RES 2012-1520 - Addition at Casey's General Store #2985 4
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STATE OF NEBRASKA
' Dave Heineman NEBRASKA LIQUOR CONTROL COMMISSION
Governor Hobert B. Rupe Executive Director
12 O C T 26 r-1 8: ri 3 301 Centennial Mall South, 5th Floor
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P.O. Box 95046
Lincoln, Nebraska 68509-5046
CITY CLERK Phone (402) 471-2571
OMAHA, N E B R . c.z ; Fax (402) 471-2814
TRS USER 800 833-7352 (TTY)
October 24, 2012
OMAHA CITY CLERK
1819 FARNAM STREET LC-1
OMAHA NE 68183
RE: ADDITION
LICENSE #: D-092579
LICENSEE NAME: CASEY'S RETAIL COMPANY
TRADE NAME: CASEY'S GENERAL STORE 2985
ADDRESS: 5120 S 118TH STREET
CITY/COUNTY: OMAHA/ DOUGLAS
PREMISE PHONE: 402-895-2410
CURRENT DESCRIPTION: ONE STORY BLDG APPROX 45'X 60'
NEW DESCRIPTION: ONE STORY IRREGULAR SHAPED BLDG APPROX 78'X 63'
Please present this request to you city/village/county board and send us a copy of their recommendation. If
recommendation of denial or no recommendation is made the Commission has no alternative but to cease
• • -ssing thi ue .
•andy Seybe
Licensing Division
Nebraska Liquor Control Commission
rs
cc: file
Janice Wiebusch Bob Batt William Austin
Commissioner Chairman Commissioner
An Equal Opportunity/Affirmative Action Employer
FORM 35-4001
REV. 12/99
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.
Sincerely yours,
Buster Brown
City Clerk
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ADDITION REQUEST
DATE: OCTOBER 26, 2012
APPLICANT: CASEY'S RETAIL COMPANY, DBA "CASEY'S
GENERAL STORE "2985"
LICENSED LOCATION: 5120 SOUTH 118TH STREET
PERSON PROVING INFORMATION ON BEHALF OF THE APPLICANT:
DEBBIE DOLASH, STORE OPERATIONS - 515-965-6517
REQUESTING:
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LICENSE CURRENTLY READS:.
1 STY BLDG APPROX 45' X 60'
BY: CARMAN JOHNSON, LIQUOR CLERK
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Print Form
APPLICATION FOR ADDITION
TO LIQUOR LICENSE Office Use
RECEIVE®
NEBRASKA LIQUOR CONTROL COMMISSION
301 CENTENNIAL MALL SOUTH O C T 2 2 2012
PO BOX 95046
LINCOLN,NE 68509-5046 •
FAX:(402)471-2814 7I NEBRASKA LIQUOR
Website: www.Icc.ne.eov • CONTROL COMMISSION
Application:
• Must include processing fee of$45.00 made payable to Nebraska Liquor Control Commission
• Must include a copy of the lease or deed showing ownership of area to be added R S
• o This is still required even if it's the same as on file with our office
• Must include simple sketch showing existing licensed area and area to be added,must include
outside dimensions in feet(not square feet),direction north. No blue prints.
• May include a letter of explanation
b
92579
LIQUOR LICENSE#
LICENSEE NAME CASEY'S RETAIL COMPANY
TRADE NAME CASEY'S GENERAL STORE#2985
PREMISE ADDRESS 5120 S 118TH .
CITY OMAHA, NE 68137
CONTACT PERSON DEBBIE DOLASH, STORE OPERATIONS @ CORP OFFICE
PHONE NUMBER OF CONTACT PERSON 515-965-6517
Complete the following questions:
1) Are you adding.on to your building? ® Yes f} No
• Include a sketch of the area to be added showing:
o existing building
O outside dimensions (in feet)
o direction north
2) Are you adding an,outdoor area? (0 Yes 0 No
If an outdoor area(check one of the following)
❑ 012.07"Beer garden" shall mean an outdoor area included in li I I I I id
consumption of alcoholic liquors,and which is contained by a fence or v of
persons from the premises,and preventing the passing of alcoholic liquo ay
include,but are not restricted to sand volleyball,horseshoe pits...) 1200020508
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• ® 012.08"Sidewalk cafe"shall mean an outdoor area included in licensed premises,which is used by a restaurant or
hotel with a restaurant license,for the service of meals as well as alcoholic liquors,and which is contained by a permanent
fence,wall, railing,rope or chain, defining the licensed area,provided that one open entrance not to exceed eight(8) feet
shall be allowed.
What type of permanent fencing will you be using?
• Include a sketch of the area to be added showing:
o existing building
o outside dimensions (in feet) RECEIVED
o direction north
OCT 2 2 2012
NEBRASKA LIQUOR
JULIA JACKOWSKI, SECRETARY FOR CASEY'S RETAIL COMPANY CONTROL COMMISSION
Print Name of Signature
44-1L6::?'Qael-614)1/441L.
; •
Signature of Licensee or Officer JULIA JACKOWSKI
State of Nd l* MI IOWA
County of POLK
•
The forgoing instrument was acknowledge before
me this OCTOBER 19,2012
Date
•
Notary Public Signature CHRI MCCREADY
Affix seat Hen ev,..�
' w CHRIS MCCREADY
Commission Nu nber 150693
, My COMM.E)11/29/14
2
s:
1) Are you adding.on to your building? ® Yes f} No
• Include a sketch of the area to be added showing:
o existing building
O outside dimensions (in feet)
o direction north
2) Are you adding an,outdoor area? (0 Yes 0 No
If an outdoor area(check one of the following)
❑ 012.07"Beer garden" shall mean an outdoor area included in li I I I I id
consumption of alcoholic liquors,and which is contained by a fence or v of
persons from the premises,and preventing the passing of alcoholic liquo ay
include,but are not restricted to sand volleyball,horseshoe pits...) 1200020508
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sketch of the area to be added showing:
o existing building
O outside dimensions (in feet)
o direction north
2) Are you adding an,outdoor area? (0 Yes 0 No
If an outdoor area(check one of the following)
❑ 012.07"Beer garden" shall mean an outdoor area included in li I I I I id
consumption of alcoholic liquors,and which is contained by a fence or v of
persons from the premises,and preventing the passing of alcoholic liquo ay
include,but are not restricted to sand volleyball,horseshoe pits...) 1200020508
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DEED2010120811 "a n Tax
Datr s DEL_ __SCAN FU l
] G -- -` - Received-DIANE L.BATT1ATO
DEC 20 2110 Ij i:.C 1 L r;v 1 1'�y Reoistei al Deeds.Douglas County,NE
itflJ I Ill���l l�J' ��N6
201012081IIB
WARRANTY DEED
Olderbak Enterprises North, LLC, a Nebraska Iimited liability company, GRANTOR, in
consideration of TEN and 00/100`h DOLLARS ($10.00) and other good and valuable
consideration, received from GRANTEE, Casey's Retail Company, an Iowa corporation,
conveys to GRANTEE, the following described real estate(as defined in Neb. Rev. Stat 76-201):
Lot 1, Cenex Addition, an Addition to the City of Omaha, as surveyed, platted
and recorded in Douglas County,Nebraska.
GRANTOR covenants with GRANTEE, that GRANTOR:
(1) is lawfully seized of such real estate and that it is free from encumbrances Except:
(i) easements, covenants and restrictions of record and (ii) applicable zoning and
building ordinances and regulations;
(2) has legal power and lawful authority to convey the same;
(3) warrants and will defend title to the real estate against the lawful claims of all
persons.
Executed December , 2010.
RECEIVED Olderbak Enterprises North,LLC,
a Nebraska limite liability comp
GRANTOR
OCT 2 2 2012
NEBRASKA LIQUOR
CONTROL COMPJIISSION By.
Mic iael D. Olderbak,
Member
14(6)
By: 1, L G A1T<
Marl J. Olderb `i
Member 1'A
IO
//�� SG
' 7C�7C� v661(Ft i�.A.._ $ InQ ez 553..
preventing the passing of alcoholic liquo ay
include,but are not restricted to sand volleyball,horseshoe pits...) 1200020508
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RECEIVED
OCT 222012
STATE OF NEBRASKA ) NEBRASKA 'iG4UOR
COUNTY OF LANCASTER) ss CONTROL COfirlhVehSSION
The foregoing instrument was acknowledged before me this I day of December,
2010, by Michael D. Olderbak, a Member of Olderbak Enterprises North, LLC, a Nebraska
Iimited liability company for and on behalf of said limited liability company.
III GENERAL NOTARY•State of Nebraska •
HEIDI M.HAYES
My Comm.Exp.July 14,2013
Not Public
STATE OF NEBRASKA )
COUNTY OF LANCASTER) ss.
The foregoing instrument was acknowledged before me this PL.
day of ecember,
2010, by Mark J. Olderbak, a Member of Olderbak Enterprises North, LLC, a Nebraska Iimited
liability company,for and on behalf of said limited liability coi pany.
fft GENERAL NOTARY.State ofNebraska
HEIDI M.HAYES
My Comm,Exp,July 14,2013
Notary Public
After Recording Return To:
Union Title Company
Attn: Linda Diaz; Store# 109
3800 Normal Blvd.,Suite 100
Lincoln,NE 68506
regulations;
(2) has legal power and lawful authority to convey the same;
(3) warrants and will defend title to the real estate against the lawful claims of all
persons.
Executed December , 2010.
RECEIVED Olderbak Enterprises North,LLC,
a Nebraska limite liability comp
GRANTOR
OCT 2 2 2012
NEBRASKA LIQUOR
CONTROL COMPJIISSION By.
Mic iael D. Olderbak,
Member
14(6)
By: 1, L G A1T<
Marl J. Olderb `i
Member 1'A
IO
//�� SG
' 7C�7C� v661(Ft i�.A.._ $ InQ ez 553..
preventing the passing of alcoholic liquo ay
include,but are not restricted to sand volleyball,horseshoe pits...) 1200020508
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PLANNING DEPARTMENT REPORT
RECEIVED
DATE: OCTOBER 26,2012 DUE DATE: NO 8T 2� s.
46
CITY COUNCIL HRG NOVEMBER 20,2012 C Y
LOCATION: 5120 SOUTH 118Th STREET 0 M A H A. N�p R s K,
LEGAL DESCRIPTION:REQ ADD OF AN AREA APPROX 22' X 35' TO THE NORTH
APPLICANT: CASEY'S RETAIL COMPANY,DBA"CASEY'S GENERAL STORE #2985"
REQUESTED LICENSE OR ACTION: ADDITION TO THEIR PRESENT PACKAGE
LIQUOR LICENSE LOCATION
NEW LOCATION(X)NEW OWNERSHIP () TYPE OF FACILITY: CONVENIENT STORE
THIS REQUEST DOES 0 DOE NOT(X) PERTAIN TO N OUTSIDE AREA
IF SIDEWALK CAFE: R-O-W-LEASE 13 PERMITS OBTAINED
IF OUTSIDE: OUTSIDE AREA IS S..� FEET FROM THE NEAREST RESIDENCE
THIS PROPERTY IS ( X ) IS NOT ( ) WITHIN OMAHA'S CORPORATE LI TS
(If not,do not proceed-Notify the City Clerk's Office and return this form)
ANNEXATION DATE: ORDNANCE NO. Only if within last 24 nths)
EXIST' G ZONING: / • EXITING LAND USE: LJD kl V LF IJ1 EN� e
ADJ E T LAND USE A P Z t NING: r
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PARKING STALLS ROVIDED:
EXISTING USE DOES(',) DOES NOT( )COMPLY WITH ZONING REGULA S '
PLUMBING FIXTURES PROVIDED: WOMEN'S (7)%l 61D.',I
MEN'S - l O
DATE SUBJECT PROPERTY WAS POSTED: , . _ e .
(Rule#7) DISTANCE OF PROPOSED LICENSE TO ANY SCHOOL,CHURCH,OR CITY PARK:
DISTANCE OF PROPOSED LICENSE TO ANY EXISTING LICENSE: C) tL__—
(State Law) DISTANCE OF PROPOSED LICENSE TO ANY CHURCH o
SCHOOL 6 I,i-HOSPITAL 6 r - HOME FOR THE AGED,INDIGENT
OR VETERAN 3 -- -COLLEGE OR UNIVERSITY O(��—
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PARKING STALLS ROVIDED:
EXISTING USE DOES(',) DOES NOT( )COMPLY WITH ZONING REGULA S '
PLUMBING FIXTURES PROVIDED: WOMEN'S (7)%l 61D.',I
MEN'S - l O
DATE SUBJECT PROPERTY WAS POSTED: , . _ e .
(Rule#7) DISTANCE OF PROPOSED LICENSE TO ANY SCHOOL,CHURCH,OR CITY PARK:
DISTANCE OF PROPOSED LICENSE TO ANY EXISTING LICENSE: C) tL__—
(State Law) DISTANCE OF PROPOSED LICENSE TO ANY CHURCH o
SCHOOL 6 I,i-HOSPITAL 6 r - HOME FOR THE AGED,INDIGENT
OR VETERAN 3 -- -COLLEGE OR UNIVERSITY O(��—
7,7/4:34,/ f/- 7- iZ
(Authorized Signature) (Date)
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ADDITION REQUEST
DATE: OCTOBER 26, 2012
APPLICANT: CASEY'S RETAIL COMPANY, DBA "CASEY'S
GENERAL STORE "2985"
LICENSED LOCATION: 5120 SOUTH 118TH STREET
PERSON PROVING INFORMATION ON BEHALF OF THE APPLICANT:
DEBBIE DOLASH, STORE OPERATIONS - 515-965-6517
REQUESTING:
P/ a� di
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LICENSE CURRENTLY READS:
1 STY BLDG APPROX 45' X 60'
BY: CARMAN JOHNSON, LIQUOR CLERK
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City ofImfia,." (, gars,-? w
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1819 Farnam — Suite LC 1 M { �l :.
Omaha, Nebraska 681 83-01 1 2 ®
Buster Brown (402) 444-5550 -
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City � �
Clerk FAX (402) 444-5263 �� �j4
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November 6, 2012
Casey's Retail Company Application for an addition to your present
Dba"Casey's General Store#2985" Package Liquor License location of an area
5120 South 118th Street approx. 23' x 35' to the north
Omaha, NE 68137
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 November 20, 2012 . 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 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.
If you are making changes to the type of business or the type of activities that will be operated
on the new premises. Please complete and return the attached. Ordinance No. 37046, passed
June 7, 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.
Sincerely yours,
Buster Brown -
City Clerk
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VETERAN 3 -- -COLLEGE OR UNIVERSITY O(��—
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(Authorized Signature) (Date)
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NOTICE OF LIQUOR LICENSE APPLICATION
This notice is to inform you that
CASEY'S RETAIL COMPANY
DBA "CASEY'S GENERAL STORE #2985"
has applied for an
ADDITION TO THEIR PRESENT PACKAGE LIQUOR
LICENSE LOCATION (On and Off Sale beer,wine and liquor] TO ADD
AN AREA APPROX. 22' X 35' TO THE NORTH
located at 5120 SOUTH 118TH STREET
The Omaha City Council will hold a public hearing regarding this
application on Tuesday, NOVEMBER 20, 2012 at 2:00
P.M. in the Legislative Chambers, Omaha/Douglas Civic Center at
1819 Farnam Street. Testimony will be received from interested
parties at this meeting. You may submit written testimony to the City
Clerk, 1819 Farnam Street, Omaha, NE 68183 prior to the hearing
date.
Buster Brown
City Clerk
REQUESTS FOR SIGN-LANGUAGE INTERPRETERS (SIGNERS), REQUIRE A MINIMUM OF 48 HOURS
ADVANCE NOTICE. IF ALTERNATIVE FORMATS ARE NEEDED, REQUESTS REQUIRE A MINIMUM
OF 72 HOURS ADVANCE NOTICE. IF YOU NEED ACCOMODATIONS, PLEASE NOTIFY BUSTER
BROWN,CITY CLERK,AT 444-5557.
icense". Failure to be present at this
Council Meeting is grounds to recommend denial of your application to the Nebraska Liquor
Control Commission.
If you are making changes to the type of business or the type of activities that will be operated
on the new premises. Please complete and return the attached. Ordinance No. 37046, passed
June 7, 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.
Sincerely yours,
Buster Brown -
City Clerk
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VETERAN 3 -- -COLLEGE OR UNIVERSITY O(��—
7,7/4:34,/ f/- 7- iZ
(Authorized Signature) (Date)
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