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RES 2010-0562 - Appoint Jason B Kruse manager of Fox & Hound Pub & Grille �%�E ST9Tg1t ( j� E D STATE OF NEBRASKA „ Dave Heineman NEBRASKA LIQUOR CONTROL COMMISSION Governor �j p I ; `i 2 Hobert B. Rupe -.!,,- 6� i I` i Executive Director ' ygRCFI 1=♦a 301 Centennial Mall South, 5th Floor P.O.Box 95046 • CITY CLERK l C,� Lincoln,Nebraska 68509-5046 OMAHA, N E 5 R ASK', Phone(402)471-2571 April 13, 2010 Fax(402)471-2814 TRS USER 800 833-7352(TTY) web address:http://www.lcc.ne.gov/ OMAHA CITY CLERK 1819 FARNAM STREET LC-1 OMAHA NE 68183 RE: Fox & Hound of Nebraska Inc LICENSE #I - 83504 • Dear Clerk: Enclosed is a copy of a manager application for Jason B Kruse in connection with Fox & Hound Pub & Grille, located at 17602 Wright Street in Omaha. Please present this application for manager to your City/Village Council or County Commissioners and send us the results of their action. Sincerel IA lb farIMIS • Lynn make. Licensing Division NEBRASKA LIQUOR CONTROL COMMISSION • encl. cc: file Janice M.Wiebusch Bob Logsdon Robert Batt Commissioner Chairman Commissoner An Equal Opportunity/Affirmative Action Employer Printed with soy ink on recycled paper me this (1}roKY1 q 1 a1 l` by ►)cLe1ck. buyer me this by o ary 'u lic signature Notary Public signature Affi re Affix Seal Here All eA$MUSWI. ONwral Wary State of Nebraska My Coit+tnlWoa Expires Apr 24.2013 In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. Revised 9/2008 Form 3c Page 4 ert form 3o is available in other formats for persona with disabilities. y�, A ten day advance period is required in writing to produce the alternate format, % ©\` 64/19120011 ----------- ------------ G(14141 Form 3c ... .._........ __... .:..___..._. Page 4 • • MANAGER APPLICATION • Office Use a INSERT-FORM 3c Et) NEBRASKA LIQUOR CONTROL COMMISSION 30.1 CENTENNIAL MALL SOUTH PO Box 95046 APR 122510 LINCOLN,NE 68509-5046 PHONE:(402)471.2571 FAX:(402)4712814 t RASI(pl.IG1U0R Website:www.kc,ne.eov CONTROL COMMISSIO Corporate manager,including spouse,are required to adhere to the following requirements 1f spouse flied affidavit of non-participation fingerprints and proof of citizenship not required 1) Must be a citizen of the United States 2) Must be a Nebraska resident(Chapter 2—006) 3) Must provide a copy of birth certificate,naturalization paper or US passport 4) Must submit their fingerprints(2 cards per person) 5) Must be 21 years of age or older 6) Applicant may be required to take a training course Name of Corporation/LLC: Fox & Hound of Nebraska, inc. Premise License.N (if new application leave blank) Premise Trade Name/DBA:Fox & Hound Pub & Grille Premise Street Address: 17602 Wright St. City:Omaha State: NE Zip Code::68130 Premise Phone Number:4.02.-334-3133 ORPORATE OFFICER SIGNATURE (Faxed si •atures are accestable) ' ' 1 �,...- ga Yr` • ._ .. .•i2'.x,ti<ki 1�' x 't", P3h y'fy �1�. •u , .., ... ♦ Form 3c I 1000008157 recycled paper me this (1}roKY1 q 1 a1 l` by ►)cLe1ck. buyer me this by o ary 'u lic signature Notary Public signature Affi re Affix Seal Here All eA$MUSWI. ONwral Wary State of Nebraska My Coit+tnlWoa Expires Apr 24.2013 In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. Revised 9/2008 Form 3c Page 4 ert form 3o is available in other formats for persona with disabilities. y�, A ten day advance period is required in writing to produce the alternate format, % ©\` 64/19120011 ----------- ------------ G(14141 Form 3c ... .._........ __... .:..___..._. Page 4 M.. 4.Iere rw ors • APR 12 2010 • Gender: ❑ MALE • FEMALE - Last Name: Kruse First Name:Jason MI: Home Address(include PO Box if applicable): 1313 S. 124th St. City:Omaha State: NE Zip code:68144 Home Phone Number:402-980-6993 Business Phone Number:402-334-3133 Social Security Number:.' - - - Drivers License Number&State: NE Date Of Birth: - Place Of Birth:Lincoln., :NE • *YES ❑NO Spouses Last Name: Kruse First Name:Tammy MI: M Social Security Number:. Drivers License Number&.State:NE Date Of.Birth: Place Of Birth:Omaha, NE I. _ . CITY&-STATE YEAR CITY&STATE YEAR FROM TO FROM TO Omaha, NE 7/08 Present Omaha, NE 7/08 Present Gretna, NE 6/06 7/08 . Gretna, NE 6/06 7/08 Omaha, NE 7/04 6/06 Omaha, NE 7/04 6/06 Lincoln, NE 6/02 7/04 Lincoln,NE 6/02 7/04 ,, s*;, _. YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO 8/04 Present Fox 8 Hound Restaurant Group Don Stack 316-634-0505 3/97 7/04 Track Side/Four Sons Craig Blake 402-786-2500 Form 3c Page 2 ♦ Form 3c I 1000008157 recycled paper me this (1}roKY1 q 1 a1 l` by ►)cLe1ck. buyer me this by o ary 'u lic signature Notary Public signature Affi re Affix Seal Here All eA$MUSWI. ONwral Wary State of Nebraska My Coit+tnlWoa Expires Apr 24.2013 In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. Revised 9/2008 Form 3c Page 4 ert form 3o is available in other formats for persona with disabilities. y�, A ten day advance period is required in writing to produce the alternate format, % ©\` 64/19120011 ----------- ------------ G(14141 Form 3c ... .._........ __... .:..___..._. Page 4 1. READ PARAGRAPH CAREFULLY AND ANSWER COMPLETELY AND ACCURATELY. 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 a of � �®this application. If more than one party,please list charges by each individual's name. EYES DNO If yes,please explain below or attach a separate page. APR 1 22010 Z000 S �Krtic.�-F �a�,,c. dakk b f occurai e.) AILLNAIQUOR 631 3(1 t'( Du I @a.k f bC/ .r u- u�o(i es.. ctPf C*1 o ^ANTRUI COMMISSION 2. Have you or your spouse ever been approved or made application for a liquor license in Nebraska or any other state? IF YES,list the name of the premise. DYES 21NO 3. Do you,as a manager,have all the qualifications required to hold a Nebraska Liquor License? Nebraska Liquor Control Act(§53-131.01) [ YES ONO 4. Have you filed the required fingerprint cards and PROPER FEES with this application? (The check or money order must be made out to the Nebraska State Patrol for$38.00 per person) [YES DNO 5: List the training and/or experience(when and where) Date: Where: Form 3c Page 3 o ary 'u lic signature Notary Public signature Affi re Affix Seal Here All eA$MUSWI. ONwral Wary State of Nebraska My Coit+tnlWoa Expires Apr 24.2013 In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. A ten day advance period is required in writing to produce the alternate format. Revised 9/2008 Form 3c Page 4 ert form 3o is available in other formats for persona with disabilities. y�, A ten day advance period is required in writing to produce the alternate format, % ©\` 64/19120011 ----------- ------------ G(14141 Form 3c ... .._........ __... .:..___..._. Page 4 3. •Have you ormade yo r spouse ever a compromise settlement for violation of such laws? 'RECEIVED D p :_ YES IJ NO • _ _ _- 4. Do you,as a manager,have all the qualifications required by any person entitled to hold a Nebraska Liquor Licenses; Nebraska Liquor Control Act(053-131.01) N�UH�s L,i�IUO ' ! YES 0No �co m oL COMMISSIO''' 5. Have you filed fingerprint cards and PROPER FEES(if check,made out to the NE State Patrol),with this application? _ YES ONO LIST PRINCIPAL RESIDENCE FOR PAST 10 YEARS,APPLICANT AND SPOUSE MUST COMPLETE APPLICANT CITY&STATE • YF.AR SPOUSE:CITY&STATE YEAR 1 FROM TO FROM TO 31'S s.1a_ a.p1Y,a.1,Ql, 7102 Pfo �� r oa.11o Gk."w,o re tr.4`Z,.Grt p/TJE 1(o t `I1c S Cr31SMcuplc&oo®ot Eipt. .Dka.1.a,l fE `Llot-F 4(ou, ,� . WO0VtreSA-,4I-54I,l'At c,rn1ktE QJo -71 4 EMPLOYERS—LIST LAST TWO EMPLOYERS • YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO 1 5It4 PrAr.o. x)t+:kc;u-bl K 344CLati. G-r-cL-co `L 1 StrAC- 51 L9.tp- •oCbs . 31 a-1 - t0 4' `TTrac k-Sot° / V-C.LXS0s C, -bj-61 a..k--.— 4 ...72io•a6°° . PERSONAL OATH AND CONSENT OF INVESTIGATION—MUST BE SIGNED BY APPLICANT&SPOUSE STATE OF NEBRASKA ) . ) SS COUNTY OF ) • The;dime individtlnl(sI.being first duly sworn upon oath.deposes and sates 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 etntents thereof and all statements contained therein are true.If any false statement is inside in any part of this application.the applicants)shall be damned guilty of perjury and subject to penalties provided by law.(Sec.it53•131.91)Nebraska Liquor Control Act. The undersigned applicant hereby consents to an investigation of blather background including all records of every kind and description including police records,tat records (State and Federal).and hank 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 Ncbnlska 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,an affidavit may be attached however,fingerprint cards are still required to be filed. The undersigned understand and acknowledge that any license issued,based nn the information submitted in this application.is subject to cancellation if the information contained herein is incomplete and inaccurate. f 717 g., jhluAplcani i -�y P'Aigtare of Spouse(If applicable) Subscribe • y prose c end sw to before me this 8 Subscribed rpy presence d sworn to before me this 8 tiny'of {.�" / � • day of.. d t)CA / Q . dA • Notar0/174"i*V-- ta &Senn Notary 'gesture&,cal GENERA!.NOTARY-State of Nebraska 14la""'y", GENERAL NOTARY-State of Nebraska NE`.s"'•' . LORI MILES mm.Exp.MILES rst<;r . • 'Z My Comm.Exp.Oct.10.2010 My Comm. Oct.10,2010 SPOUSAL AFFIDAVIT OF office use NON PARTICIPATION INSERT ECEIVED NEBRASKA LIQUOR CONTROL COMMISSION 301 CENTENNIAL MALL SOUTH y PO BOX 95046 APR 1 2 ZU10 LINCOLN,NE 68509-5046 PHONE:(402)471-2571 FAX:(402)471-2814 NE�RASKA LtQUOh website: www.lcc ne goy CONTROL COMMISSI(►" +i\�.ep;G.. C 111 L:'fM f..}{[( e 14 e .SRr''.. I�'py r F�'�}7LP 4 ' i'F•k 19i f :F f1} �?Y!{r '�t4. .11 7'7,.}I,:�rtRR 4�Pi1-' 'U-i,kl:i f'�''tP 1[fil.i.�` t_. 4r`t t! S. rs :} 5.,r., -_. .r1. of, >, 1 s `> ,pFr f , St' ,i �a `7.M ��,.�y s»'l"}.i„ }{1ie .ic,E iy ' ,d,p(+ a;¢.,, k A eV,r1�. its y rt u'i.itfk.. •K t Prf,y.r. .�.�„ 4; > ,� v a r 4 Y Jf4 i rr fi :p :,,�.��?�:tFgY'Yitgi SSA S x '}E 2 -.�PCCa#, a'a7?w dL'L.:f!' tt.9g •_w,4^,- #tT `: yt.1 h. r o `:••y�',i• I , ..}•f £�M'Of q ky @ -1ir � • ix [,yh•0.-• edhl:i'" '�•:C+. a 34;id 1 4Arfi 4 i i.i.:i,''P f ..,4; *,.y' ,+.tt 9-s1. i'S;F !`"b 'm F,R.2ft f i rtf 7,,^r 3$'741 4' � ` N �1'✓, h..wl' yp S' cu;,' `� i ,}u i�� + ii, >k �,r2, a 4 Pfi'•t �s� !+a a 17' Y � i P`?r �' �tc.Sr cy,y," )S`t.Mt1.Ntpt [tt P vi'JIN3, y�:4 1 b ``,1 1r il' . py,4,JYy 3 '�i "�r' 7 axi 4} 'P 7''aEiy 'irj. Acy' f<,., re, °L '_ 0 �i t #tgUi i` ".'tis iRg;Gd .„i.a fAf'Ar,�.ee {r,'.a 5,1 tl +�n.dir�F ryr }.e •4'iai�i�l a."ti.'�'} 9;.'t 1!� -..°rt�wA rFo,�, .. ?!�,iilxs }�h irYn"t' a3r i�rt"ttTRr iFt"ww��'skt t ,c' .r � ,e.t. .r a xt. t-^ : f,d ,...18 J•%t a r.;'f hl .. US.�VSa'r i �I'a�•pr:;.°f;,i- M e:•Ja D:ry p.ut r:7��i • 1r.� }.., yi%�sr ..'r.� � $'�Rt F'I I��t p�!�a.: EI �c r' re�a£€',. j: eih:, .,fin/ 't."x„�.ur'v '''!!°' '?4Y M Zr .t 1 x $,+:�1�q�t r'.�; t4., 4 } $li, r'4,0 a hA��''",- . }'�'4> 's l a,".„1 tbi. zi t.1 BIa77; i i.11 'b 6 #c.s,l/ ,•l .My�. ° ¢. 'v �7, of x f, its . t t,�r" { b , i• . r6pi' FY .tI r,t ?tl A11Atlr .Ta,.C� rT 4tlfrT447, f Z9f8@r$� 9i' .@ Srt �4i¢E; r}f N H.'"t � (.'V i.� i A ` , , . ,xx. i!.4 y 4^n F� 7 a, _.r . tb,#lli ,.• •ui ;, y F�xr' t• m f M i - �' d f. ,r... rr t ` % p�t+ itl .. 9w•}irr, II'r� C' 3 C'w�4r 4 vl� `� � '.Y$°?ryt; ;J ''a,IaP�y?'':i • y'A. a} mr w� t , sd a ��.tl. O sa L it k `s Jar u � Q ...�: ' e .'wz . .(b, Via' h r; gF1Yt 7 1e tip' '^'ram '/�J 2-Gc t� T ?7,2 ��f+i/ ',/ / L krt.ASe. Signature of sp a asking for waiver Printed name of spouse askXng for waiver (Spouse of indi dual listed below) State of AalliStA County oft. The foregoing instrument was acknowledged before me this DA-( ( = \. Z524\6 by .1AAKKI +i ke--AXei date name of person acknowledged Affix Seal No��..-.tary Pu•if; atNre XEmyNsERALumpmN014.E09T4.N,ovembe,Y-Strge d NeErdska BRGREN 30,2011 pf4 it jnd;}E t,£N'.+7aik:»:' w<�,4rx9' �. w?:9} ^�c.tl.t7:Cvh S°i r a4:•�"P. p .r .h4.diJ;�., c f cP ry: • S{.� i nit •a1'g5 �e a t1" : 4. .7 [raga tl ,943 a c1 >'nnf?E l�, $, aat t-aXe a- t�6S n • t.l�tl(;'o.. .t n f it .,e y "nY� 9 " ). r ,nS4, .C3,", .T a rr T$,L,.t`r Stnc{,r,✓Yl^cl1t; _�_,✓,ra4.,,� �1 'Ra}��u'r,i§,� 1.' r htf il-t s- 4.it (Rc. ,� .t fa�:d "d x ry r I �C,r,.� h,t d 1 � � (3n#cS;FR 7 1,t�.a:r t"Jrv;,,,.r P i �rJ k.E k �$ ..i r ,l, y t'r• t d�4 s d m`s t:f ;: t,t'},;, t 2 : t i 44:. t• 13 ii 1 ; i��A vr1 eA 'cl!rtr ');,'"SgT �pi.gt- 4S'f5f9,afan�f�!!'1s,n rri,. le, , .+�,ct y 01t' 'ei>}aLI '4,4b: f$i1(j.jNar..! ,`}9-h .. s4a� 1' *'". ' A i ,.. a 1 r IM13• e t a. y0"v bl ;;i St"#5' i::' ,+�)r� 4 t� y-rv.f Jk Ystd.E. ri 4 r k ��, 1�'Q57 41 ly t 1!} a e:' '' 4-7dF� a; y , r 6 I.1„ rl' 1 f •• p , 7 6 tl�t '1^ tY�^r �y4FT AY, .lLt { it 2 �+ r. �s /.'f '~a �•,,��. i @ �" '�S � �.A;2f7 .,[ gi� 'iS r#�� v d cha 1 t:or8 +i-gt .�,... � rr wrW I.� } „j u. r ''!f. ?rud l J. gr X' ••:,;I • e of individual involved with application Printed name of applying individual (Spo t4i of individual listed above) State of •-QkO1 0 k:ct County of ')v..C\`(7S The foregoing instrument was acknowledged before me this b�t cry a©l() by 6Ck.� ,� KrU�A date name of rson acknowledged Affix Se GENERAL NOTARY•State of Nebraska rI uv�� DAWN M.DRIES ::b • . is Signature My Comm.Exp,Oct.4,2012 In compliance with the ADA,this spousal affidavit of non participation is available in other formats for persons with disabilities. A ten day advance period is requested in writing to produce the alternate format. FORM 35-4178 Revised 1/2008 014,A1-1IA, 1y� • • OF 9 v' ,p City ofOmaha Ne bras a `� 1 ' =°� Diaf6elel 1819 Farnam — Suite LC 1 z Ark - 1 Omaha, Nebraska 6813-0112 0� - 1 � �+ Buster Brown (402) 444-5550 City Clerk FAX (402) 444-5263 o�'rD FEaRvt'�-� April 27, 2010 Fox & Hound of Nebraska, Inc. Application to appoint Jason B. Kruse dba"Fox & Hound Pub& Grille" manager of your present Class "I" Liquor 17602 Wright Street License Omaha,NE 68130 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 May 11, 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 to the Nebraska Liquor Control Commission. • Sincerely yours, 4e5;<' ra'4"-:"?-4" Buster Brown City Clerk BJB:clj iRg;Gd .„i.a fAf'Ar,�.ee {r,'.a 5,1 tl +�n.dir�F ryr }.e •4'iai�i�l a."ti.'�'} 9;.'t 1!� -..°rt�wA rFo,�, .. ?!�,iilxs }�h irYn"t' a3r i�rt"ttTRr iFt"ww��'skt t ,c' .r � ,e.t. .r a xt. t-^ : f,d ,...18 J•%t a r.;'f hl .. US.�VSa'r i �I'a�•pr:;.°f;,i- M e:•Ja D:ry p.ut r:7��i • 1r.� }.., yi%�sr ..'r.� � $'�Rt F'I I��t p�!�a.: EI �c r' re�a£€',. j: eih:, .,fin/ 't."x„�.ur'v '''!!°' '?4Y M Zr .t 1 x $,+:�1�q�t r'.�; t4., 4 } $li, r'4,0 a hA��''",- . }'�'4> 's l a,".„1 tbi. zi t.1 BIa77; i i.11 'b 6 #c.s,l/ ,•l .My�. ° ¢. 'v �7, of x f, its . t t,�r" { b , i• . r6pi' FY .tI r,t ?tl A11Atlr .Ta,.C� rT 4tlfrT447, f Z9f8@r$� 9i' .@ Srt �4i¢E; r}f N H.'"t � (.'V i.� i A ` , , . ,xx. i!.4 y 4^n F� 7 a, _.r . tb,#lli ,.• •ui ;, y F�xr' t• m f M i - �' d f. ,r... rr t ` % p�t+ itl .. 9w•}irr, II'r� C' 3 C'w�4r 4 vl� `� � '.Y$°?ryt; ;J ''a,IaP�y?'':i • y'A. a} mr w� t , sd a ��.tl. O sa L it k `s Jar u � Q ...�: ' e .'wz . .(b, Via' h r; gF1Yt 7 1e tip' '^'ram '/�J 2-Gc t� T ?7,2 ��f+i/ ',/ / L krt.ASe. Signature of sp a asking for waiver Printed name of spouse askXng for waiver (Spouse of indi dual listed below) State of AalliStA County oft. The foregoing instrument was acknowledged before me this DA-( ( = \. Z524\6 by .1AAKKI +i ke--AXei date name of person acknowledged Affix Seal No��..-.tary Pu•if; atNre XEmyNsERALumpmN014.E09T4.N,ovembe,Y-Strge d NeErdska BRGREN 30,2011 pf4 it jnd;}E t,£N'.+7aik:»:' w<�,4rx9' �. w?:9} ^�c.tl.t7:Cvh S°i r a4:•�"P. p .r .h4.diJ;�., c f cP ry: • S{.� i nit •a1'g5 �e a t1" : 4. .7 [raga tl ,943 a c1 >'nnf?E l�, $, aat t-aXe a- t�6S n • t.l�tl(;'o.. .t n f it .,e y "nY� 9 " ). r ,nS4, .C3,", .T a rr T$,L,.t`r Stnc{,r,✓Yl^cl1t; _�_,✓,ra4.,,� �1 'Ra}��u'r,i§,� 1.' r htf il-t s- 4.it (Rc. ,� .t fa�:d "d x ry r I �C,r,.� h,t d 1 � � (3n#cS;FR 7 1,t�.a:r t"Jrv;,,,.r P i �rJ k.E k �$ ..i r ,l, y t'r• t d�4 s d m`s t:f ;: t,t'},;, t 2 : t i 44:. t• 13 ii 1 ; i��A vr1 eA 'cl!rtr ');,'"SgT �pi.gt- 4S'f5f9,afan�f�!!'1s,n rri,. le, , .+�,ct y 01t' 'ei>}aLI '4,4b: f$i1(j.jNar..! ,`}9-h .. s4a� 1' *'". ' A i ,.. a 1 r IM13• e t a. y0"v bl ;;i St"#5' i::' ,+�)r� 4 t� y-rv.f Jk Ystd.E. ri 4 r k ��, 1�'Q57 41 ly t 1!} a e:' '' 4-7dF� a; y , r 6 I.1„ rl' 1 f •• p , 7 6 tl�t '1^ tY�^r �y4FT AY, .lLt { it 2 �+ r. �s /.'f '~a �•,,��. i @ �" '�S � �.A;2f7 .,[ gi� 'iS r#�� v d cha 1 t:or8 +i-gt .�,... � rr wrW I.� } „j u. r ''!f. ?rud l J. gr X' ••:,;I • e of individual involved with application Printed name of applying individual (Spo t4i of individual listed above) State of •-QkO1 0 k:ct County of ')v..C\`(7S The foregoing instrument was acknowledged before me this b�t cry a©l() by 6Ck.� ,� KrU�A date name of rson acknowledged Affix Se GENERAL NOTARY•State of Nebraska rI uv�� DAWN M.DRIES ::b • . is Signature My Comm.Exp,Oct.4,2012 In compliance with the ADA,this spousal affidavit of non participation is available in other formats for persons with disabilities. A ten day advance period is requested in writing to produce the alternate format. FORM 35-4178 Revised 1/2008 oMAHA, Art • 0 I'!City ofOmaha, Webras&a ,� Gar_ 1819 Farnam— Suite LC 1 n® d� Omaha, Nebraska 68183.0112 0 > '' �° Buster Brown (402) 444-5550 City Clerk FAX (402) 444-5263 o4p FEBRv!4� April 27, 2010 • • Jason B. Kruse Application to be appointed manager of the present 1313 South 124th Street Class "I" Liquor Licenses for Fox & Hound of Omaha,NE 68144 Nebraska, Inc., dba"Fox & Hound Pub & Grill", 17602 Wright 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 May 11, 2010 . The City Council Meeting begins at 2:00 P.M. in the Legislative Chamber, (LC-4), Omaha/Douglas •Civic Centers 1819 Farnarn 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, Sincerely yours, .. Buster Brown City Clerk BJB:clj . • . ,• ... , • fAf'Ar,�.ee {r,'.a 5,1 tl +�n.dir�F ryr }.e •4'iai�i�l a."ti.'�'} 9;.'t 1!� -..°rt�wA rFo,�, .. ?!�,iilxs }�h irYn"t' a3r i�rt"ttTRr iFt"ww��'skt t ,c' .r � ,e.t. .r a xt. t-^ : f,d ,...18 J•%t a r.;'f hl .. US.�VSa'r i �I'a�•pr:;.°f;,i- M e:•Ja D:ry p.ut r:7��i • 1r.� }.., yi%�sr ..'r.� � $'�Rt F'I I��t p�!�a.: EI �c r' re�a£€',. j: eih:, .,fin/ 't."x„�.ur'v '''!!°' '?4Y M Zr .t 1 x $,+:�1�q�t r'.�; t4., 4 } $li, r'4,0 a hA��''",- . }'�'4> 's l a,".„1 tbi. zi t.1 BIa77; i i.11 'b 6 #c.s,l/ ,•l .My�. ° ¢. 'v �7, of x f, its . t t,�r" { b , i• . r6pi' FY .tI r,t ?tl A11Atlr .Ta,.C� rT 4tlfrT447, f Z9f8@r$� 9i' .@ Srt �4i¢E; r}f N H.'"t � (.'V i.� i A ` , , . ,xx. i!.4 y 4^n F� 7 a, _.r . tb,#lli ,.• •ui ;, y F�xr' t• m f M i - �' d f. ,r... rr t ` % p�t+ itl .. 9w•}irr, II'r� C' 3 C'w�4r 4 vl� `� � '.Y$°?ryt; ;J ''a,IaP�y?'':i • y'A. a} mr w� t , sd a ��.tl. O sa L it k `s Jar u � Q ...�: ' e .'wz . .(b, Via' h r; gF1Yt 7 1e tip' '^'ram '/�J 2-Gc t� T ?7,2 ��f+i/ ',/ / L krt.ASe. Signature of sp a asking for waiver Printed name of spouse askXng for waiver (Spouse of indi dual listed below) State of AalliStA County oft. The foregoing instrument was acknowledged before me this DA-( ( = \. Z524\6 by .1AAKKI +i ke--AXei date name of person acknowledged Affix Seal No��..-.tary Pu•if; atNre XEmyNsERALumpmN014.E09T4.N,ovembe,Y-Strge d NeErdska BRGREN 30,2011 pf4 it jnd;}E t,£N'.+7aik:»:' w<�,4rx9' �. w?:9} ^�c.tl.t7:Cvh S°i r a4:•�"P. p .r .h4.diJ;�., c f cP ry: • S{.� i nit •a1'g5 �e a t1" : 4. .7 [raga tl ,943 a c1 >'nnf?E l�, $, aat t-aXe a- t�6S n • t.l�tl(;'o.. .t n f it .,e y "nY� 9 " ). r ,nS4, .C3,", .T a rr T$,L,.t`r Stnc{,r,✓Yl^cl1t; _�_,✓,ra4.,,� �1 'Ra}��u'r,i§,� 1.' r htf il-t s- 4.it (Rc. ,� .t fa�:d "d x ry r I �C,r,.� h,t d 1 � � (3n#cS;FR 7 1,t�.a:r t"Jrv;,,,.r P i �rJ k.E k �$ ..i r ,l, y t'r• t d�4 s d m`s t:f ;: t,t'},;, t 2 : t i 44:. t• 13 ii 1 ; i��A vr1 eA 'cl!rtr ');,'"SgT �pi.gt- 4S'f5f9,afan�f�!!'1s,n rri,. le, , .+�,ct y 01t' 'ei>}aLI '4,4b: f$i1(j.jNar..! ,`}9-h .. s4a� 1' *'". ' A i ,.. a 1 r IM13• e t a. y0"v bl ;;i St"#5' i::' ,+�)r� 4 t� y-rv.f Jk Ystd.E. ri 4 r k ��, 1�'Q57 41 ly t 1!} a e:' '' 4-7dF� a; y , r 6 I.1„ rl' 1 f •• p , 7 6 tl�t '1^ tY�^r �y4FT AY, .lLt { it 2 �+ r. �s /.'f '~a �•,,��. i @ �" '�S � �.A;2f7 .,[ gi� 'iS r#�� v d cha 1 t:or8 +i-gt .�,... � rr wrW I.� } „j u. r ''!f. ?rud l J. gr X' ••:,;I • e of individual involved with application Printed name of applying individual (Spo t4i of individual listed above) State of •-QkO1 0 k:ct County of ')v..C\`(7S The foregoing instrument was acknowledged before me this b�t cry a©l() by 6Ck.� ,� KrU�A date name of rson acknowledged Affix Se GENERAL NOTARY•State of Nebraska rI uv�� DAWN M.DRIES ::b • . is Signature My Comm.Exp,Oct.4,2012 In compliance with the ADA,this spousal affidavit of non participation is available in other formats for persons with disabilities. A ten day advance period is requested in writing to produce the alternate format. FORM 35-4178 Revised 1/2008 a , 1 F o u, r: 5Px '71 z cD a. 12. o cu o C7 '� N \ . . . Q, nto � o0 En 510 rd ° � c' x o r c0 O_ cto CD co °� CA p 1-9 CrA i CD 'c3 I o oh g C o PO � 0. P Of Birth: CITY&STATE YEAR CITY&STATE YEAR '. FROM TO FROM TO ' !it 9; Egal YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO jai/ G'ANDAC� wale- r Q_ Form 3c Page 2