RES 2008-0267 - Appoint Christopher Van Tassell manager of Old Chicago .........................
STATE OF NEBRASKA
Dave Heineman E C E I i' f NEBRASKA LIQUOR CONTROL COMMISSION
TI i, � �...,A > Governor Hobert B. Rupe
t41t\ R.!.....86_.- 08 FEB —i Am .Ai e� • Executive Director
``�..�`'' '_1= 7 G 301 Centennial Mall South,5th Floor
,�, �„ P.O.Box 95046
v _ � Lincoln,Nebraska 68509-5046
t Phone(402)471-2571
Fax(402)471-2814
• TRS USER 800 833-7352(TTY)
web address:http://www.lcc.ne.gov/
January 31, 2008
OMAHA CITY CLERK
1819 FARNAM STREET LC-1
OMAHA NE 68183
Dear Clerk:
Enclosed is a copy of a manager application for Christopher Van Tassell in connection
with Wadsworth Old Chicago Inc dba Old Chicago, located at 425 N 78th Street, Omaha
NE.
Please present this application for manager to your Council and send us the results of
their action.
Sincerely,
NEBRASKA LIQUOR CONTROL COMMISSION •
0,a/k)
Jerilyn A Cash
Licensing Division
jc
encl.
cc: file
Rhonda R.Flower Bob Logsdon Pat Thomas
Commissioner Chairman Commissoner
An Equal Opportunity/Affirmative Action Employer
Printed with soy ink on recycled paper
-
*Signature of applying individual Print name of applying individual
(spouse of individual listed above)
SUBSCRIBED in my presence and sworn to before me this 7 day
of ,2p 7 ,y'4v49'.
GENERAL NOTARY-State of INebraska y
.� my
gym.E p F.Nov.11942011 Signature of Notary Public
*spouse of individual listed above is the individual required to sign bottom portion of affidavit
FORM 35-4178
REV 9/05
x Seal Here Affix Seal Here
mew IK N-SubdNeb►aska jeoGENERALN0?ARY-StateofNetlrastm
;111R.E KINNEY
Cow 6p.ilor.19,2011 11yMIC mm.HA Eq.Nor 9
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 5/2007
2003 St. Louis, MO 1999 2004
Bellevue, NE3 1986 1999
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a .
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM. TO
2005 2006 Skyway Airlines George Velguth 414-570-2300
2004 2005 Saint Louis University Parks College Andora Vreeman 314-977-2360
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'Jan 04 2008 3: 35PM HP LASERJET FRX P.2
APPLICATION FOR LIQUOR LICENSE
CORPORATION MANAGER-FORM 3b
*MUST BE A NEBRASKA RESIDENT* — C/
301 CENTENNIAL MALL SOUTH fr r r
FO BOX 95046
LINCOLN,NE 68509.5046
PHONE:(402)471-2571
FAX;(402)471-2814.
Website:btt fwwwI ,Kte,gpv:
7 17 al � °ci i l� li JI y e''i i��-6•. ;11 i t e a 11lI rif'l4; ' li•1<. � .'I,m ,+3 � F s, r g.o' 's.e•
.. c • �... ��• T. -,� y t• .'r-' 1;' i sou' 3
NAME OF LICENSED CORPORATION lil)l',l GLSc.�JO D Ch 1 C.0.G,C� y1 v •
CLASS&LICENSE NUMBER 1 Li COY t -
TRADE NAME old
STREET ADDRESS 'I'4 YJ � �'�"` S�' CITY C ' `CA-VVA---
_ .. .. •
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NAME -►'opt✓ -37 ✓ar• (ASSe.,
ADDRESS 2-41
(='<61 A+� "' S �Q(�� OttzcAt
CITY QI`.P• STATE BYE- ZIP CODE La (4%114
HOME PHONE DUMBER )I - �'f'4+I 3 ,-(ct - __BUSINESS PHONE NUMBER O2'3' 17)45 5
SEX raZeIALE[ !f FEMALE SOCIAL SECURITY NUMBER
I
DATE OF BIRTH _ PLACE OF BIRTH 7-ZzRet-k !k-1 •
DRIVERS LICENSE NUMBER&STATE E-g(L# S ILA
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SPOUSE NAME ' N CSC 1%-"`•P•4?-.0L.14
SOCIAL SECURITY NUMBER DATE OF BIRTH
DRIVERS LICENSE NUMBER&STATE
FORM 35-1013
RF.v.u03
0800001777
FORM 35-4178
REV 9/05
x Seal Here Affix Seal Here
mew IK N-SubdNeb►aska jeoGENERALN0?ARY-StateofNetlrastm
;111R.E KINNEY
Cow 6p.ilor.19,2011 11yMIC mm.HA Eq.Nor 9
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 5/2007
2003 St. Louis, MO 1999 2004
Bellevue, NE3 1986 1999
N r ,r �:+ o-� __ p 14 t�`St•,'�,;k ' ' �' t "'4�_.�i: r"t . & a• ,,,-,1 ,,,, ...
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a .
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM. TO
2005 2006 Skyway Airlines George Velguth 414-570-2300
2004 2005 Saint Louis University Parks College Andora Vreeman 314-977-2360
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1. READ CAREFULLY. ANSWER COMPLETELY AND ACCURATELY. •
Has an one 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 an one party,please list charges by each individual's name.
DYES NO
If yes,please explain below or attach a separate page.
2. Have you or your spouse ever made application for any liquor license or manager for any liquor license? IF YES,for what premise give
license number and da
EYES NO
3. Have you or your ouse ever made a compromise settlement for violation of such laws?
OYES NO
4. Do you,as a manager,have all the qualifications required by any person entitled to hold a Nebraska Liquor License?
Nebraska Liquor Control Act(§53-131.01)
ES ONO
5. ve you filed fingerprint cards and PROPER FEES(if check,make out to the NE State Patrol),with this application?
YES ONO I
PRM—Es /VCR!CA
r.41
APPLICANT:CITY&STATE YEAR SPOUSE:CITY&STATE YEAR
FROM TO FROM TO
W iGick J(•.c 4)‘‘ _
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MONTH/YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM TO
(o ao (a�n 3 "T).*0 D,1c24J PJ'- (� -,� l`O .
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FORM 35-4013
REV.4/05
REV 9/05
x Seal Here Affix Seal Here
mew IK N-SubdNeb►aska jeoGENERALN0?ARY-StateofNetlrastm
;111R.E KINNEY
Cow 6p.ilor.19,2011 11yMIC mm.HA Eq.Nor 9
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 5/2007
2003 St. Louis, MO 1999 2004
Bellevue, NE3 1986 1999
N r ,r �:+ o-� __ p 14 t�`St•,'�,;k ' ' �' t "'4�_.�i: r"t . & a• ,,,-,1 ,,,, ...
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a .
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM. TO
2005 2006 Skyway Airlines George Velguth 414-570-2300
2004 2005 Saint Louis University Parks College Andora Vreeman 314-977-2360
1
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PERSONAL OATH AND CONSENT OF INVESTIGATION jt;:.
MUST BE SIGNED BY APPLICANT& SPOUSE
•
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.§53-13I.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
(Slate 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,an 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.
•
•
Signature of Applicant Signature of Spouse
•
Subscribed in my presence and sworn to before me this 4o Subscribed in my presence and sworn to before me this
day of J6a/? t7✓ . sC- ) day of
•
Notary Signature&Seal • Notary Signature&,Seal
GEr1ERAtNOTARYState of Nebraska
DEBF Aug.R 10IE
2009 •
My Comm.Exp.Aug
•
FORM 35-4013
REV.4/05
;111R.E KINNEY
Cow 6p.ilor.19,2011 11yMIC mm.HA Eq.Nor 9
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 5/2007
2003 St. Louis, MO 1999 2004
Bellevue, NE3 1986 1999
N r ,r �:+ o-� __ p 14 t�`St•,'�,;k ' ' �' t "'4�_.�i: r"t . & a• ,,,-,1 ,,,, ...
:t:* 1 1,' 9d'h '144AIWP'qi' '''' t x}r d,:a:,ge .• na 'A .t.isk. N�9t'.1 .'RtM1r4'1 It!rI� ',.,',1 1w'::v.'+�5 li iii 1, ,'� tY Yi.
a .
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM. TO
2005 2006 Skyway Airlines George Velguth 414-570-2300
2004 2005 Saint Louis University Parks College Andora Vreeman 314-977-2360
1
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. OMAHA' NF
City
� 4 ;rr 6�o Omaha
rn�
1819 Farnam —Suite LC 1 2 NA -'t
Omaha, Nebraska 68183-0112 0 v:=- �;.•
Buster Brown (402) 444-5550 ?"A
City Clerk FAX (402) 444-5263 4rED FeBR‘ �►4�
February 12, 2008
Wadsworth Old Chicago, Inc. Application to appoint Christopher Van Tassell
Dba"Old Chicago" manager of your present Class "I" Liquor
425 North 78th Street License
Omaha, NE 68114
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 February 26,
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
ate,or fraudulent.
•
•
Signature of Applicant Signature of Spouse
•
Subscribed in my presence and sworn to before me this 4o Subscribed in my presence and sworn to before me this
day of J6a/? t7✓ . sC- ) day of
•
Notary Signature&Seal • Notary Signature&,Seal
GEr1ERAtNOTARYState of Nebraska
DEBF Aug.R 10IE
2009 •
My Comm.Exp.Aug
•
FORM 35-4013
REV.4/05
;111R.E KINNEY
Cow 6p.ilor.19,2011 11yMIC mm.HA Eq.Nor 9
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 5/2007
2003 St. Louis, MO 1999 2004
Bellevue, NE3 1986 1999
N r ,r �:+ o-� __ p 14 t�`St•,'�,;k ' ' �' t "'4�_.�i: r"t . & a• ,,,-,1 ,,,, ...
:t:* 1 1,' 9d'h '144AIWP'qi' '''' t x}r d,:a:,ge .• na 'A .t.isk. N�9t'.1 .'RtM1r4'1 It!rI� ',.,',1 1w'::v.'+�5 li iii 1, ,'� tY Yi.
a .
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM. TO
2005 2006 Skyway Airlines George Velguth 414-570-2300
2004 2005 Saint Louis University Parks College Andora Vreeman 314-977-2360
1
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OMAHA, Ark'
F 94 4r 6
4.
City ofOmaha, Webras&a . _eiga I' . t
e
1819 Farnam—Suite LC 1 2 0, t�
Omaha, Nebraska 68183-0112 0�:w � n;,,
Buster Brown (402) 444-5550 A eV"
City Clerk FAX (402) 444-5263 NQ .0 FEBRv�►I.
February 12, 2008
Christopher Van Tassell Application to be appointed manager of the present
12708 Ames Plaza#204 Class "I"Liquor License for Wadsworth Old
Omaha, NE 68164 Chicago, Inc., dba"Old Chicago", 425 North 78th
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 February
26, 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,
674?
Buster Brown
City Clerk
BJB:clj
use
•
Subscribed in my presence and sworn to before me this 4o Subscribed in my presence and sworn to before me this
day of J6a/? t7✓ . sC- ) day of
•
Notary Signature&Seal • Notary Signature&,Seal
GEr1ERAtNOTARYState of Nebraska
DEBF Aug.R 10IE
2009 •
My Comm.Exp.Aug
•
FORM 35-4013
REV.4/05
;111R.E KINNEY
Cow 6p.ilor.19,2011 11yMIC mm.HA Eq.Nor 9
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 5/2007
2003 St. Louis, MO 1999 2004
Bellevue, NE3 1986 1999
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YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM. TO
2005 2006 Skyway Airlines George Velguth 414-570-2300
2004 2005 Saint Louis University Parks College Andora Vreeman 314-977-2360
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ACCIDENT REPORT AT ADJACENT INTERSECTION: L-4- / 7>4-ree
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POTENTIAL TRAFFIC AND PARKING PROBLEMS: AYY
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(Authori ed Signature) (Date)
(Date)