RES 2013-1117 - Appoint Ryan Albers manager of THe Sydney - 4g8S Ta q i
STATE OF NEBRASKA
1 . 11111.-
4 Dave Heineman 3 1 I ., , NEBRASKA LIQUOR CONTROL COMMISSION
''�' Governor Hobert B. Rupe
' r... °_� .. ,- a
Executive Director
301 Centennial Mall South,5th Floor
C i Y P.O.Box 95046
fi a r� 1 ' Lincoln,Nebraska 68509-5046
Phone(402)471-2571
Fax(402)471-2814 or(402)471-2374
July 31, 2013 TRS USER 800 833-7352(rrY)
web address:http://www.lcc.ne.gov/
OMAHA CITY CLERK
1819 FARNAM STREET LC-1
OMAHA NE 68183
RE: The Sydney
LICENSE #C-084121
Dear Clerk:
Enclosed is a copy of a manager application for Ryan Albers in connection with The Sydney 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,
qa t de e. ei411- Y")
Jacqueline Rodriguez
q 9
Licensing Division
NEBRASKA LIQUOR CONTROL COMMISSION
402-471-2572
encl.
Janice M.Wiebusch Robert Batt William F.Austin
Commissioner Chairman Commissioner
An Equal Opportunity/Affirmative Action Employer
Printed with soy Ink on recycled paper
MANAGER APPLICATION of1C Use R`Cl
V E D
INSERT-FORM 3c
NEBRASKA LIQUOR CONTROL COMMISSION JUL 12 2013
301 CENTENNIAL MALL SOUTH N E B RA S K
PO BOX 95046 CON A L I Q O R
LINCOLN,NE 68509-5046 N TR O L C O M M I c.PHONE: (402)471-2571
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 (JJ
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 fingerprints(unless a non-participating spouse)(2 cardsR>rt���pgr4ps reVtecof$38
per person,made payable to Nebraska State Patrol ����
5) Must be 21 years of age or older
6) May be required to take a training course JUL 3 1 2013
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• � '• • t � •
Name of Corporation/LLC: 11 Y i2
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Premise License Number: — 9
(if new application leave b )
Premise Trade Name/DBA: (� y (�
Premise Street Address: J�j l \( (\c'f
City: K\-€2.-Lkt\ r\ State: kkk Zip Code: Lo ( d `�
Premise Phone Number: 1-E0 Z — 9 3 2 5 2 4 Z
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.
htta://www.lcc.ne.eov/license search/licsearch.caj
•
L, w i i,,"l i�
CORPORATE OFFICER/MANAGING MEMBER SIGNATURE
(Faxed signatures are acceptable)
Form 103
Itev 11/2012
Page 2 of S
1300017099
... , .. ... ...
•
Gender: �14)MALE ()FEMALE
Last Name: a(b1.r5 First Name: ��n MI: �► l
Home Address(include PO Box if applicable): c 8 (So-
City: (:) "Nei County: LA),..)i,) car S Zip Code: �SCC)2
Home Phone Number: (102—7 ck,' f'O Business Phone Number: 4-f0 Z ce 8 97)
Social Security Number:_ _ _ Drivers License Number&State. „ _
Date Of Birth: Place Of Birth: ( A c(A l ��
� C;,:- 7 `�{, w ,�.: s'`,Mr
OYES ,,./ o RECEN
JUL a 1 2413 JUL 1 ZU13
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M, • CONTRO
Spouses Last Name: First Name: MI:
Social Security Number: Drivers License Number& State:
Date Of Birth: Place Of Birth:
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CITY& STATE YEAR YEAR CITY&STATE YEAR YEAR
FROM TO FROM TO
C!YNe,-c •'\ac / 1 `ile/17 S No
Form 103
Rev 11/2012
Page 3 of 5
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE
FROM TO NUMBER
SE -F e •PL D•?
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_,},.• r- • u -• : •• the year and month of the
conviction or plea. Also list any charges pending at the ti Y nY. a,' ,: 'ore than one party,please list
c es by each individual' name.
YES NO
I yes,please explain ow or attach a separate page.arg
JUL 3 1 2013
Name of Applicant Date of Wh: :r,A q&E�f Charge Disposition
Conviction Col ! '1.01.COMMISSION
( m'y) . (ci . .
RECEIVED
JUL 12 2013
NEBRASKA LIQUOR
CONTROL COMMISSION
2. Have you or your spouse ever been approved • ade application for a liquor license in Nebraska or
(Y
any other state? ES A' O
IF YES,list the name of the premise.
3. Do you,as a manager, qualify under Nebraska Liquor Control • ct(§53-131 01)and do you intend to
supervise, in person,the management of the business? .a:$4 S 010
4. Have you enclosed the required fingerprint cards and PROPER FEES with this application?
Check or mane order made payable to the Nebraska State Patrol for$38.00 per person)
STO
5. List any alcohol related training and/or experience(when and where).
Form 103
Rev 11/2012
Page 4 of 5
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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. RE-CE1VED
2013
1 attire of Manager Applicant Signature of Spouse
,. ':'. LIQUOR
_ PISSION
ACKNOWLEDGEMENT
State of Nebr
x,
County of B'7�tG The foregoing instrument was acknowledged before me this
S}but(d._ /OJ U/- by Rtd,t.,„ ame,t„
name of person acknowledged
Affix Seal040.GENERAL NOTARY•Stye of Nebraska
Notary Public signature BEVERLY J.RITTHALER
My Comm.Exp,Feb.12,2015
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.
RECEIVED
JUL 12 2013
NEBRASKA LIQUOR Rei no°i
CONTROL COMMISSIOI e5of5
OSHA, N�6
City ofOmaha, fAlebras&a 4_ I °,�
`'~vie-
oot MI
Ttit
tip
1819 Farnam—Suite LC 1 ® �(r ,1t
Omaha, Nebraska 68183-0112 O�� �, ���-• "', :V
Buster Brown (402) 444-5550 i0
City Clerk FAX (402) 444-5263 o,�'TED FEgR't►4A
August 6, 2013
JJRK, LLC Application to appoint Ryan M. Albers
Dba"The Sydney" manager of your present Class "C" Liquor
5918 Maple Street License location
Omaha,NE 68104
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 August 20, 2013 . 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,
Buster Brown
City Clerk
BJB:clj
City ofOmaha, SAle bras a A 4,
1819 Farnam—Suite LC 1 z
Omaha, Nebraska 68183-0112 0��-- �y ,
Buster Brown (402) 444-5550 /i0 ti'
City Clerk FAX (402) 444-5263 O4) FE$R�t►41-
August 6, 2013
Ryan M. Albers Application to be appointed manager of the
2808 South 2nd Street present Class "C" Liquor License location
Omaha,NE 68108 for JJRK, LLC, dba"The Sydney", 5918
Maple 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 August 20, 2013 . 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,
.
01
Buster Brown
City Clerk
BJB:clj
No. ,r7/7
JJRK, LLC, dba "The Sydney", 5918 Maple
Street, requests permission to appoint Ryan M.
Albers manager of their present Class "C"
Liquor License location.
08-20-13;cj
f ( .
l
RECEIVED
Presented to Council:
August 20, 2013 - Approved '!'-
Buster Brown
City Clerk