RES 2007-1459 - Appoint Jim Williamsen manager of Happy Hollow Club c • , om,\\,11
4
°14 STATE OF NEBRASKA
R CC-4 u �, E NEBRASKA LIQUOR CONTROL COMMISSION
x=,w,: Dave Heineman
a% Q� Hobert B. Rupe
Governor �7 t�1� t h
U 1F I AM $� !:3 Executive Director
• 301 Centennial Mall South,5th Floor
C r f P.O.Box 95046
t i CLERK Lincoln,Nebraska 68509-5046
, N Phone(402)471-2571
Fax(402)471-2814
TRS USER 800 833-7352(ITY)
web address:http://www.lcc.ne.gov/
November 8, 2007
•
Omaha City Clerk
1819 Farnam Street LC-1
Omaha NE 68183
Dear Clerk:
Enclosed is a copy of a manager application for Jim Williamsen in connection with
Happy Hollow Club Inc dba Happy Hollow Club, located at 1701 S 105th 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
•
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
Sincerely yours,
Buster Brown
City Clerk
BJB:clj
te of Nebraska
�
•
County of I, VO.l t•V- County of 1_:)L 1_ t(-- L I �
The foregoing instrument was acknowledged before The foregoing instrument was acknowledged before
me this I I- I - 2 L1- 1 by me this )I • I 1.L L, by
LI
Notary g Public si nature Notary Public siig atttire
Affix Seal Hcrc Affix Seal Here
oliGENERAL NOTARY-State of Nebraska XNERAL NOTARY-State of Nebraska
THERESA R.SCHULTZ THERESA R.SCHULTZ
My Comm.Exp.Mar.17,2008 My Comm.Eirp.Mar.17,2008
•
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
-- J
n 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.
DYES gNO 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.
glYES ONO /lerrn#zc �/Vc
3. Do you, as a manager,have all the qualifications required to hold a Nebraska Liquor License? Nebraska
Liquor Control Act (§53-131.01)
IYES 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)
'ES T.❑NO-
PRkA) ok)
23.19 Landlord will use its best efforts to get a right-in/right-out off of 84''' Street adjacent to
the Shopping Center. Tenant acknowledges that Landlord has already unsuccessfully attempted to have a
right-in/right-out approved by the City of Omaha.
•
235537
21 •
nt set out in Article 1, Section 1.1(e) above, and the amount of the Initial Insurance Escrow Payment
will be that amount set out in Article I, Section 1.1(d) above. The Initial Tax Escrow Payment and Initial
Insurance Escrow Payment are based upon Tenant's proportionate share of the estimated Taxes and
insurance premiums for the year in question, and the monthly tax escrow payment and insurance escrow
payment are subject to increase or decrease as determined by Landlord to reflect an accurate escrow of
235537
I4
•
•
MANAGER APPLICATION
r
INSERT-FORM 3c
NEBRASKA LIQUOR CONTROL COMMISSION
301 CENTENNIAL MALL SOUTH .•.. .,
PO BOX 95046
LINCOLN,NE 68509-5046 •
PHONE:(402)471-2571 { S .
FAX:(402)471-2814 " E�T4�4 �iM ir«Yq.,.4��c •
Website:ww��w Icc.ne.Ko� . 1 +
- �ra.lhaT�:C:1".�C�I��.P15ialOP
•
Corporate manager,including their spouse,are required to adhere to the following requirements
l) Must be a citizen of the United States
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)
5) Must be 21 years of age or older
6) Applicant may be required to take a training course •
Cor a, -•••--�r— 'CSi'I .IIi r r,,
oratfonYI L n; r r � ,c F�. w - -- ,,::
-..S•`' +rx7 h'#�'fi"� "+�?��, 3 �,:' Yfi' ;.'l+.'rji` C.� .r t 3. X- -ri AN j • .sa. �?:i r •�Y� .
. 1a..� i+r_�.� 'f�[�` {c,��'_�j ...,,`,�, �.���''c`'�'�,�5 b'�, •. It� .tit ��Z'"x 'rk..' nu n � a.yL,a ..a ' ,.:p.�t. ,�' �. .
.µ',,�j r i3YYI•:•..Q.: � - s •.L"�•_: • �6''d`•..
Name of Corporation/LLC: //A No//pW b
iti
e kfief tMre emas G_xi.,Y oLY ‘o5ar v4rt '� Ft'�3:iT vac i.v:„i � i
; y `'� ; i b.." i�.!...�om+,;�,.�N`�.�•.�
r''•Premise License Number: •
Premise Trade Name/DBA: /A fey
71 W C/ b •
•
Premise Street Address: /7D /
•
City: )yy, N 4. State: IL) Zip Code:
Premise Phone Number: .$10 -,39/ 5/
he iti ividual h`i6s�a i"� t n h"e �r s e r 'o' �t "��y,e» fier"c�a gO on ith r:insert form 3aoror 3b
^�' R�+'.'T `.1.ytd�w',X' �tiey�{t"�c��•}" �.,:��};,i-+t1Xi�i"`A�wti.. �+=+A•1 �y(�y =Y�s'' r . 'its r,7T,�a.,,.}3y« - o;r,�b � - ti, ;k' .oli
>nn "t s�gntheiral� �17GIb "d4 �1hr �/*fie rgh�)� -rl r w p WJ art r4JT • o!:. y
"7 �. �.. � • '•
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:..S,X'. .vi1S'...7t`'^'.�t,'`.t ,+4'�"' Y'r-�""2c.' ci:c.,i ;l: L ?a` Y :r;,r (�Y6acb t- fR' f`• r ,...
�i;,a ✓r ��'6%�5`.w::T� c � ?ffM.i•F4., �, �..v���,-•s ��.��.. �.,.:., s• �jaci��:c':.,"+i,.c," .;471.7
•
/Zdf
C i 6 RATE OFFICER SIGNATURE
axed signatures are acceptable)
•
0111111111111111
0700019805
§53-131.01)
IYES 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$38.00 per person)
'ES T.❑NO-
PRkA) ok)
23.19 Landlord will use its best efforts to get a right-in/right-out off of 84''' Street adjacent to
the Shopping Center. Tenant acknowledges that Landlord has already unsuccessfully attempted to have a
right-in/right-out approved by the City of Omaha.
•
235537
21 •
nt set out in Article 1, Section 1.1(e) above, and the amount of the Initial Insurance Escrow Payment
will be that amount set out in Article I, Section 1.1(d) above. The Initial Tax Escrow Payment and Initial
Insurance Escrow Payment are based upon Tenant's proportionate share of the estimated Taxes and
insurance premiums for the year in question, and the monthly tax escrow payment and insurance escrow
payment are subject to increase or decrease as determined by Landlord to reflect an accurate escrow of
235537
I4
Ma . logettifttftEARLy. e-.,.:.41 4,,, _.„t-i , ,- .,, .:
nagfr' :nfOrmation'mtis;be:-0141eted 44�6iw
J I
Gender: 2 MALE ❑FEMALE
Last Name: LO I b V� � A.XIA j1`N t. ,:- irsti me`'' w\
MI: //kV .
Home Address(include PO Box if applicable): 1-2 4 I l e S z i—
City: 0 INA.0,,(4,c,..... State: Oe- Zip Code: LQ Ci I (1' 4
Home Phone Number:CPO) S—oI ,)')(� Business Phone Number: (Q.> 3 q( D-3 7 1
Social Security Number._ Drivers License Number&State�p /_ n n
Date Of Birth:_ Place Of Birth: �/�1,L (.:d 1 & �/
*e,i tiro ` 1✓$;G itii i to s Rtyyt.xa i uci f,j5V§* fi !f i .,� t t r
A, gars,'4,4"`t�3+9 - 'a4Aay .+ , pt .` c. ,g tdv` n ,41,: a •;.7', t '.,aa . x � ...,..
❑YES O
$.busP.'�slia rttlat'to a 4r ' Y (t- : =a' 1,y p- s ,:, -t
1_,*1 a .vy!,.5 a�",✓ x ' ,.4'^r� F,:;. � ,r` ba F� "N Vu . ,,.tyn`i" "zap , is .,ems { '"., '..:
r. " a,i r . f..t'a .r0 r.' f 4. '4' °l�i� `: v. 64 Ss7,"V '- u,,. .'+�.i,, ",, 7,,t; : "�`. �'. y ✓F ^S:
Spouses Last Name: First Name:
MI:
Social Security Number: Drivers License Number& State:
Date Of Birth: Place Of Birth:
"` 9APPLICAN'I':-ANJYSPOUSJ MUST UST RESJD'ENCE(S;)"FOR'THE'PAST:10 YEARS
APPLICANT , , :,4"" ::SPOUSE
CITY&STATE YEAR CITY&STATE YEAR
FROM TO FROM TO
ic)6*- 6(\ 1 I i t4r)cc b 3 G 7
SA- .. (L- 6�- 0 3
L&L 13� c_ cv a )..
MANAGRSLAST WEPLOYER$TO M :
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM TO /„
j 3-
f Vt vct-rit e-zs F C C4 1Zwc( v- W1- 3s1-v54,la
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>nn "t s�gntheiral� �17GIb "d4 �1hr �/*fie rgh�)� -rl r w p WJ art r4JT • o!:. y
"7 �. �.. � • '•
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:..S,X'. .vi1S'...7t`'^'.�t,'`.t ,+4'�"' Y'r-�""2c.' ci:c.,i ;l: L ?a` Y :r;,r (�Y6acb t- fR' f`• r ,...
�i;,a ✓r ��'6%�5`.w::T� c � ?ffM.i•F4., �, �..v���,-•s ��.��.. �.,.:., s• �jaci��:c':.,"+i,.c," .;471.7
•
/Zdf
C i 6 RATE OFFICER SIGNATURE
axed signatures are acceptable)
•
0111111111111111
0700019805
§53-131.01)
IYES 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)
'ES T.❑NO-
PRkA) ok)
23.19 Landlord will use its best efforts to get a right-in/right-out off of 84''' Street adjacent to
the Shopping Center. Tenant acknowledges that Landlord has already unsuccessfully attempted to have a
right-in/right-out approved by the City of Omaha.
•
235537
21 •
nt set out in Article 1, Section 1.1(e) above, and the amount of the Initial Insurance Escrow Payment
will be that amount set out in Article I, Section 1.1(d) above. The Initial Tax Escrow Payment and Initial
Insurance Escrow Payment are based upon Tenant's proportionate share of the estimated Taxes and
insurance premiums for the year in question, and the monthly tax escrow payment and insurance escrow
payment are subject to increase or decrease as determined by Landlord to reflect an accurate escrow of
235537
I4
11/15/07 16:35 FAX 4023915860 HAPPY HOLLOW CLUB 001
RECEIVE [
07 NOV15 PI II: 30
CITY CLERK
56/xyc off'our��uG OMAHA. NE € ASKi,
• 1701 South 105th Street,Omaha,NE 68124
Telephone: (402)391-2341 - Business Office Facsimile: (402) 391-5860 or Banquet
Office Facsmiie: (402)391-7670
TELECOPIER COVER SHEET
This facsimile transmission is intended only for the addressee named below. It contains
information that is privileged, confidential or otherwise protected from use and disclosure_ If
you are not the intended recipient, you are hereby notified that any review, disclosure, copying
or dissemination of this transmission, or the taking of any action in reliance on its contents, or
other use is strictly prohibited. If you have received this transmission in error,please notify us
by telephone immediately so that we can arrange for its return to us. Thank you for your
cooperation. v..,
DATE: I TO: •G -
FIRM:
TOTAL NUMBER OF PAGES INCLUDING THIS COVER SHEET:
If you do not receive all the pages,please call(402)391-2341.
FAX #: Cit
FROM: \Vv� �JV• �t `- �
Response Requested: Phone , FAX , Mail ,None .
REMARKS: 0121.14.001/-u►k
VA\f t1i J C1 (55:—
01A,)\•tc(A.A.
Place Of Birth:
"` 9APPLICAN'I':-ANJYSPOUSJ MUST UST RESJD'ENCE(S;)"FOR'THE'PAST:10 YEARS
APPLICANT , , :,4"" ::SPOUSE
CITY&STATE YEAR CITY&STATE YEAR
FROM TO FROM TO
ic)6*- 6(\ 1 I i t4r)cc b 3 G 7
SA- .. (L- 6�- 0 3
L&L 13� c_ cv a )..
MANAGRSLAST WEPLOYER$TO M :
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM TO /„
j 3-
f Vt vct-rit e-zs F C C4 1Zwc( v- W1- 3s1-v54,la
1(�9 -/ 0(4.14,t"151 - @( i We) Y--004-
.ytd�w',X' �tiey�{t"�c��•}" �.,:��};,i-+t1Xi�i"`A�wti.. �+=+A•1 �y(�y =Y�s'' r . 'its r,7T,�a.,,.}3y« - o;r,�b � - ti, ;k' .oli
>nn "t s�gntheiral� �17GIb "d4 �1hr �/*fie rgh�)� -rl r w p WJ art r4JT • o!:. y
"7 �. �.. � • '•
ft4cr �"".
`-t ,,,k,.,c� r.r..ar4 i y,•"r• -�a�,°�✓�r� clt} dR. 'v.:.'r,I,+: a? +n :^v�..tt; +seAyf;. ' .,qhf•,.: ,. •.,..'.Sj r.. a'.. .i...,.
:..S,X'. .vi1S'...7t`'^'.�t,'`.t ,+4'�"' Y'r-�""2c.' ci:c.,i ;l: L ?a` Y :r;,r (�Y6acb t- fR' f`• r ,...
�i;,a ✓r ��'6%�5`.w::T� c � ?ffM.i•F4., �, �..v���,-•s ��.��.. �.,.:., s• �jaci��:c':.,"+i,.c," .;471.7
•
/Zdf
C i 6 RATE OFFICER SIGNATURE
axed signatures are acceptable)
•
0111111111111111
0700019805
§53-131.01)
IYES 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$38.00 per person)
'ES T.❑NO-
PRkA) ok)
23.19 Landlord will use its best efforts to get a right-in/right-out off of 84''' Street adjacent to
the Shopping Center. Tenant acknowledges that Landlord has already unsuccessfully attempted to have a
right-in/right-out approved by the City of Omaha.
•
235537
21 •
nt set out in Article 1, Section 1.1(e) above, and the amount of the Initial Insurance Escrow Payment
will be that amount set out in Article I, Section 1.1(d) above. The Initial Tax Escrow Payment and Initial
Insurance Escrow Payment are based upon Tenant's proportionate share of the estimated Taxes and
insurance premiums for the year in question, and the monthly tax escrow payment and insurance escrow
payment are subject to increase or decrease as determined by Landlord to reflect an accurate escrow of
235537
I4
•
Manager and spouse must rev eve+a clans.c+ rMt ie cf s o s bel�ivv• ':
, :PLEAS$Pll`lNT CLEARLY ,n,
1. READ PARAGRAPH CAREFULLY AND ANSWER COMPLETELY AND ACCURATELY.
Has anyone who is a party to this application,or theirt+p'tttrSil; YY.l i,bepnicp,nvicted 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 an month of the conviction or plea. Also list any charges pending at the time of
this application. If re than one party, please list charges by each individual's name.
EYES O 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 na of the premise.
EYES NO
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 ENO
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$38.00 per person)
YES L '71V0
: 0121.14.001/-u►k
VA\f t1i J C1 (55:—
01A,)\•tc(A.A.
Place Of Birth:
"` 9APPLICAN'I':-ANJYSPOUSJ MUST UST RESJD'ENCE(S;)"FOR'THE'PAST:10 YEARS
APPLICANT , , :,4"" ::SPOUSE
CITY&STATE YEAR CITY&STATE YEAR
FROM TO FROM TO
ic)6*- 6(\ 1 I i t4r)cc b 3 G 7
SA- .. (L- 6�- 0 3
L&L 13� c_ cv a )..
MANAGRSLAST WEPLOYER$TO M :
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM TO /„
j 3-
f Vt vct-rit e-zs F C C4 1Zwc( v- W1- 3s1-v54,la
1(�9 -/ 0(4.14,t"151 - @( i We) Y--004-
.ytd�w',X' �tiey�{t"�c��•}" �.,:��};,i-+t1Xi�i"`A�wti.. �+=+A•1 �y(�y =Y�s'' r . 'its r,7T,�a.,,.}3y« - o;r,�b � - ti, ;k' .oli
>nn "t s�gntheiral� �17GIb "d4 �1hr �/*fie rgh�)� -rl r w p WJ art r4JT • o!:. y
"7 �. �.. � • '•
ft4cr �"".
`-t ,,,k,.,c� r.r..ar4 i y,•"r• -�a�,°�✓�r� clt} dR. 'v.:.'r,I,+: a? +n :^v�..tt; +seAyf;. ' .,qhf•,.: ,. •.,..'.Sj r.. a'.. .i...,.
:..S,X'. .vi1S'...7t`'^'.�t,'`.t ,+4'�"' Y'r-�""2c.' ci:c.,i ;l: L ?a` Y :r;,r (�Y6acb t- fR' f`• r ,...
�i;,a ✓r ��'6%�5`.w::T� c � ?ffM.i•F4., �, �..v���,-•s ��.��.. �.,.:., s• �jaci��:c':.,"+i,.c," .;471.7
•
/Zdf
C i 6 RATE OFFICER SIGNATURE
axed signatures are acceptable)
•
0111111111111111
0700019805
§53-131.01)
IYES 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)
'ES T.❑NO-
PRkA) ok)
23.19 Landlord will use its best efforts to get a right-in/right-out off of 84''' Street adjacent to
the Shopping Center. Tenant acknowledges that Landlord has already unsuccessfully attempted to have a
right-in/right-out approved by the City of Omaha.
•
235537
21 •
nt set out in Article 1, Section 1.1(e) above, and the amount of the Initial Insurance Escrow Payment
will be that amount set out in Article I, Section 1.1(d) above. The Initial Tax Escrow Payment and Initial
Insurance Escrow Payment are based upon Tenant's proportionate share of the estimated Taxes and
insurance premiums for the year in question, and the monthly tax escrow payment and insurance escrow
payment are subject to increase or decrease as determined by Landlord to reflect an accurate escrow of
235537
I4
,...
2 pL CI�N sUatii� ® rt°
ti 4 Win., ANC , 5 N` �IG.ATION
4 s°Y Y, 4-a " ',.,,F,�, &.'i - ty ` ,iot a rye Y '"s„A*E* ,,x4r r -`§� ,�t .-: H '
s.,'. :h.i t;f f�•.,'k "° 4iigl, i �,"t'+i"',�*.RS`. sii* 1e0 I!'&tt- .' `�`.,h�.'177,.�.«' r{'.io.,; k",4 1C� '''> !
The above individual(s),being first duly sworn upon oath,deposes and states that the undersigned is the applic4nt,and/or spouse
of applicant who makes the above and foregoing applicationthat alid ap' nation has been read and tht}t:tkie gontenits'theteof and
all statements contained therein are true. If any false statemi&ismade•in'lariy}Sart`cfFthis application, the appficarit(s)ghall 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.
nature of Manager Applicant Signature of Spouse
State of Nebraska
County of a,e c 44 County of _ ,
The foregoing instrument was acknowledged before The foregoing instrument was acknowledged before
me this 2 , d b p 4+4.4.4. rby me this by
7-401 7
z "C;;37,� -
Notary Public signature Notary Public signature
Affix Seal I Affix Seal Here
° MERU ROTARY State of thsb asga
F LEONARD B.KEWIN JR.
—�_ My Comm.Ery.Nov.4,2008
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
: ,. •.,..'.Sj r.. a'.. .i...,.
:..S,X'. .vi1S'...7t`'^'.�t,'`.t ,+4'�"' Y'r-�""2c.' ci:c.,i ;l: L ?a` Y :r;,r (�Y6acb t- fR' f`• r ,...
�i;,a ✓r ��'6%�5`.w::T� c � ?ffM.i•F4., �, �..v���,-•s ��.��.. �.,.:., s• �jaci��:c':.,"+i,.c," .;471.7
•
/Zdf
C i 6 RATE OFFICER SIGNATURE
axed signatures are acceptable)
•
0111111111111111
0700019805
§53-131.01)
IYES 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)
'ES T.❑NO-
PRkA) ok)
23.19 Landlord will use its best efforts to get a right-in/right-out off of 84''' Street adjacent to
the Shopping Center. Tenant acknowledges that Landlord has already unsuccessfully attempted to have a
right-in/right-out approved by the City of Omaha.
•
235537
21 •
nt set out in Article 1, Section 1.1(e) above, and the amount of the Initial Insurance Escrow Payment
will be that amount set out in Article I, Section 1.1(d) above. The Initial Tax Escrow Payment and Initial
Insurance Escrow Payment are based upon Tenant's proportionate share of the estimated Taxes and
insurance premiums for the year in question, and the monthly tax escrow payment and insurance escrow
payment are subject to increase or decrease as determined by Landlord to reflect an accurate escrow of
235537
I4
•
City of Omaha, �ebras �' °��
of le
••" .111111k7
-Ma `I 4.1 43
1819 Farnam — Suite LC 1
Omaha, Nebraska 68183-0112 0� :_�a ;.�::
Buster Brown (402) 444-5550 .o
City Clerk FAX (402) 444-5263 'rED FEBR��'44
November 20, 2007
Happy Hollow Club, Inca Application to appoint Jim Williamsen
Dba "Happy Hollow Club" manager of your present Class "C"
1701 South 105th Street Liquor License
Omaha, NE 68124
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 December 4,
2007. 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,
dry
•
Buster Brown
City Clerk
BJB:clj
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.
nature of Manager Applicant Signature of Spouse
State of Nebraska
County of a,e c 44 County of _ ,
The foregoing instrument was acknowledged before The foregoing instrument was acknowledged before
me this 2 , d b p 4+4.4.4. rby me this by
7-401 7
z "C;;37,� -
Notary Public signature Notary Public signature
Affix Seal I Affix Seal Here
° MERU ROTARY State of thsb asga
F LEONARD B.KEWIN JR.
—�_ My Comm.Ery.Nov.4,2008
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
: ,. •.,..'.Sj r.. a'.. .i...,.
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�i;,a ✓r ��'6%�5`.w::T� c � ?ffM.i•F4., �, �..v���,-•s ��.��.. �.,.:., s• �jaci��:c':.,"+i,.c," .;471.7
•
/Zdf
C i 6 RATE OFFICER SIGNATURE
axed signatures are acceptable)
•
0111111111111111
0700019805
§53-131.01)
IYES 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)
'ES T.❑NO-
PRkA) ok)
23.19 Landlord will use its best efforts to get a right-in/right-out off of 84''' Street adjacent to
the Shopping Center. Tenant acknowledges that Landlord has already unsuccessfully attempted to have a
right-in/right-out approved by the City of Omaha.
•
235537
21 •
nt set out in Article 1, Section 1.1(e) above, and the amount of the Initial Insurance Escrow Payment
will be that amount set out in Article I, Section 1.1(d) above. The Initial Tax Escrow Payment and Initial
Insurance Escrow Payment are based upon Tenant's proportionate share of the estimated Taxes and
insurance premiums for the year in question, and the monthly tax escrow payment and insurance escrow
payment are subject to increase or decrease as determined by Landlord to reflect an accurate escrow of
235537
I4
•
O1,0HA, 1V
�� 9'I ;i�
City ofOmaha J\lebras&a `�-411
1 ' =erP°sok
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1819 Farnam - i `t d
a nam Suite LC 1kr"
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Omaha, Nebraska 68183-0112 o = 1 ` _:.
Buster Brown (402) 444-5550 .0 '1,"
City Clerk FAX (402) 444-5263 041.ED FEBR°*A
November 20, 2007
Jim Williamsen Application to be appointed manager of the
11427 Iowa Circle present Class "C" Liquor License for Happy Hollow
Omaha,NE 68142 Club, Inc., dba"Happy Hollow Club", 1701 South
105th 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 December
4, 2007. 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,
f�A
om=' P
Buster Brown
City Clerk
BJB:clj
n contained herein is incomplete, inaccurate,or fraudulent.
nature of Manager Applicant Signature of Spouse
State of Nebraska
County of a,e c 44 County of _ ,
The foregoing instrument was acknowledged before The foregoing instrument was acknowledged before
me this 2 , d b p 4+4.4.4. rby me this by
7-401 7
z "C;;37,� -
Notary Public signature Notary Public signature
Affix Seal I Affix Seal Here
° MERU ROTARY State of thsb asga
F LEONARD B.KEWIN JR.
—�_ My Comm.Ery.Nov.4,2008
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
: ,. •.,..'.Sj r.. a'.. .i...,.
:..S,X'. .vi1S'...7t`'^'.�t,'`.t ,+4'�"' Y'r-�""2c.' ci:c.,i ;l: L ?a` Y :r;,r (�Y6acb t- fR' f`• r ,...
�i;,a ✓r ��'6%�5`.w::T� c � ?ffM.i•F4., �, �..v���,-•s ��.��.. �.,.:., s• �jaci��:c':.,"+i,.c," .;471.7
•
/Zdf
C i 6 RATE OFFICER SIGNATURE
axed signatures are acceptable)
•
0111111111111111
0700019805
§53-131.01)
IYES 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)
'ES T.❑NO-
PRkA) ok)
23.19 Landlord will use its best efforts to get a right-in/right-out off of 84''' Street adjacent to
the Shopping Center. Tenant acknowledges that Landlord has already unsuccessfully attempted to have a
right-in/right-out approved by the City of Omaha.
•
235537
21 •
nt set out in Article 1, Section 1.1(e) above, and the amount of the Initial Insurance Escrow Payment
will be that amount set out in Article I, Section 1.1(d) above. The Initial Tax Escrow Payment and Initial
Insurance Escrow Payment are based upon Tenant's proportionate share of the estimated Taxes and
insurance premiums for the year in question, and the monthly tax escrow payment and insurance escrow
payment are subject to increase or decrease as determined by Landlord to reflect an accurate escrow of
235537
I4
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RCLE LA VISTA,NE 68128 BUS.(402)333-0202 ext.1108 CEL(402)681-3699
0 PEEL CIRCLE LA VISTA,NE 68128 BUS.(4021333-0202 ext 1108 CEL(402)681-3699
idian, as surveyed, platted and recorded in Douglas County, Nebraska.
235537
22
/(OLD MGR)-BRENT LAMBI (H)
551-9340)