RES 2006-0661 - Appoint Greg Cutchall manager of Famous Dave's .166: : = RECEIVED STATE OF NEBRASKA
Dave Heineman
Vj�`,•� ,i v ,,� ;r W t�' NEBRASKA LIQUOR CONTROL COMMISSION
ii, •.;,;1;- , > Governor A 1 1 9 �I 1 B'
441 "� , $bti =" 6 Hobert B. Rupe
r_p, -.. Executive Director
'w t �1 301 Centennial Mall South,5th Floor
NE BR ASK�������r Nr_` � � P.O.Box 95046
Lincoln,Nebraska 68509-5046
Phone(402)471-2571
Fax(402)471-2814
TRS USER 800 833-7352(TTY)
web address:http://www.lcc.ne.gov/
May 17, 2006
Omaha City Clerk
1819 Farnam LC1
Omaha NE 68183
Re: Old Market Ventures LLC
Dear Clerk:
Enclosed is a copy of a manager application for Greg Cutchall in connection with Famous
Dave's, located at 1101 Harney St, Omaha, liquor license#I-57724...
Please present this application for manager to your City/Village Council or County
Commissioners and send us the results of their action.
Sincerely,
NEBRASKA LIQUOR CONTROL COMMISSION
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Holly Erickson
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Licensing Division
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cc: file -
Rhonda R.Flower Bob Logsdon R.L. (Dick)Coyne
Commissioner Chairman Commissioner
An Equal Opportunity/Affirmative Action Employer
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APPLICATION FOR LIQUOR LICENSE `""
CORPORATION MANAGER-FORM 3b APR `° i 2C33
*MUST BE A NEBRASKA RESIDENT*
301 CENTENNIAL MALL SOUTH NEBRASKA LIQUQp'
PO BOX 95046 CONTROL COMMISSION
PHONE:(,N2)68509-5046 /% 2�yL
PHONE:(402)471-2571 ‘a ,
FAX:(402)471-2814
Website:http://www.lcc.ne.gov/ %.9'
ILIQUURIICENSE INFORMATION - _II::
_ 'I
NAME OF LICENSED CORPORATION O IA0 MA -y r (fie'N T U ci-e S j L L- e
CLASS&LICENSE NUMBER I 5-7 -7 d- q
TRADE NAME V ol(1^®U 7 D U e 5 I
STREET ADDRESS ( ( 0 1 ( + n CL I& e-4 CITY
ri4
SIGNATURE OF CORPORATIO PRESIDE T/CEO
AEPLICANT JNFORMATION,( . ST_BE 21 OR OVER AND.NEBRASKA RESIDENT) ' A
NAME ( \ -e__ e- a —C A A-L L
ADDRESS '- D (l A) i S 1 C, (L
CITY N N 1 N L-'1e2 4\-) STATE N e ZIP CODE (� V OO 7
HOME PHONE NUMBER ti O 0 - 6 5 "Li(3 a BUSINESS PHONE NUMBER VOd- ) F'- 3 3 _:
SEX IK.MALE El FEMALE SOCIAL SECURITY NUMBER , -
DATE OF BIRTH PLACE OF BIRTH 7v(,5 ON 4] z
I
DRIVERS LICENSE NUMBER&STATE - , - , - - >)e (n`
SPOUSES-INFORMATION(IF NOT MARRIED INDICATE) .. '
SPOUSE NAME IA O L. ('/ 0(-) t L-L -
SOCIAL SECURITY NUMBER _ _ _ DATE OF BIRTH _
XDRIVERS LICENSE NUMBER&STATE I
FORM 35-4013
REV.4/05
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i. READ CAREFULLY. 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. C i
OYES NO
If yes, please e' plain below or attach a separate page.
APR 2 2026
NEBRASKd LIQUOR
CONTROL COMMISSION
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 date.
0.YES ONO
it‘) i‘ (2003)40 4 a a s-ci s (.2_0 s- s.--1?
3. Have you or your pouse ever made a compromise settlement for violation of such laws?
DYES 10
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)
YES ONO
S. Have you filed fingerprint cards and PROPER FEES(if check,make out to the NE State Patrol),with this application?
%YES ONO
C /r1 AfritS lit 6-6 P c T J S-i,
, RESIDENCES FOR THE PAST 10.YEARS,APPLICANT AND SPOUSE MUST COMPLETE
APPLICANT:CITY&STATE a/Y,"-/M,/NQ YEAR SPOUSE:CITY&STATE YEAR
FROM TO FROM TO
6,ReC CUice=if /,L /'27GC -
7 3 b 3 N Oe' 5.`- e 2OO( - cf//L:.-o"3
3 8 3 d g. sv_s#-,n-C /L ( ?' e1 ra y Si 206
3 -7(8 let?1 '( '5 .tee /i7 l /4:/c,)'
EMPLOYERS-LIST LAST TWO EMPLOYERS
MONTH/YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER
FROM TO
re/ CUPx,' evzz/t/tJ-, n16 7 ces . 0 4-F 551C-33 3 -
FORM 35-4013
REV.4/05
v ' .‘
PERSONAL OATH AND CONSENT OF INVESTIGATION
APR 2 1 2005
MUST BE SIGNED BY APPLICANT & SPOUSE �+pNEBRASa LIQUOR
The above individual(s), being first duly sworn upon oath,deposes and states that the undersigned is the applicant�aiO/ s 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,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.
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Ji Lam` - -v"`:f �i G:t i.'1\_34.—‹ _' ,'.
Signature of Applicant Signature of Spoese
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Subscribed in m presence and sworn to before me this 1 Subscribed in presence and sworn to before me this 1 1
day of pfl ' j OOf2 . day of --r ' .2006
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.C .141/11r116-ff-
&Seal Nota Si nature .Seal
Notary Signature ry g
4 GENERAL NOTARY-Slate of Nebraska A GENERAL NOTARY-State of Nebraska
DIANE THOMSEN DIANE THOMSEN
My Comm.Exp.Oct 17.2007 * My m E>p.Oct 17.2007
FORM 35-4013
REV.4/05
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