RES 2018-0687 - SDL for Septemberfest Salute to Labor August 31st and September 1st 1
NEBRASKA LIQUOR CONTROL COMMISSION
PHONE:(402)471-2571 l E I
Website: www.lcc.nebraska.gov
Special Designated License t. Z't
Local Recommendation (Form' t._-
Applications must be entered on the portal after local approval—no exceptions
Late applications are non-refundable and will be rejectet l `( c
Septemberfest-Salute to Labor
Retail Liquor License Name or*Non-Profit anization(*Must include Form#201 as Page 2)
6gto 2?e)efl-c_ . tea/cy(p
Retail Liquor License Address or Non-Profit Business Address
37- 0 V3 7 Off-0
Retail License Number or Non-Profit Federal ID#
Event Date(s): 8/31/18 9/1/18 9/2/18 9/3/18
Event Start Time(s): 5 p.m. Noon Noon Noon •
Event End Time(s): Midnight Midnight Midnight Midnight
•
Alternate Date: NONE
Alternate Location Building&Address: NONE •
Event Building Name: Century Link, outside in Lot D
Event Street Address/City: 455 N. 10 Street, Omaha, NE.. 6810$2
Indoor area to be licensed in length&width: X
Outdoor area to be licensed in length&width: 880' X 510' (Diagram Form#109 must be attached)
Type of Event: 4 Day Festival Estimate#of attendees: 1 OCX) +-
Type of alcohol to be served: Beer X Wine Distilled Spirits
(If not marked,you will not be able to serve this type of alcohol)
Event Contact Name: Linda Morin Event Contact Phone Number:402-981-7115
Event Contact Email: linda@omahafed.org
*Signature Authorized Representative•
etail license —Must be si a by a member listed on permanent license
*Non-Profit rganizatiion— ust be signed by a Corporate Officer
*Local Governing Body completes below:
The local'governing body for the City of C is AAA._ OR County of approves the
issuance of a Special De ' nated License as requested above.
/2LIIs .
ocal o r ng Body Authorized Signature Date
19 /f5,5 Yia9Y, 620ir
OUTDOOR AREA DIAGRAM
HOW AREA WILL BE PATROLLED off duty state patrol
• IF APPLICABLE,OUTDOOR AREA MUST BE CONNECTED TO INDOOR AREA IF INDOOR AREA IS
TO LICENSED
• MEASUREMENT OF OUTER WALLS OF AREA TO BE LICENSED MUST INCLUDED LENGTH&
WIDTH IN FEET
• DOUBLE FENCING IS REQUIRED FOR ALL NON-PROFIT ORGANIZATIONS UNLESS FORM#140 IS
FILED WITH THIS FORM AND IS APPROVED BY THE COMMISSION
• RETAILER LIQUOR LICENSE HOLDERS ARE NOT REQUIRED TO DOUBLE FENCE,ALTHOUGH
MEASURES NEED TO BE TAKEN TO SECURE THE AREA
DIAGRAM OF PROPOSED AREA:
5G.c. 1\-\-ckockm
Form 109
Rev Nov 2016
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455 N. 1Oh'STREET, LOT D
SEPTEMBERFESTOMAHA.ORG •
APPLICATION FOR SPECIAL •
DESIGNATED LICENSE
Non-Profit Applicants ONLY
NEBRASKA LIQUOR CONTROL COMMISSION
301 CENTENNIAL MALL SOUTH
PO BOX 95046
LINCOLN,NE 68509-5046
PHONE:(402)471-2571
FAX:(402)471-2814
Website:www.lcc.nebraska.gov/
Email Applications: michelle.porter@nebraska.gov
This page is required to be completed by Non-Profit applicants only.
Application for Special Designated License
Under Nebraska Liquor Control Act
Affidavit of Non-Profit Status
I HEREBY DECLARE THAT THE CORPORATION MAKING APPLICATION FOR A SPECIAL DESIGNATED LICENSE
UNDER THE NEBRASKA LIQUOR CONTROL ACT IS EITHER A MUNICIPAL CORPORATION, A FINE ARTS MUSEUM
INCORPORATED AS A NONPROFIT CORPORATION, A RELIGIOUS NONPROFIT CORPORATION WHICH HAS BEEN
EXEMPTED FROM THE PAYMENT OF FEDERAL INCOME TAXES, A POLITICAL ORGANIZATION WHICH HAS BEEN
EXEMPTED FROM THE PAYMENT OF FEDERAL INCOME TAXES, OR ANY OTHER NONPROFIT CORPORATION,THE
PURPOSE OF WHICH IS FRATERNAL,CHARITABLE,OR PUBLIC SERVICE AND WHICH HAS BEEN EXEMPTED FROM
THE PAYMENT OF FEDERAL INCOME TAXES AS PER§53-124.11(1).
AS SIGNATORY I CONSENT TO THE RELEASE OF ANY DOCUMENTS SUPPORTING THIS DECLARATION AND ANY
DOCUMENTS SUPPORTING THIS DECLARATION WILL BE PROVIDED TO THE NEBRASKA LIQUOR CONTROL
COMMISSION, THE NEBRASKA STATE PATROL OR ANY AGENT OF THE LIQUOR CONTROL COMMISSION
IMMEDIATELY UPON DEMAND. I ALSO CONSENT TO THE INVESTIGATION OF THIS CORPORATE ENTITY TO
DETERMINE IT'S NONPROFIT STATUS.
I AGREE TO WAIVE ANY RIGHTS OR CAUSES OF ACTION AGAINST THE NEBRASKA LIQUOR CONTROL
COMMISSION, THE NEBRASKA STATE PATROL OR ANY PARTY RELEASING INFORMATION TO THE
AFOREMENTIONED PARTIES.
NAME OF CORPORATION
FEDERAL ID NUMBER
SIGNA OF LE F C O ICERS
THE ABOVE INDIVIDUAL STATES THAT THE STATEMENT ABOVE IS AND CORRECT: IF ANY FALSE STATEMENT IS MADE ON THIS
APPLICATION,THE APPLICANT SHALL BE DEEMED GUILTY OF PERJUR AND SUBJECT TO PENALTIES PROVIDED BY LAW. (SEC.§53-131.01)
NEBRASKA LIQUOR CONTROL ACT f
SUBSCRIBED IN MY PRESENCE AND SWORN TO BEFORE ME THIS I 1 f" DAY OF JLLi1, , Q 01 Oo
JI/lcwke 5 -. rina-1\ie
NOTARY PUBLIC SIGNATURE&SEAL
State of Nebraska•General Notary
MARIE A.SMITH
MY 20
20
FORM 201
REV NOV 2016
Cityof Omaha, J'lebras&a OlVIAHA, A,
p.
1819 Farnam —Suite LC 1 �. fg ipr LIE
Omaha, Nebraska 681 83-01 1 2 C� , v,. WAIMc
Elizabeth Butler (402) 444-5550
City Clerk FAX (402) 444-5263 O4 4�
91'FD FEB �R5
July 10, 2018
Septemberfest— Salute to Labor Application for Special
6910 Pacific Street Designated License for August
Suite 450 31 & September 1-3, 2018 with
Omaha, NE 68106 music until 12:00 midnight
each night
Dear Liquor License Applicant: -
This letter is notification that a hearing before the Omaha City Council on your
application(s) for a Special Designated liquor license has been set for
July 24, 2018.
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 or his/her representative 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(s) to the Nebraska Liquor Control Commission.
Sincerely yours,
Eliz eth
City Clerk
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