RES 2006-0259 - SDL during CWS at Anchor Inn June 21-16 2006 ' .• ., APPLICATION FOR SPECIAL DESIGNATED LICENSE _.
• LICENSEE
3RASKA i,IQUOR CONTI20f,COMMISSION
.Box 95046
:oln NE 68509-5046 •
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.L ISSUED LICENSES ARE MAILED TO LOCAL CLERKS WHERE THE EVENT iS HELD
All Applications must he received in the Commission Office I(1 working days (excluding weekends and holidals)prior to the date of
the event
Complete and return THE ORIGINAL WITH A DUPLICATE to the Nebraska Liquor Control Commission
A license fee of S40 (payable to Nebraska Liquor Control Commission) for each day(no fees if caterer)
APPROVAL FROM CITY,VILLAGE OR COUNTY CLERK must be included with this application
A Signed Statement from Local Police Chief or County Sheriff•
Type of Beverage(s) to be served or consumed: Jas. Beer - Wine ( . Distilled Spirits
License number and class O9 79, Retailer ❑ Caterer
(i.e. I/K-12345)
Na1�c and Address of Applicant(as listed on liquor license)(City, County,Zip Code)
Yd�4_ +.-pc,. . .�� Rd
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O Uilci N E (8 i 10
. Address or location of premises to be covered by license, (street,city,coun y, zip code)
1310
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7 0F6� 06/
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. Address of where alcohol is tobe stored if other titan at location listed in question #4 above
N c.' e-
. Name, address, phone number/cell phone number of owner or lessee of premises for which the license is requested
MAI; S . FtEN (r
3- to is.N ' i-v\J I.a Sro'iln,:,I1 .: Kt (ogl 3 7 1--)0.3 ' (75O' I790
. DATE(S) OF EVENT(If Sunday,attach Sunday sales ordinance) no more then six(6)consecutive days per application
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a) If alterna e date is requested please list below: (nitrlst happroved at local level prior tovevent)� d" �- �Si "�CJ�
ALTERNATE DATE:
b) If alternate location is requested please list below: (must be approved at local,level prior to event)
ALTERNATE LOCATION:
. Time(s) of event (example Stun to lam, this is considered one day) JV(kV) 1-6 Ito 1,1 StA 4AIC,,,J
FROM: /� " + �
TO: /� /N� iv\t/ i.+•L to , )\ e h✓> _� I I //
cm P--1
'. Describe type of activity to be carried on during the time period for which the license is requested
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i .i C (/'�/5 I)i'l b•-t [J"iy S y 1',y( b'I L, G fr� ( t+ i c', L9 yrt`1 G` e:. t']:z r e�,,;+.+� �.,,�.(
h Del Ci+ i 0/7Y1d I1 r. A `'v vI.A ?S ca..,/ r'v,+,'t?. V, Sf + .^c eYP�LS, can n C It'ohYLL c! h�:�
0. Provide an estimated number of attendees at this event ii 5-7: . If the number of attendees is over 150 attach a separate page
indicating the steps that will be taken to prevent underage persons access to alcoholic beverages.
I)nr0_ /s a..‘ LvhAt ofe p, , c 0,'1:,i ltnut pvt �� e rY, a;c u1.
I.Attach a signed statement from)our local police chieforcounty sheriff,whichever is applicable,that local law enforcement has been informed
in advance of this event. and if they ::re a1varc of any reason the event should not occur
i 2. Description of the premises: VI Inside Building • ❑ Outdoor Area t
Dimensions of area to be covered by license: x . Please draw in the space providedbelow,the area where
:iquors will be sold and consumed. LENGTH WIDTH (In feet),
If outdoor area, how will premises be separated from areas open to-the general public?
❑ Fence, type of fence
❑ Tent
❑ Other (if other, please explain) •
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s , V t� t1 re c �,�o'., prv'n�r}y �1�c'.
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13. Is the premises to be covered by the license located within the city/village limits'? YES ❑ NO
14. Is the premises to be covered by the license within 150 feet of any church,school,hospital,or home for the agedor indigent persons or for
veterans, their wives or children? ❑ YES IRNO
15. Is the premises to be covered by the license within 300feet of any university or college campus 0 YES gNO
16. Explain how alcoholic liquors will be purchased by the licensee. If purchased from a retail licensee,please give thermic and license number.
vv1`vfes«tzrS
Check here if for consumption only ❑ (no purchases or sales, i.e.byo) •
17. Will the premises to be covered by the license comply with all Nebraska sanitation laws? • YES ONO
18. Arc there separate toilets for both men and women? ,YES ENO
A
19. Other information or requests for exemptions, must be requested and approved prior to event:
20. Will there be any games of chance operating during the event? DYES WO If so, describe activity
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NOTICE: Only games of chance approved by the Department of Revenue, Charitable Gaming Division arc permitted. All other forms of
gambling are prohibited by State Law: There are no exceptions fer Nen 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.
21- Name and telephone number/cell phone number of immediate supervisor, who will actually be present at the location of the event when
it occurs, that can be contacted by law enforcement before and during the event, and who is responsible for ensuring that any applicable lays,
ordinances, rules and regulations arc adhered to. Supervisor must sign on page 2.
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To Whom It?►fxy Concern:
This is to certify that we have agreed to permit Oscar's,Inc.or it's affiliates or assignees to operate a casual
restaurant operation on my premises outside and inside located at
SITE LOCATION 1310 Phelps St. Korean Presbyterian Church Lot
The Period of this agreement is to be - June U6 through� O
�1 g June 28,206.
Dated February 6,2006
.Alittnerica NVS,LLC.
l y:
Printed name
01/31/2006 07: 46 4023458129 ANCHOR INN PAGE 01
02/24/200b 12:20 d0244452b3 • CITY CLERK/COUNCIL ('AGE 02/02 , ,
I.Cle4Iare that am the authorized representative of the above named license applicant and that the statements made on this application are
ing
to the best of my kt owaivge;nd belief. I also consent ction agn ainst the Nation of my background including ebraskaL Liquor Control Commission,the Nebraska StatePatrol s or every kind lorany
cc records. I agree to waive anl�rights or causes of g
:t individual releasing said information to thcu or
rl declare that the
ganization orporztionforp profit olforp
CommissioncenSe
roitlandthalttltteventIsillbe�supeniscd
.lied for will not be used by 2nl�olltcr person,group, o
?ersons directly responsible to the holder of this Special Designated License. •
pi eSfli,.� t- a.•.1t1,o 1.,
( Title bate
(/ ri ee cpr .,ntative/Applicant
J_ , )CFI. ) / y/6;A)
Print Name
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;re f/(L-r„i < � Title Date
Print Name
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'he law requires that no special designated license provided for by this section shall be issued by the Commission hithout the approval
f the local govcrnine body. For the purposes of this section, the local governing body shall be the city or t•illegew'ithin which the
artt ulatr place for which the special designated license is requested is located,or ii such place is not within the corporate limits of a city
r village,then the local governing body shall he the county within which the place for which the special designated license is requested
s located. -.
n Compliance with ADA,this form is available in
.thcr formats for persons with disabilities.
4 ten day advance period is reqo_stcd in writing
o produce the alternate format. •
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Rev 1,04
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O10.HA,
o Omaha Nebras a ;City �..'�_�
1819 Farnam—Suite LC 1 f *ri
�altittir
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Omaha, Nebraska 68183-0112 0 �;�� :,
Buster Brown (402) 444-5550 0 -4�'
City Clerk FAX (402) 444-5263 17.FD FEgR‘��
February 28, 2006
Port Corporation Application for Special Designated
Dba "Anchor Inn" Licenses on June 21-26, 2006
2499 Freedom Park Rd at the Hofer Bldg, 1310 Phelps Street
Omaha, NE 68110 (College World Series)
Dear Liquor License Applicant:
This letter is notification that a hearing before the Omaha City Council on your
application for a Special Designated liquor license has been set for MARCH 14,
2006.
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,
uster Brown
City Clerk
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