RES 2008-1332 - Appoint Debbie Arroyo manager of Infinite l ;, 1 E U STATE OF NEBRASKA
�!°��, �a ,.� " Dave Heineman NEBRASKA LIQUOR CONTROL COMMISSION
'�ii�`�C- °c ''= Governor t �,i _ Hobert B. Rupe
!►! _ '� 8 V Executive Director
\ q��t� t i t ('i4 301 Centennial Mall South,5th Floor
P.O.Box 95046
1 Y C I_r'=Ott Lincoln,Nebraska 68509-5046
Phone(402)471-2571
?A E+Hit.. 71'R A J'A Fax(402)471-2814
TRS USER 800 833-7352(TTY)
September 4, 2008 web address:http://www.lcc.ne.gov/
OMAHA CITY CLERK
1819 FARNAM STREET , SUITE LC-1
OMAHA NE 68183
Re: M &A PETROLEUM CORP
DBA INFINITE •
License# B-79522
Dear Clerk:
Enclosed is a copy of a manager application for DEBBIE ARROYO in connection INFINITE located at
1222 S 24th Street Omaha NE 68108, Liquor License # B-79522.
Please present this application for manager to your CityNillage Council or County
Commissioners and send us the results of their action.
Sincerely,
•
NEBRASKA LIQUOR CONTROL COMMISSION
Tami Applebee
Licensing Division
encl. •
cc: file
Rhonda R.Flower Bob Logsdon Robert Batt
Commissioner Chairman Commissoner
An Equal Opportunity/Affirmative Action Employer
Printed with soy ink on recycled paper
ommission.
Sincerely yours,
& #e Zib'C":10'21
Buster Brown
City Clerk
BJB:clj
cipation 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.
D OS F .
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Signature tiri Manager Applicant. • S nature of Spouse• .
• State of Nebraska .
County of Tlti ,
�' . . . County of
. .The foregoing instru e t was acknowledged before ' The foregoing instrument was acknowledged before ;,•
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Affix Seal Here . • Affix Seal Here
GENERAL NOTARY•State of Nebraska
MEEGAN THIBODEAU
•
My Comm.Exp.Aug.6,2011 • '
•
•
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 5/2001 •
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.CORPORATE OFFICER SIGNATURE •
(Faxed signatures are acceptable)
0800016709
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MANAGER APPLICATION Office Use
INSERT-FORM 3c
NEBRASKA LIQUOR CONTROL COMMISSION
301 CENTENNIAL MALL SOUTH RECEIVED
PO BOX 95046
LINCOLN,NE 68509-5046
PHONE:(402)471.2571 AM t u
FAX:(402)471-2814 ►""' et
Website:ww*v!cc.ne,gov
NEBRASKA UOUOR
CON i HOL COMMISSION
Corporate manager,including their spouse,are required to adhere to the following requirements
1) Must be a citizen of the United States ....P
2) Must be a Nebraska resident(Chapter 2—006)
3) Must provide a copy of their certified birth certificate or INS papers
4) Must submit their fingerprints(2 cards per person)
S) Must be 21 years of age or older
6) Applicant may be required to take a training course
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Premise License Number: /5 795.2�
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Premise Trade Name/DBA: __- __ _..,_. _____-_.:
Premise Street Address: /fie? ? %... e. 4 3i'
City: �/Y2Q-44. State: A/e Zip Code: gr/D.�
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CORPORATE OFFICER SIGNATURE
(Faxed signatures are acceptable)
0800016708 .
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0800016707' .
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Managers intbrnLatign must lie c0ntpietea below PLEA fa PRINT CLEA .
Gender: ❑MALE in FEMALE
Last Name: , ,e, L First Name:.. Bi L MI: t-f
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Home Address(include PO Box if applicable): 'ki4 r ? / , 6/ S7 'Z7` ,
City: Q/3J/:/ - State: ,C),6. Zip Code: (p I d`'`�J
Home Phone Number: G1 4 - 7Q� - 95a-g Business Phone Number: 'VOA Ill/;-/4,5 l
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Social Security Number:_ Drivers License Number& State: L , _ _
Date Of Birth: Place Of Birth: .L cv
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YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
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CORPORATE OFFICER SIGNATURE
(Faxed signatures are acceptable)
0800016708 .
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Manager. d spouse mist review and answer;the questions;beiow
PLEASE PRINT CL ARL Y Y
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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 at the time of
this application. If more than one party,please list charges by each individual's name.
OYES (' 10 If yes,please explain below or attach a separate page.
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 [ O.
3. Do you,as a manager,have all the qualifications required to hold a Nebraska Liquor License? Nebraska
Liquor Control Act(§53-131.01)
EKES 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)
v ES {ENO
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Spouses Last Name: -. First Name:
Social Security Number: Drivers License Number& State:
Date Of Birth: Place Of Birth:
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CITY&STATE' YEAR CITY&STATE YEAR
FROM TO FROM TO
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YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
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CORPORATE OFFICER SIGNATURE
(Faxed signatures are acceptable)
0800016708 .
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: .CORPORATE OFFICER SIGNATURE • • •
(Faxed signatures are acceptable) • .
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0800016707' .
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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. .
. ...._1, .
,. . • • . . AIO .‘gi3O LIS A` . . .
Signature • Manager'Applicant Sithatire.of Spouse •
State of Nebraska- - • . ' - •
County of . q S ..• • County of •
The foregoing instru e-twas:acknowledged.before.:.. -. .The foregoing instrument was acknowledged:before •• . ..
me this Z54'h . .t l�j. •try` . • me this.:. . . • :by. .
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No,; Public..siguature. • . ' Notary Public.Sign.ature
• Affix Seal Here Affix Seal Here
GENERAL NOTARY•State of Nebta0a
MEEGAN THIBODEAU
�''°'1' My Comm.Exp.Aug.6,2011
•
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 5/I007
re acceptable)
0800016708 .
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: .CORPORATE OFFICER SIGNATURE • • •
(Faxed signatures are acceptable) • .
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0800016707' .
1 .
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KELLEY, JERRAM &t KOHOppUT, P.C., L.L.O.
7134 PACIFIC STREET
MICHA[L A. KELLEY(NEI OMAHA. NES)1ASICA 61101 LINCOLN OFFICE
CNSISTOINES O.JETSAM(NE.MO KS) TELEPMOIVE (402) 397.1406 426 SOUTH 14TH STStSt,SUITE S ..
JOSEPH O.KONOUT INE) LINCOLN.NESSA$KA/S60$
TACSIMILE I402)347-1342
TELETHONS(402)474.2802
TOM K[LL[V I1S/S•1S60) wANONSTANINKHAeuLtris
QACS)MILS 14021 474-4042
M16401161 OFFIC[
000 SAYUESSY LANE.SUITE 106
LE['S SUMMIT,MISSOUSI 04004
T[LEMION[(S1 S)472.4621
August 27,2008
Nebr Liquor Control Commission . • RECEIV '�D
Licensing Division
PO Box 95046 i e 29 ZOO}°
Lincoln NE 68509-5046 .
Re: . 13&K Petroleum Corp.,d/b/a Infinite 0 CONTROLCOMMlSS10N1
M&A Petroleum Corp.,d/b/a Infinite . .
B&A Petroleum Corp.,d/b/a Infinite
Enclosed please find new corporate manager applications for the above--referenced licensees.
?lease be advised that Debbie Arroyo was unable to locate her birth certificate and has had to
iequest a duplicate from the State of Nebraska. We will provide a copy of that document as soon
as it is received.
• SW
(0/
(67(ger
i • ,, ./ Mic 1 ael A.Kelley
ue. 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. .
. ...._1, .
,. . • • . . AIO .‘gi3O LIS A` . . .
Signature • Manager'Applicant Sithatire.of Spouse •
State of Nebraska- - • . ' - •
County of . q S ..• • County of •
The foregoing instru e-twas:acknowledged.before.:.. -. .The foregoing instrument was acknowledged:before •• . ..
me this Z54'h . .t l�j. •try` . • me this.:. . . • :by. .
•
•
•
: ' el$A3144b0.‘ AtZ;<:- ,i• •
•
No,; Public..siguature. • . ' Notary Public.Sign.ature
• Affix Seal Here Affix Seal Here
GENERAL NOTARY•State of Nebta0a
MEEGAN THIBODEAU
�''°'1' My Comm.Exp.Aug.6,2011
•
In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. •
A ten day advance period is required in writing to produce the alternate format. -
• . Revised 5/I007
re acceptable)
0800016708 .
.9i::�:5•. _3<,. 3'.�j:"�,... �:.,;� 1.+. tk, X:..y,!, f..,. _Si?.:: Cr•d"�rk.>•,:
+d.:•_._e.u ...c'.'.:;5'r.•..:...{^f:�sei:.F.:i^...:a...,...J.e•�,,. �•"+L7J.`,1>u,iiv.F:h.,dY:sY R-`:.•irv.ne. ,r. i-.i:..7+:7 ....._3•kti:+a•:' o:ka$a�'},.n�w<......<.. :'S`L"�!•.tew.,.....s;' �a�i :.-i�1'X'.:;,.'i..n.s.:...k3,=a.L,..1,1
•
•
f .'
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. .
: .CORPORATE OFFICER SIGNATURE • • •
(Faxed signatures are acceptable) • .
•
•
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0800016707' .
1 .
OMAHA NF
�ii it 6�
City ofOmaha, WebraskgC.Mirzter19*-'4*,
1I'
1819 Farnam—Suite LC 1 z . , �1
Omaha, Nebraska 68183-0112 0 v � ;.�
Buster Brown (402) 444-5550
City Clerk FAX (402) 444-5263 lib11 D F68Rvt*�4
September 16, 2008
M &A Petroleum Application to appoint Debbie Arroyo
Dba"Infinite" manager of your present Off Sale Beer
1222 South 24th Street License
Omaha,NE 68108
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 September 30,
2008 . 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,
.
Buster Brown
City Clerk
BJB:clj
s 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. .
. ...._1, .
,. . • • . . AIO .‘gi3O LIS A` . . .
Signature • Manager'Applicant Sithatire.of Spouse •
State of Nebraska- - • . ' - •
County of . q S ..• • County of •
The foregoing instru e-twas:acknowledged.before.:.. -. .The foregoing instrument was acknowledged:before •• . ..
me this Z54'h . .t l�j. •try` . • me this.:. . . • :by. .
•
•
•
: ' el$A3144b0.‘ AtZ;<:- ,i• •
•
No,; Public..siguature. • . ' Notary Public.Sign.ature
• Affix Seal Here Affix Seal Here
GENERAL NOTARY•State of Nebta0a
MEEGAN THIBODEAU
�''°'1' My Comm.Exp.Aug.6,2011
•
In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. •
A ten day advance period is required in writing to produce the alternate format. -
• . Revised 5/I007
re acceptable)
0800016708 .
.9i::�:5•. _3<,. 3'.�j:"�,... �:.,;� 1.+. tk, X:..y,!, f..,. _Si?.:: Cr•d"�rk.>•,:
+d.:•_._e.u ...c'.'.:;5'r.•..:...{^f:�sei:.F.:i^...:a...,...J.e•�,,. �•"+L7J.`,1>u,iiv.F:h.,dY:sY R-`:.•irv.ne. ,r. i-.i:..7+:7 ....._3•kti:+a•:' o:ka$a�'},.n�w<......<.. :'S`L"�!•.tew.,.....s;' �a�i :.-i�1'X'.:;,.'i..n.s.:...k3,=a.L,..1,1
•
•
f .'
1 4( r• r . .
. .
: .CORPORATE OFFICER SIGNATURE • • •
(Faxed signatures are acceptable) • .
•
•
.
0800016707' .
1 .
•
(rt.&A.
HA 74.Cit o fA Omaha ebras aWitqwwri
�1 I' °s�
1819 Farnam - Suite LC 1 r r . lir";
Omaha, Nebraska 68183-0112 0 ;,� .
Buster Brown (402) 444-5550 ,� el,"
City Clerk FAX (402) 444-5263 o,�'�ED FEB�ut�4
September 16, 2008
Debbie Arroyo Application to be appointed manager of the present
4623 North 61 St Street Package Liquor Licenses and Off Sale Beer•License
Omaha,NE 68104 for M&A Petroleum & B & A Petroleum., see
attached list
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 September
30, 2008 . 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,
•
Buster Brown
City Clerk
BJB:clj
iquor 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. .
. ...._1, .
,. . • • . . AIO .‘gi3O LIS A` . . .
Signature • Manager'Applicant Sithatire.of Spouse •
State of Nebraska- - • . ' - •
County of . q S ..• • County of •
The foregoing instru e-twas:acknowledged.before.:.. -. .The foregoing instrument was acknowledged:before •• . ..
me this Z54'h . .t l�j. •try` . • me this.:. . . • :by. .
•
•
•
: ' el$A3144b0.‘ AtZ;<:- ,i• •
•
No,; Public..siguature. • . ' Notary Public.Sign.ature
• Affix Seal Here Affix Seal Here
GENERAL NOTARY•State of Nebta0a
MEEGAN THIBODEAU
�''°'1' My Comm.Exp.Aug.6,2011
•
In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. •
A ten day advance period is required in writing to produce the alternate format. -
• . Revised 5/I007
re acceptable)
0800016708 .
.9i::�:5•. _3<,. 3'.�j:"�,... �:.,;� 1.+. tk, X:..y,!, f..,. _Si?.:: Cr•d"�rk.>•,:
+d.:•_._e.u ...c'.'.:;5'r.•..:...{^f:�sei:.F.:i^...:a...,...J.e•�,,. �•"+L7J.`,1>u,iiv.F:h.,dY:sY R-`:.•irv.ne. ,r. i-.i:..7+:7 ....._3•kti:+a•:' o:ka$a�'},.n�w<......<.. :'S`L"�!•.tew.,.....s;' �a�i :.-i�1'X'.:;,.'i..n.s.:...k3,=a.L,..1,1
•
•
f .'
1 4( r• r . .
. .
: .CORPORATE OFFICER SIGNATURE • • •
(Faxed signatures are acceptable) • .
•
•
.
0800016707' .
1 .
M& A Petroleum
Dba"Infinite"
2401 Leavenworth Street
Omaha, NE 68105
M & A Petroleum
Dba"Infinite"
1222 South 24th Street
Omaha,NE 68108
B & A Petroleum
Dba"Infinite"
2302 South 13th Street
Omaha,NE 68108
-. 4 0 \r...1,
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otA k" , Ark
F i ' 6�
City ofOmaha fI'lebras&a 1/I'
1819 Farnam—Suite LC 1 i WM)
r��� - N
•
®fir. �! �
Omaha, Nebraska 68183-0112 0 ,;PSI';
Buster Brown (402) 444-5550 �A rv'
City Clerk FAX (402) 444-5263 Olio p FEBR9-
September 16, 2008
•
Mike Kelley, Attorney Application to appoint Debbie Arroyo manager
7134 Pacific Street of the Package Liquor Licenses and Off Sale
Omaha,NE 68106 Beer License for M& A Petroleum & B &A
Petroleum—see attached list
Dear Liquor License Applicant's Attorney:
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 September
30, 2008. 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,
Lsi
Buster Brown
City Clerk
BJB:clj •
onsents 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. .
. ...._1, .
,. . • • . . AIO .‘gi3O LIS A` . . .
Signature • Manager'Applicant Sithatire.of Spouse •
State of Nebraska- - • . ' - •
County of . q S ..• • County of •
The foregoing instru e-twas:acknowledged.before.:.. -. .The foregoing instrument was acknowledged:before •• . ..
me this Z54'h . .t l�j. •try` . • me this.:. . . • :by. .
•
•
•
: ' el$A3144b0.‘ AtZ;<:- ,i• •
•
No,; Public..siguature. • . ' Notary Public.Sign.ature
• Affix Seal Here Affix Seal Here
GENERAL NOTARY•State of Nebta0a
MEEGAN THIBODEAU
�''°'1' My Comm.Exp.Aug.6,2011
•
In compliance with the ADA,this manager insert form 3c is available in other formats for persons with disabilities. •
A ten day advance period is required in writing to produce the alternate format. -
• . Revised 5/I007
re acceptable)
0800016708 .
.9i::�:5•. _3<,. 3'.�j:"�,... �:.,;� 1.+. tk, X:..y,!, f..,. _Si?.:: Cr•d"�rk.>•,:
+d.:•_._e.u ...c'.'.:;5'r.•..:...{^f:�sei:.F.:i^...:a...,...J.e•�,,. �•"+L7J.`,1>u,iiv.F:h.,dY:sY R-`:.•irv.ne. ,r. i-.i:..7+:7 ....._3•kti:+a•:' o:ka$a�'},.n�w<......<.. :'S`L"�!•.tew.,.....s;' �a�i :.-i�1'X'.:;,.'i..n.s.:...k3,=a.L,..1,1
•
•
f .'
1 4( r• r . .
. .
: .CORPORATE OFFICER SIGNATURE • • •
(Faxed signatures are acceptable) • .
•
•
.
0800016707' .
1 .
M &A Petroleum
Dba "Infinite"
2401 Leavenworth Street
Omaha,NE 68105
M &APetroleum
Dba"Infinite"
1222 South 24th Street
Omaha,NE 68108
B & A Petroleum
Dba"Infinite"
2302 South 13th Street
Omaha, NE 68108
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oleum
Dba"Infinite"
2302 South 13th Street
Omaha, NE 68108
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