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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 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 gg gg _ �- , •I J h .17 f�i ii „ II ir ,1 11.- 1 ■ ■1 144 F I 11 wi ` , 1-�a��I lf1 �Il n �N.II' 1■ YI � � 1'� Iv 1 11 11 11 li ii ,I -P ■I i! 1 i.___., y11 p1 11 II I 1 11 ii 11 ■ .1 Ni y _ :r ;! iL, ii a �i Ii n 11 rr 111 fl of ry 1 i .� r 11 11 it 11 M ■I 1I( I! ► i I1 ,, II 11 II 1 11 -■ 1 1, *A 0•' • 111 ;i ••i 11 i II II II 1i II 11 it r I II D ,l, li , R ,,� 1i ;; II II 1 11 11 ■ ■Ut ,1 � ,,, I i` li ! ii It ii I' 'If ii !1 I is' I ,' , L ~• Igi40I ,, i1i+ ,i®Ioolfleh■r� ' -0 i' ! ii 4 ,,ii, ,!j.-■n II e1n t'xp'�h7 iim: : i r 7 / Ia r n u u n n M !ern it, n,,...._ -..:-•";awl,. o '; :,; 1_-11 -■cf ttll !Van •! -�,. i b b ) b 6c b 6 b b • . .1� . b b k yy • 1 961 K $i 104 -um 3 t fi/,It b M m'., i g E /1 O7J ` a��1:I;,} . g o xg� maB V O w'�` _ A-g —I paA 4!S- D r—C f.•- I.. rj liij'j� nl 041 g jr =CJ c 1u • t,'^± 11 a a —I o z #; I ;!; 6gf i $Z—1• t . rgg -0 a, ...c ---> r iihiat31 -'1pA 4, f C 5- _t ; Ft ,a n$ b i c.J u m ,-,M }}iJ Mill ilk R ' ••.I 0 Z 1,1 1 1 1. 1II 8 2 '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--- _ .. .. • 3':_.c, a(;- _y ,r _"r:,._ .'4'yr �i_�_-•''•'•.tt�!'�..,W.'t ,r '�,...�, ,M,�+.`,�",,c .s.. • •" 1 70 7 r 1 t. •�; h'9� �J�. .+..':K`><'1'qi k+�.b•—i� •.A. 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 ., , 1,5,9 f~�� ei� Kr.iul'•.'�.:.fi >.•` ti-� '� 1'` ;� i i_ ft. .r:'p� III19 yy Pr 4t may ;�$'3;1"y-t 71, y 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 ,,,, ... :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 gg gg _ �- , •I J h .17 f�i ii „ II ir ,1 11.- 1 ■ ■1 144 F I 11 wi ` , 1-�a��I lf1 �Il n �N.II' 1■ YI � � 1'� Iv 1 11 11 11 li ii ,I -P ■I i! 1 i.___., y11 p1 11 II I 1 11 ii 11 ■ .1 Ni y _ :r ;! iL, ii a �i Ii n 11 rr 111 fl of ry 1 i .� r 11 11 it 11 M ■I 1I( I! ► i I1 ,, II 11 II 1 11 -■ 1 1, *A 0•' • 111 ;i ••i 11 i II II II 1i II 11 it r I II D ,l, li , R ,,� 1i ;; II II 1 11 11 ■ ■Ut ,1 � ,,, I i` li ! ii It ii I' 'If ii !1 I is' I ,' , L ~• Igi40I ,, i1i+ ,i®Ioolfleh■r� ' -0 i' ! ii 4 ,,ii, ,!j.-■n II e1n t'xp'�h7 iim: : i r 7 / Ia r n u u n n M !ern it, n,,...._ -..:-•";awl,. o '; :,; 1_-11 -■cf ttll !Van •! -�,. i b b ) b 6c b 6 b b • . .1� . b b k yy • 1 961 K $i 104 -um 3 t fi/,It b M m'., i g E /1 O7J ` a��1:I;,} . g o xg� maB V O w'�` _ A-g —I paA 4!S- D r—C f.•- I.. rj liij'j� nl 041 g jr =CJ c 1u • t,'^± 11 a a —I o z #; I ;!; 6gf i $Z—1• t . rgg -0 a, ...c ---> r iihiat31 -'1pA 4, f C 5- _t ; Ft ,a n$ b i c.J u m ,-,M }}iJ Mill ilk R ' ••.I 0 Z 1,1 1 1 1. 1II 8 2 • 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)‘‘ _ p r�tk l\J a-- 0 ( 3 _-__ .._. ' :.ls .� + -3"L'R� J,r.171 +�C , i! - 4 .R..-rs:`• -_ ._.....�.._....�. ^r'7.'s�i�',r MONTH/YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER FROM TO (o ao (a�n 3 "T).*0 D,1c24J PJ'- (� -,� l`O . 3 '"7 (4a 0-0 cAbD 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 ,,,, ... :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 gg gg _ �- , •I J h .17 f�i ii „ II ir ,1 11.- 1 ■ ■1 144 F I 11 wi ` , 1-�a��I lf1 �Il n �N.II' 1■ YI � � 1'� Iv 1 11 11 11 li ii ,I -P ■I i! 1 i.___., y11 p1 11 II I 1 11 ii 11 ■ .1 Ni y _ :r ;! iL, ii a �i Ii n 11 rr 111 fl of ry 1 i .� r 11 11 it 11 M ■I 1I( I! ► i I1 ,, II 11 II 1 11 -■ 1 1, *A 0•' • 111 ;i ••i 11 i II II II 1i II 11 it r I II D ,l, li , R ,,� 1i ;; II II 1 11 11 ■ ■Ut ,1 � ,,, I i` li ! ii It ii I' 'If ii !1 I is' I ,' , L ~• Igi40I ,, i1i+ ,i®Ioolfleh■r� ' -0 i' ! ii 4 ,,ii, ,!j.-■n II e1n t'xp'�h7 iim: : i r 7 / Ia r n u u n n M !ern it, n,,...._ -..:-•";awl,. o '; :,; 1_-11 -■cf ttll !Van •! -�,. i b b ) b 6c b 6 b b • . .1� . b b k yy • 1 961 K $i 104 -um 3 t fi/,It b M m'., i g E /1 O7J ` a��1:I;,} . g o xg� maB V O w'�` _ A-g —I paA 4!S- D r—C f.•- I.. rj liij'j� nl 041 g jr =CJ c 1u • t,'^± 11 a a —I o z #; I ;!; 6gf i $Z—1• t . rgg -0 a, ...c ---> r iihiat31 -'1pA 4, f C 5- _t ; Ft ,a n$ b i c.J u m ,-,M }}iJ Mill ilk R ' ••.I 0 Z 1,1 1 1 1. 1II 8 2 • r, 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 gg gg _ �- , •I J h .17 f�i ii „ II ir ,1 11.- 1 ■ ■1 144 F I 11 wi ` , 1-�a��I lf1 �Il n �N.II' 1■ YI � � 1'� Iv 1 11 11 11 li ii ,I -P ■I i! 1 i.___., y11 p1 11 II I 1 11 ii 11 ■ .1 Ni y _ :r ;! iL, ii a �i Ii n 11 rr 111 fl of ry 1 i .� r 11 11 it 11 M ■I 1I( I! ► i I1 ,, II 11 II 1 11 -■ 1 1, *A 0•' • 111 ;i ••i 11 i II II II 1i II 11 it r I II D ,l, li , R ,,� 1i ;; II II 1 11 11 ■ ■Ut ,1 � ,,, I i` li ! ii It ii I' 'If ii !1 I is' I ,' , L ~• Igi40I ,, i1i+ ,i®Ioolfleh■r� ' -0 i' ! ii 4 ,,ii, ,!j.-■n II e1n t'xp'�h7 iim: : i r 7 / Ia r n u u n n M !ern it, n,,...._ -..:-•";awl,. o '; :,; 1_-11 -■cf ttll !Van •! -�,. i b b ) b 6c b 6 b b • . .1� . b b k yy • 1 961 K $i 104 -um 3 t fi/,It b M m'., i g E /1 O7J ` a��1:I;,} . g o xg� maB V O w'�` _ A-g —I paA 4!S- D r—C f.•- I.. rj liij'j� nl 041 g jr =CJ c 1u • t,'^± 11 a a —I o z #; I ;!; 6gf i $Z—1• t . rgg -0 a, ...c ---> r iihiat31 -'1pA 4, f C 5- _t ; Ft ,a n$ b i c.J u m ,-,M }}iJ Mill ilk R ' ••.I 0 Z 1,1 1 1 1. 1II 8 2 . 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 gg gg _ �- , •I J h .17 f�i ii „ II ir ,1 11.- 1 ■ ■1 144 F I 11 wi ` , 1-�a��I lf1 �Il n �N.II' 1■ YI � � 1'� Iv 1 11 11 11 li ii ,I -P ■I i! 1 i.___., y11 p1 11 II I 1 11 ii 11 ■ .1 Ni y _ :r ;! iL, ii a �i Ii n 11 rr 111 fl of ry 1 i .� r 11 11 it 11 M ■I 1I( I! ► i I1 ,, II 11 II 1 11 -■ 1 1, *A 0•' • 111 ;i ••i 11 i II II II 1i II 11 it r I II D ,l, li , R ,,� 1i ;; II II 1 11 11 ■ ■Ut ,1 � ,,, I i` li ! ii It ii I' 'If ii !1 I is' I ,' , L ~• Igi40I ,, i1i+ ,i®Ioolfleh■r� ' -0 i' ! ii 4 ,,ii, ,!j.-■n II e1n t'xp'�h7 iim: : i r 7 / Ia r n u u n n M !ern it, n,,...._ -..:-•";awl,. o '; :,; 1_-11 -■cf ttll !Van •! -�,. i b b ) b 6c b 6 b b • . .1� . b b k yy • 1 961 K $i 104 -um 3 t fi/,It b M m'., i g E /1 O7J ` a��1:I;,} . g o xg� maB V O w'�` _ A-g —I paA 4!S- D r—C f.•- I.. rj liij'j� nl 041 g jr =CJ c 1u • t,'^± 11 a a —I o z #; I ;!; 6gf i $Z—1• t . rgg -0 a, ...c ---> r iihiat31 -'1pA 4, f C 5- _t ; Ft ,a n$ b i c.J u m ,-,M }}iJ Mill ilk R ' ••.I 0 Z 1,1 1 1 1. 1II 8 2 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 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 gg gg _ �- , •I J h .17 f�i ii „ II ir ,1 11.- 1 ■ ■1 144 F I 11 wi ` , 1-�a��I lf1 �Il n �N.II' 1■ YI � � 1'� Iv 1 11 11 11 li ii ,I -P ■I i! 1 i.___., y11 p1 11 II I 1 11 ii 11 ■ .1 Ni y _ :r ;! iL, ii a �i Ii n 11 rr 111 fl of ry 1 i .� r 11 11 it 11 M ■I 1I( I! ► i I1 ,, II 11 II 1 11 -■ 1 1, *A 0•' • 111 ;i ••i 11 i II II II 1i II 11 it r I II D ,l, li , R ,,� 1i ;; II II 1 11 11 ■ ■Ut ,1 � ,,, I i` li ! ii It ii I' 'If ii !1 I is' I ,' , L ~• Igi40I ,, i1i+ ,i®Ioolfleh■r� ' -0 i' ! ii 4 ,,ii, ,!j.-■n II e1n t'xp'�h7 iim: : i r 7 / Ia r n u u n n M !ern it, n,,...._ -..:-•";awl,. o '; :,; 1_-11 -■cf ttll !Van •! -�,. i b b ) b 6c b 6 b b • . .1� . b b k yy • 1 961 K $i 104 -um 3 t fi/,It b M m'., i g E /1 O7J ` a��1:I;,} . g o xg� maB V O w'�` _ A-g —I paA 4!S- D r—C f.•- I.. rj liij'j� nl 041 g jr =CJ c 1u • t,'^± 11 a a —I o z #; I ;!; 6gf i $Z—1• t . rgg -0 a, ...c ---> r iihiat31 -'1pA 4, f C 5- _t ; Ft ,a n$ b i c.J u m ,-,M }}iJ Mill ilk R ' ••.I 0 Z 1,1 1 1 1. 1II 8 2 . ErnD o CD � p .. n o p �- ( o PD r 0 til 'CI� �- 00 o a •'-o (IQ '''t N 53., 4 C-) Co c• ,,' • I � #' # 0 ƒ . H '':,'- n _ 4 ? . _ _ n \ §. . as 02 CD ¢ § - ° 3 I ~ k ° 7 / % CD k \ . " § CD 3 & H t4j ACCIDENT REPORT AT ADJACENT INTERSECTION: L-4- / 7>4-ree I C Inc E j-oyt- 1 a.CC r i`- POTENTIAL TRAFFIC AND PARKING PROBLEMS: AYY _ ...__ /- (Authori ed Signature) (Date) (Date)