON Applicant Name Name of program(attach copy of course completion certificate) (mm/yyyy) *For list of NLCC Certified Training Programs see www.lcc.ne.gov/traininginfo.html Experience: Applicant Name/Job Title Date of Name&Location of Business: pp Employment: 5. Have you enclosed the required fingerprint cards and PROPER FEES with this application? (Check or money order made payable to the Nebraska State Patrol for$38.00 per person) EYES ONO Form 103 Rev 9/2013 Page 5of6 of E ;• g ,+ i b. .r.. � f:. r ...c .... :..t,.1 .....,...s. I. .... ., -'..,.{ .�, ...a x�:. 4, tE., a ...,,. s:... ,t, y g gg 9 a. v�. 7 �'' ^!h• aems+ 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. RECEIVED �. JUN 5 2014 Signature of Manager Applicant Signatu f • .�.•i ASKA LIQUOR g CONTROL COMMISSION S ON ACKNOWLEDGEMENT State of N b .•"; County of op,_ if � The foregoing instrument was acknowledged before g g g me this I by doo S kA )1e4,1c-T- , date name of person acknowledged �Ctk-d Affix Seal Notary Public signature FERAL NOTARY=State of Nebraska MICHELLE R.PORTER My Comm.Exp.March 21,2017 � 1 � 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. Form 103 Rev 9/2013 Page 6 of 6 City of Omaha, Nebraska v �,.�., 1819 Farnam—Suitexvj '!"„At LC 1 _ . f :, Omaha, Nebraska 68183-0112 0 V:.- ;. ._ ,� -,�*�T�s" :* Buster Brown (402) 444-5550 • 445 -_ •: =f ti City Clerk FAX (402) 444-5263 ._ t•�` �o FEB1 June 17, 2014 Allen Enterprises, Inc. Application for a Class"C" Liquor License Dba"Omaha Mining Company" 1715 Leavenworth Street Omaha,NE 68102 Dear Liquor License Applicant: This letter is notification that a hearing before the Omaha City Council on your application for liquor license has been set for July 1, 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 pp 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, 4e‘els Buster Brown City Clerk BJB:clj OrgAHA, 1V4 City Grp► f t ' 1819 Farnam Suite LC 1 r . ifiAr Omaha, Nebraska 68183-0112 0 Buster Brown (402) 444-5550 � * _: - � City Clerk FAX (402) 444-5263 4) �t►4 �� FEBR June 17, 2014 Allen Enterprises, Inc. Application for a Class "C" Liquor License Attn: Joseph L. Allen, Jr. for Allen Enterprises, Inc., dba"Omaha 3 815 Wirt Street Mining Company", 1715 Leavenworth Omaha,NE 68111 Street Dear Liquor License Applicant: This letter is notification that a hearing before the Omaha City Council on your application for liquor license has been set for July 1, 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. Ordinance No. 37046, passed June 27, 2005, requires each applicant to submit a written statement describing all types of business or activities that will be operated on the premises in conjunction with the proposed license. Attached is the statement to be signed and returned (hand deliver, mail or fax) to the City Clerk's Office 7 days in advance of the public hearing. Sincer y yours, O*44" Buster Brown City Clerk BJB:clj RECOMMENDATION OF THE NEBRASKA LIQUOR CONTROL COMMISSION RS Date Mailed from Commission Office: June 8,2014 I, Buster Brown Clerk of The City of Omaha,A Municipal Corporation (City,Village or County) Nebraska,hereby report to the Nebraska Liquor Control Commission in accordance with Revised Statutes of Nebraska, Chapter 53, Sec 134(7)the recommendation of said city,village or county,as the case may be relative to the application for a license under the provisions of the Nebraska Liquor Control Act as applied for by: ALLEN ENTERPRISES INC dba OMAHA MINING COMPANY C-108506 1715 LEAVENWORTH STREET OMAHA NE 68102 DUE: 07/24/2014 1. Notice of local hearing was published in a legal newspaper in or of general circulation in city,village or county, one time not less than 7 nor more than 14 days before time of hearing. Check one Yes X No The Statutes require that such hearing shall be held not more than 45 days after the date of receipt of this notice from the Commission. 2. Local hearing was held not more than 45 days after receipt of notice from the Nebraska Liquor Control Commission. Check one Yes X No 3. Date of hearing of Governing Body: July 1,2014 4. Type or write the Motion as voted upon by the Governing Body. If additional Motions are made by the Governing Body,then use an additional page and follow same format. MOTION TO GRANT 5. Motion was made by: Christopher Jerram Seconded by: Garry Gernandt 6. Roll Call Vote: 7-0 7. Check one: The motion passed: X The motion failed: 8. If the motion is for recommendation of denial of the applicant,then list the reasons of the governing body upon which the motion was made. (Attach additional page if necessary) SIGN HERE 4 DATE‘ ,7461; e6< Clerk signature REV 7/99 Form 35-4115 C-25A CITY OF OMAHA LEGISLATIVE CHAMBER Omaha,Nebraska RESOLVED BY THE CITY COUNICL OF THE CITY OF OMAHA: THAT, in accordance with the provisions of the Nebraska Liquor Control Act, as amended, after a hearing held within 45 days after receiving notice and a copy of the license application and upon due consideration of all standards and criteria provided by law,this Council hereby recommends that the following application for a Class"C"Liquor License be granted. Allen Enterprises, Inc., dba"Omaha Mining Company", 1715 Leavenworth Street. That,the cost of publication of notice of the hearing was $26.00. July 1,2014 - Resolution No. 826 -Motion to adopt. Carried 7-0. I hereby certify that the foregoing is a true and correct copy of one original document now on file in the City Clerk's Office. ,/ Buster Brown,City Clerk,City of Omaha Christopher Jerram By Councilmember July 1,2014 7-0 Adopted Buster Brown City Clerk Jean Stothert Approved Mayor NO. A• .+ , Resolution by Res. to grant Class"C"Liquor License to Allen Enterprises, Inc., dba"Omaha Mining Company", 1715 Leavenworth Street. 07/01/2014 -Res. #826 - Motion to adopt. Carried 7-0. Presented to City Council July 1, 2014 1 Adopted 7-0 &Eer grown City Clerk