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RES 2008-1249 - SDL for fashion show at Nomad Lounge September 20-21 2008 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.lcc.ne.gov/ Include approval from the City,Village or County Clerk where the event is to be held Include signed statement from the local law enforcement(see question#8) A license fee $40(payable to Nebraska Liquor Control Commission) for each day/event to be licensed(i.e. if you have two separate areas at one event they both need to be licensed)(unless licensed as a K Caterer no fees required) +; Application MUST be received at the Liquor Control Commission Office no later than 10 working days prior to event(excluding weekends, Federal and State observed holidays) alvit'LE � -° �{,J'��; . '(C:�.".�51"�'V'i y'': ,. �',f:`s� ^�f:�� ;4 i"v�Y� .. .. .. .:-G,_..,._ ........ ... .. ._ ...2,,._.:...,,�......._o..:ti:.:._..<........ ..��.�.a:=: x�2`tii$;L:c_5�::�J,'.et.�a.}:.3_.��h...t5a"m'Es.�i-ti.�...�ab�'iae 1. Type of alcohol to be served and/or consumed Beer Wine Distilled Spirits 2. Liquor license number and class(i.e.C-55441) 71-1 S20 S 3. Licensee name (last, first,middle),A Corporate name,Limited Liability Company(LLC) NAME:MO(1(1 a Cl Loo(ne. ADDRESS: 10/3 c)pnc .S rtQ -i-- COUNTY N., ,°y �GL� Sri ate—. 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. Sincerel yours, ' tip . Buster Brown City Clerk BJB:clj . • .° ,, .• •.� • : , C' '. 44,'`t•kF r,� ' . d 4` ''. S . f l... ♦ L..... ....,,:.,.., i,, ::,..:,,:;:,1:',..:s..1;:itt'Tgi':I . i,p' 'r : '^,?A _ rf{S�' 1 t ♦fir r • r • f'!f ,' .s t t, i r t Ytlad mow 11. - Will there be any games of chance operating during the event? 0 YES KNO 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. 12. Any other information or requests for exemptions: 13. 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. a&cuT- c Phone: Before LIQZ, gi (••124-- During/40-i k'1 i• 1 2-2-11 Print name of Event upervisor s Signature f Event Supervisor Consent of Authorized Represetitativve/Applicant 14. 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 cret( t`-6L. / 9 Authorized Representative/Applicant Title Date Print Name 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. • i 11 ,..41. 540. • , w - . Fay-, ,fv3r j......... t.,. . i -74,.. L...... ______.... . ri :.. . ....__A ,'.-- 0 D R1 ...".. „......0 ,. ; • .. r. rn tr, • .- 0 \p * ° . , 114) .......D , ..,• . ‘ - , -r--. „....„---.) -,, - , ,..._. .. , .. _.,. ,..... _ .r JI P t" .„....._„..1 C ,--N I . . t . . I ...... r ,,A., r... 0 . -.‹. :, , r-, 414etit . • , iv -��- o r) i1 0 S. Ily . i sent of Authorized Represetitativve/Applicant 14. 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 cret( t`-6L. / 9 Authorized Representative/Applicant Title Date Print Name 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. „Am., ,v4. City o Omaha •Nebras a 6�,.. _!.►7 �)r r 1819 Farnam—Suite LC 1 ® �t l � : Omaha, Nebraska 68183-0112 0 �. ';.• �' Buster Brown (402) 444-5550. o • City Clerk FAX (402) 444-5263 0'P47. F13 Fe13.1kvl+4� September 3, 2008 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 Nomad Lounge, LLC, dba "Nomad Lounge”, 1013 Jones Street on September 20, 2008 from 7:00 a.m. to 11:59 p.m. and September 21, 2008 from 12:00 noon to 12:00 midnight. APPLICATION APPROVED CONTIGENT UPON THE OMAHA CITY COUNCIL APPROVING THE APPLICATION ON SEPTEMBER 9, 2008 Sin -rely yours uster Brown City Clerk BJB:clj Enclosure S. Ily . i sent of Authorized Represetitativve/Applicant 14. 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 cret( t`-6L. / 9 Authorized Representative/Applicant Title Date Print Name 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. „HA, A,,,_ City of Omaha fAle6ras&a ,43. `1 1819 Farnam—.Suite LC 1 n® fiordow-vila Omaha, Nebraska 68183-0112 0 .w ,� ` - Buster Brown (402) 444-5550 A City Clerk FAX (402) 444-5263 O� 44- 9TPU FEBR9. September 3, 2008 Nomad Lounge, LLC, Application for a Special Designated Dba "Nomad Lounge” License for September 20-21, 2008 1013 Jones Street Music will end 11:00 p.m. each night Omaha, NE 68102 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 September 9, 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(s) to the Nebraska Liquor Control Commission. Sincerely yours, AL' Buster Brown City Clerk BJB:clj ts 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 cret( t`-6L. / 9 Authorized Representative/Applicant Title Date Print Name 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. <• 't. • • .% 0 '778 A - ? \ '\ co, 7o 141 :� ? q § • J 2 v § k \ \ U ƒ q 2 0 ƒ 0 ƒ c — R C k o �� 2 q S / /. § 1:t\.) 0 E 2 \ 2 ID , a § 0 &% p § 2 r)k \ 2 } ƒ i CP y , n / \ o m ¢ k ƒ r " \ ° § ' 2 �� cc \• CD " %� ' & 3 § \ i w } § _ / / % ci)G' 2 ? f m • . � 0