RES 2010-0920 - SDL for beer garden at Slowdown August 27 2010 • APPLICATION FOR SPECIAL •
DESIGNATED LICENSE
RETAIL LICENSE HOLDERS
NEBRASKA LIQUOR CONTROL COMMISSION
301 CENTENNIAL MALL SOUTH
PO BOX 95046
LINCOLN,NE 68509-5046
PHONE:(402)471-2571
FAX:(402)471-2814
Website:www.Icc.ne.gov/
BEFORE SUBMITTING APPLICATION TO THE LIQUOR CONTROL COMMISSION
Include approval from the City, Village or County Clerk where the event is to be held
A license fee $40 (payable to Nebraska Liquor Control Commission) for each day/event to be
licensed(i.e. if you have two separate areas at one event they both need to be licensed) (unless
licensed as a K Caterer no fees required)
ci Application MUST be received at the Liquor Control Commission Office no later than 10 working
days prior to event(excluding weekends, Federal and State observed holidays) •
COMPLETE ALL QUESTIONS
1. Type of alcohol to be served and/or consumed
0 Beer ® Wine E Distilled Spirits •
2. Liquor license number and class (i.e. C-55441) L — G 7_Z
3. Licensee name (last, first, middle), Corporate name, Limited Liability Company (LLC)
NAME: Fr-cSG'. , / ga
w,,, •
ADDRESS: ?U V c-x G 5 S`-I
CITY Q 1(N'Irt('ict ZIP k(C'S
4. Location where event will be held; name, address, city, county, zip code
ADDRESS: ) N L `{ $-t re-e---
CITY 0 VVI A kct ZIP �S to 2
COUNTY o, ti)kct. 5
REV 6/09 Page 1
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Buster Brown
City Clerk
BJB:clj
Print Name •
This individual must be listed on the application as an officer or stockholder unless a letter has been filed
appointing an individual as the catering manager allowing them to sign all SDL applications.
The law requires that no special designated license provided for by this section shall be issued by the Commission without the
approval of the local governing body. For the purposes of this section,the local governing body shall be the city or village within
.which the particular place for which the special designated license is requested is located, or if such place is not within the
corporate limits of a city or village,then the local governing body shall be the county within which the place for which the special •
designated license is requested is located.
•
•
REV 6/09 Page 3
of gambling are prohibited by State Law: There are no exceptions for Non Profit Organizations or any events raising funds
for a charity. This is only an application for a Special Designated License under the Liquor Control Act and is not a gambling
permit application.
REV 6/09
Page 2
FORM 35-4178
Revised 1/2008
ti
a. Is this location within the city/village limits? 'YES ONO
b. Is this location within the 150' of church, school, hospital or home •
aged/indigent or for veterans their wives? L1 YESM NO
c. Is this location within 300' of any university or college campus? EiYESIKNO
Must be consecutive days
5. Date(s) and Time(s) of event(no more then six(6) consecutive days on one application)
Date '2712010 Date Date Date Date Date
Hours From 7 fM Hours From Hours From Hours From Hours From Hours From
To 12 A^'‘ To To To To To
a. Alternate date: N o vle—
b. Alternate location: No. e
(Alternate date or location must be approved by local)
6. Indicate type of activity to be carried on during event
Dance® ReceptionD Fund Raisers Beer Garden D Sampling/Tasting1 Other C D 1 C P r+
7. Description of area to be licensed
® Inside building, dimensions of area to be covered IN FEET x
Name of building (not square feet or acres)
104 Outdoor area dimensions of area to be covered IN FEET S e x A-H"etvchE'A
(not square feet or acres)
If outdoor area, how will premises be enclosed
ki fence, type of fenceLl snow fencelI chain linkI cattle panelsD other 6k;5 t',�J - 'teme
tent
other, explain }� J` �' L UPI, L i/✓� '2 , ,
*If both inside and outdoor area to be licensed include simple sketch
8. How many attendees do you,expect at event? \5O O
9. If over 150, indicate the steps that will be taken to prevent underage persons from obtaining alcohol
beverages. N orw,a Slawdr,..,A Gunceit 6'°1t%(4t. S Upheld, (,vf;) 7q.1ds
AaaitwKtl Se(&(;k 1-1;K) �7� t OFf Al ty fdlice oR tvs t't?re CI
10. Will premises to be covered by license comply with all Nebraska sanitation laws?
YES O NO
a. Are there separate toilets for both men and women? YESDI NO
11. Where will you be purchasing your alcohol wholesaler retailerll both
12. Will there be any games of chance operating during the event? El YES ,NO
If so, describe activity
NOTE: Only games of chance approved by the Department of Revenue, Charitable Gaming Division are permitted. All other
forms of gambling are prohibited by State Law: There are no exceptions for Non Profit Organizations or any events raising funds
for a charity. This is only an application for a Special Designated License under the Liquor Control Act and is not a gambling
permit application.
REV 6/09 Page 2
is not a gambling
permit application.
REV 6/09
Page 2
FORM 35-4178
Revised 1/2008
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13. Any other information or requests for exemptions:
14. Name and telephone number/cell phone number of immediate supervisor. This person will be at t
the location of the event when it occurs, able to answer any questions from Commission and/or law
enforcement before and during the event, and who will be responsible for ensuring that any applicable laws,
ordinances,rules and regulations are adhered to.
K,, ` Phone: Before L 0 2-2 I ° _,S 4 5` During -sq ire
Print name of Event Supervisor
Signature of Event Supervisor
Consent of Authorized Representative/Applicant
15. I declare that I am the authorized representative of the above named license applicant and that the
statements made on this application are true to the best of my knowledge and belief. I also consent to an
investigation of my background including all records of every kind including police records. I agree to
waive any rights or causes of action against the Nebraska Liquor Control Commission, the Nebraska State
Patrol or any other individual releasing said information to the Liquor Control Commission or the Nebraska
State Patrol. I further declare that the license applied for will not be used by any other person, group,
organization or corporation for profit or not for profit and that the event will be supervised by persons
directly responsible to the holder of this Special Designated License.
sign
here-&1^ (44/4'1,- 01/11- 419//
Authorized Representative/Applicant Title ate
Print Name
This individual must be listed on the application as an officer or stockholder unless a letter has been filed
appointing an individual as the catering manager allowing them to sign all SDL applications.
The law requires that no special designated license provided for by this section shall be issued by the Commission without the
approval of the local governing body. For the purposes of this section,the local governing body shall be the city or village within
which the particular place for which the special designated license is requested is located, or if such place is not within the
corporate limits of a city or village,then the local governing body shall be the county within which the place for which the special
designated license is requested is located.
REV 6/09 Page 3
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• 0MAHA, NF
Q Omaha, Webraska City � °��
1819 Farnam— z miriorr�ju a Suite LC 1 r�'J � _
• Omaha, Nebraska 68183-0112 0® ` :°
Buster Brown (402) 444-5550
O 4
City Clerk FAX (402) 444-5263 is?47
FEBRIs�
July 27, 2010
Nebraska Liquor Control Commission .
301 Centennial Mall, South
P.O. Box 95046
Lincoln, Nebraska 68509-5046
Attn: Licensing Division
Attached is a copy of the Special Designated License application approved by the City Clerk of
the City of Omaha for Preson, Inc., dba "Slowdown", 729 North le Street on August 27, 2010
from 7:00 p.m. to 12:00 midnight.
APPLICATION APPROVED CONTIGENT UPON THE OMAHA CITY COUNCIL
APPROVING THE APPLICATION ON AUGUST 10, 2010 FOR MUSIC UNTIL 12:00
MIDNIGHT
Since ely yours,
uster rown
City Clerk
BJB:clj
Enclosure
ebraska State
Patrol or any other individual releasing said information to the Liquor Control Commission or the Nebraska
State Patrol. I further declare that the license applied for will not be used by any other person, group,
organization or corporation for profit or not for profit and that the event will be supervised by persons
directly responsible to the holder of this Special Designated License.
sign
here-&1^ (44/4'1,- 01/11- 419//
Authorized Representative/Applicant Title ate
Print Name
This individual must be listed on the application as an officer or stockholder unless a letter has been filed
appointing an individual as the catering manager allowing them to sign all SDL applications.
The law requires that no special designated license provided for by this section shall be issued by the Commission without the
approval of the local governing body. For the purposes of this section,the local governing body shall be the city or village within
which the particular place for which the special designated license is requested is located, or if such place is not within the
corporate limits of a city or village,then the local governing body shall be the county within which the place for which the special
designated license is requested is located.
REV 6/09 Page 3
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REQUEST FOR A SPECIAL DESIGNATED LIQUOR LICENSE.
DATE: JULY 27, 2010
APPLICANT REQUESTING THE PERMIT:
PRESON, INC., DBA "SLOWDOWN", 729 NORTH 14TH STREET
OMAHA, NE
DATE(S) AND TIME(S) OF THE EVENT(S): FRIDAY
AUGUST 27, 2010 FROM 7:00 P.M. TO 12:00 MIDNIGHT
LOCATION: SAME
APPLICANT'S STATUS: X CURRENT LICENSE HOLDER
NON PROFIT ORGANIZATION (STATEMENT ATTACHED)
ADDITIONAL INFORMATION APPLICATION APPROVED CONTIGENT UPON THE
OMAHA CITY COUNCIL APPROVING THE APPLICATION ON AUGUST 10, 2010
REQUESTING: MUSIC UNTIL 12:00 MIDNIGHT
APPROVED: X
DENIED:
REASON FOR DENIA •
APPROVED BY: 07/27/10
Buster Brown, City Clerk, City of Omaha Date
y of Omaha Date
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A.Hiet s NF
City ofOmaha, •Nebras a g1T4
AgieAkOlel
1819 Farnam— Suite LC 1 � i® 1r j'tct _
Omaha, Nebraska 68183-01120 = t. & '' �'
Buster Brown (402) 444-5550 .o ti
City Clerk FAX (402) 444-5263 oR 0 FEBRt►�
July 27, 2010
Preson, Inc. Application for a Special Designated
Dba "Slowdown" License at 729 North 14th Street on
P. O. Box 8554 August 27, 2010 requesting music
Omaha, NE 68108 until 12:00 midnight
'Dear Liquor License Applicant:
This letter is notification that a hearing before the Omaha City Council on your
application(s) for a Special Designated liquor license has been set for August
10, 2010
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(s) to the Nebraska Liquor Control Commission.
Sincerely yours,
414c1,,,b-
Buster Brown
City Clerk
BJB:clj
ntative/Applicant Title ate
Print Name
This individual must be listed on the application as an officer or stockholder unless a letter has been filed
appointing an individual as the catering manager allowing them to sign all SDL applications.
The law requires that no special designated license provided for by this section shall be issued by the Commission without the
approval of the local governing body. For the purposes of this section,the local governing body shall be the city or village within
which the particular place for which the special designated license is requested is located, or if such place is not within the
corporate limits of a city or village,then the local governing body shall be the county within which the place for which the special
designated license is requested is located.
REV 6/09 Page 3
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ON (STATEMENT ATTACHED)
ADDITIONAL INFORMATION APPLICATION APPROVED CONTIGENT UPON THE
OMAHA CITY COUNCIL APPROVING THE APPLICATION ON AUGUST 10, 2010
REQUESTING: MUSIC UNTIL 12:00 MIDNIGHT
APPROVED: X
DENIED:
REASON FOR DENIA •
APPROVED BY: 07/27/10
Buster Brown, City Clerk, City of Omaha Date
y of Omaha Date
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