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RES 2002-2398 - Appoint Eric L Andersen manager of Joy Inc STATE OF NEBRASKA RFCEIVFD o zaE •Ar�,�\ NEBRASKA LIQUOR CONTROL COMMISSION o. Forrest D. Chapman �{ Executive Director rid`; 02 OCT — I 8• 42 301 Centennial Mall South,5th Floor P.O.Box 95046 ° Lincoln,Nebraska 68509-5046 CITY CLERK ., 9R`8,kQ�86a: Phone(402)471 2571 OMAHA I�l_I<ikl' c, Fax(402)471-2814 ��♦ TRS USER 800 833-7352(TIY) Mike Johanns web address:http://www.nol.org/home/NLCC/ Gouernor September 30, 2002 City Clerk Omaha/Douglas Civic Center 1819 Farnam LC-1 Omaha NE 68183 RE: Manager Application Submittal Dear Sir/Madam: The enclosed Application for Manager is being submitted by Joy Inc DBA Joy located at 1516 Jones Street, Omaha, NE 68102 (Douglas County) which holds a Class C License #47629 the applicant's name is Eric L. Andersen. Please present this application to your City/County Council and return to us the results of the action taken. If you have any questions or comments, please give me a call. Sincerely, Michelle Porter Licensing Division • Enclosure Rhonda R. Flower Bob Logsdon R.L. (Dick)Coyne Commissioner Chairman Commissioner An Equal Opportunity/Affirmative Action Employer Printed with soy ink on recycled paper Application for Corporateei6 IVEDREC> ir/ *Must Be A Nebraska Residen Please submit in Triplicate Leal- ru, 7h' ', n ter\ ,/7 op Return to: Nebraska Liquor Control Commission,PO.Box 95046 QUG '26 .`' �u 2i'2002 301 Centennial Mall So.,Lincoln NE 68509 Phone: (402)471-2571 Fax: (402)471-2814 Web address: http://www.nol.o •0� 2aL D LIQUOR D�� a NTROL c:UlVl I LIQUOR LICENSE INFORMAT st' `OLCO j SSIp NAME OF LICENSED CORPORATION - ! CLASS&LICENSE NUMBER OR Joy, Inc. C1CONTROLSCAC u C(--- TRADE NAME OF LICENSED PREMISE SAP - u 200? Joy 0 11 STREET ADDRESS OF LICENSED PREMISE CITY COUNTY ZIP CODE 16 1516 Jones Street 0<6` Omaha 0 Douglas mX:" 68102 ©L- On behalf of the corporation,I designate this individual as corpora - . a•- . ati/' Signature of Corporate President/C ' 0: ' APPLICANT I• FORMATION(MU T BE 21 OR OVER) ' NAME(LAST,FIRST,MIDDLE,MAIDEN) SEX SOCIAL SECURITY NUMBER DATE OF BIRTH PLACE OF BIRTH F M Andersen, Eric, Lee M _ 02/22/66 Chicago, IL HOME STREET ADDRESS CITY COUNTY STATE ZIP CODE 11429 W. Maple Rd. , #1 Omaha. Douglas NE 68164 HOME TELEPHONE NUMBER BUSINESS TELEPHONE NUMBER DRIVERS LICENSE NUMBER&STATE (402 963-9768 (402 341 -7337 H12223468 NE SPOUSE'S INFORMATION(IF NOT MARRIED INDICATE) oc,)h _� FULL NAME(LAST ,.M}HB £-M DEN) SOCIAL SECURITY NUMBER . DRIVERS LICENSE NUMBER &STATE of Applicable 1 ,,�,-- DATE OF B TH: PLACE OF BIRTH 1. 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 criminal charge. Criminal charge means any charge alleging a felony or misdemeanor violation of a federal or state law;or 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. D Yes 3 No 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. OYES ONO • FORM 35-4013 REV 2/01 PAGE 1 • 3. Have you or your spouse ever made a compromise settlement for violation of such laws? DYES ggNO - 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) t • ®YES ONO . 5. Have you filed fingerprint cards and PROPER FEES(if check,make out to the NE State Patrol),with this application? DYES ONO +. ,,t .t.k' -1*, a-4:a- n:,4 .eigi1i 7 -44 41 3�.•+ r ''' a: , '�b - am� at.� .n �>'Y •�r•.F Y �g -*'L3 � - � a' �t-r w^3`'^ "�`' At W .. ,�4.,, aF . y1'�' s _ ,itESIDENCE Sls[CE AGE`18 AP'LIC NT AND SPOUSE FCCOMP.LETE ,. .„'.r.-,..ti`[.,.c2r.--,-q::.WR.,.... ,.. AnY.-....e.,,,' _ ."N.�r+s:... ` w"r•"C•k..v. .'''''',r . ,,•'` ."'.x,.� • :>::, .,... T,... .-a. ..ram @ §- ,VA--,,477 APPLICANT:CITY&STATE- YEAR SPOUSE:CITY&STATE YEAR FROM TO FROM TO West Lafayette, IN 89 94 Danville, IL 94 95 • Omaha, NE 95 96 Danville, IL 96 97 i :„ ''k-li: ,re, .;1, ,,AAA F. P.,LU EBS, LIST AS TWE3 h+U <E : ;`tv. f �,�r *. „. '.'lz ' YEARO NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE NUMBER . FROM TO 1994 1999 Valmont Industries Bill Clark 800-345-6825 ' 1999 2urrent Travelex • Lori Reed 800-877-1039 Nr r - ,s; 1 :a 'T ,r-' +w`74w*,s v,:.: 't:,":'-'':a : .«:. r,; r,J.-'`7.w.Y'.4,7 Aztlif av73,AV- '�4'' r >,; PERSONAL()ATH AND CONSENT OF IIYiVESTIGA `1ON `14UST'BE SIGNEDAY,APPLICAN &SPOUSEF'' ' STATE OF NEBRASKA ) ) SS COUNTY OF Douglas ) 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-I31.01)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 may be attached,however,fingerprint cards are still required to be filed. The undersigned understand and acknowledge that any license issued,based on the information submitted in this application,is subject to cancellation ifthe information contained herein is incomplete and inaccurate. / iv,� /2" 1 /,:j, .Y:X Signature Appli nt Signature of Spouse(if applicable) Subscribed in presence an sworn to before me is 2 2 Subscribed in my presence and sworn to before me this day of July, 2002 . day of tary, . 1 ,,,,- Signature&Seal • ir gNotary Signature&Seal 1 GENERAL NOTARY State#oT Nebraska • III JEFFREY A.SILVER My Comm.Exp.July 2d,2004 . , FORM 354013 REV.2/01 • , PAGE 2 I (.1);11/41iA'3VZCit o Omaha zebras a .1 °t 1819 Farnam—Suite LC 1 �v i� �� il'd Omaha, Nebraska 68183-0112 O�.� �' Buster Brown (402) 444-5550 City Clerk FAX (402) 444-5263 0 1 D FEaRX9*4. October 8, 2002 Joy, Inc. Application to appoint Eric L. Anderson 1516 Jones Street manager of your present Class "C"Liquor Omaha,NE 68102 License 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 October 22, 2002. 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. City Council Rule No. 14, requests each applicant to submit a signed statement representing that a sign indicating the birth date for buyers of alcohol will be prominently displayed on the licensed premises and that approved training in the proper procedures for checking buyers' identification will be provided to employees. Attached is the statement to be signed and returned (hand deliver, mail or fax) to the City Clerk's Office before your public hearing. FOR YOUR FILE,ATTACHED SENT TO MANGER. Since ly yours, G�Jt Buster Brown City Clerk BJB:clj 0MAHA, NF Si /494 City of Omaha, Webraska 1101(17 1819 Farnam—Suite LC 1 2 Omaha, Nebraska 68183-0112 0 ""; Buster Brown (402) 444-5550 .o City Clerk FAX (402) 444-5263 O�'TED FEBR�!►4`� October 8, 2002 Eric L. Andersen Application to be appointed manager of the 11429 West Maple Road, #1 Class "C"Liquor License for Joy, Inc., Omaha,NE 68164 1516 Jones 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 October 22, 2002. 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. City Council Rule No. 14, requests each applicant to submit a signed statement representing that a sign indicating the birth date for buyers of alcohol will be prominently displayed on the licensed premises and that approved training in the proper procedures for checking buyers' identification will be provided to employees. Attached is the statement to be signed and returned (hand deliver, mail or fax) to the City Clerk's Office before your public hearing. Sincerely yours, Buster Brown City Clerk BJB:clj i'-' , t1/4„ , O 'b r 0) n o 0 CD Na tr1 O n O d _,..' N E ( n i=1• pa Cn O II... CD CD r+ r CD cn libn t . r ° cA