RES 2018-0569 - Appoint Sidney M Gnann manager of class I liq lic loc at Joslyn Castle E-MAILED TO NLCC � yy/y
•
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`:. q STATE OF NEBRASKA
t F '.,10 Pete Ricketts NEBRASKA LIQUOR CONTROL COMMISSION
c,a'`:^'!� ''/" %`:1 Governor 2DIji1Hi -7 PM 12: 57 HobertB.Rupe
�, ip.. Executive Director
�'�, k..._li ._ 6� s' 301 Centennial Mall South,5th Floor
h.., r-' CITY
v CLERK P.O.Box 95046
Lincoln,Nebraska 68509-5046
r .,1;A, ' ':,3;iHJK + Phone(402)471-257I
Fax(402)471-2814 or(402)471-2374
TRS USER 800 833-7352(TTY)
Web address http://www.lcc.nebraska.gov/
•
5/4/2018
To: CITY CLERK OF OMAHA
•
Email: CARMAN.JOHNSON@CITYOFOMAHA.ORG
•
Manager Name: SIDNEY M. GNANN
Licensee Name:• JOSLYN CASTLE TRUST INC
•
Licensee Trade Name: JOSLYN CASTLE
License Number: 1-103338
•
Due Date: Monday, June 18, 2018 .
I have attached a copy of a new manager application that was submitted to the Nebraska Liquor
Control Commission. Please complete the following information below to indicate your
recommendation. Send back to Shelah at shelah.davis@nebraska.gov or fax to 402-471-2814.
If you have questions concerning this matter, please contact our office at 402-471-2572.
• )<, APPROVED
NO LOCAL RECOMMENDATION
DENIED •
•
COMMENTS (YOU MAY ATTACH MINUTES AND/OR ADDITIONAL NOTES): .
WRA '. -1P6 Olt3 Ae_ ht9.
4 .
•
Clerk Signature: ?----'
Date: ( /i Lilt/ --- - - -- ---
Janice M.Wiebusch Robert Batt 11111111111
Commissioner Chairman
• An Equal Opporamay Employer 1800006100
MANAGER APPLICATION Office Use
INSERT -FORM 3c RECEIVED
NEBRASKA LIQUOR CONTROL COMMISSION MAY 04 2018
301 CENTENNIAL MALL SOUTH
PO BOX 95046 NEBRASKA LIQUOR
LINCOLN, 68509-5046 CONTROL COMMISSION
PHONE:HONE:(402)2)471-2571
FAX:(402)471-2814
Website: www.Icc.nebraska.gov
MUST BE:
✓ Citizen of the United States. Include copy of US birth certificate,naturalization paper or current US
passport
✓ Nebraska resident. Include copy of voter registration card or print out document from Secretary of
State website
✓ Fingerprinted. See form 147 for further information,read form carefully to avoid delays in
processing, this form MUST be included with your application
✓ 21 years of age or older
.. :..ix,,.�'<� . -s6 �sy;tea .' [y t' - z 1r1 �:
. ' "Y,p?.�e ".1'! 't - `1;'1 r
Name of Corporation/LLC: 705 L V im! CAs 72,a /7 - c% /s!C
Liquor License Number: l#3 3 3 S Class Type 1 (if new application leave blank)
Premise Trade Name/DBA: JfbSLyif CA-S i -
Premise Street Address: act DicVE/JPo/ZT 5�
City: 6--)M/t rl County: 7)01.,c Lr9-S Zip Code:b813 /
Premise Phone Number: 02 . 5 '5.
Premise Email address: S' 1, a h n @Jo$17v\ c .c Ie •
The individual whose name is listed as a corporate officer or managing member as reported on insert
form 3a or 3b or listed with the Commission. To see authorized officers or members search your
license information here.
i ; C 01 fix _ reti-ff
SIGNA OJOR REQUIRED BY CORPORATE,OFFICER I MANAGING MEMBER
(Faxed signatures are acceptable)
Form 103
Rev Jan 2018
Page 2 of 6
TAIMGRif frigini.'"EirAii7OSt croVleigajtiefORWEAS-E
Last Name: 6^0,-Ald First Name: 5I-AA/EY MI: (/
Home Address: / egg 7Ec S7 •
City: 0A4A11A- County: Poik 6.--1.-4-5 Zip Code: E5 (5-54
Home Phone Number: V - 3 -
Driver's License Number& State:
Social Security Number:
Date Of Birth: Place Of Birth: ...Dcvli-A/NA-W
Email address: c-6,51-/e . 0.
Kitt Volt&Had? fyot . ou:se s Eveir ti3ausal a beet wimbst
ODYES EJNO
pouer'sATimition •
Spouses Last Name: (-1-APFAIA/ First Name: ‘C- (‘/f-ii MI: k
Social Security Number: . - - P
• -
Driver's License Number& State: 573/e4SKA
Date Of Birth: — • Place Of Birth: Om HA- /
Al e
.4.TPLICW.,4,SPotTginvisliusTim.rAtc:E,(4.1*,4 •Z,111!.! ,rAsr .315671i0)YEAlt,10,,
L, Ar-MICANT Sffir _
YEAR YEAR YEAR YEAR
CITY&STATE CITY &STATE
FROM TO FROM TO
0 lit frti &f .20/q- Apr 8 Oniii-pm .20 d
Ditiro of-I MT (2011- Dity-bi 01-1 PITS
Form 103
Rev Jan 2018
Page 3 of 6
;4,444ftakVitri T%-1. '4=i., WT.. ; rrir
YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE
FROM TO NUMBER
a o/r a v r l- Five-A✓oes itferieoPhgef 3,e ►r AdS`,N G 7. s 4s
004- a o /l Si- Avolo,J Y O#tucal 04 jeis CEMA-A 9S7 -as3 • q/3a-
I. READ CAREFULLY. ANSWER COMPLETELY AND ACCURATELY.
Must be completed by both applicant and spouse, unless spouse has filed an affidavit of non-
participation.
Has anyone wlio 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,include traffic violations. Also list any charges pending at the time of this application. If more than
one party, please list charges by each individual's name. Commission must be notified of any arrests and/or
convictions that may occur after the date of signing this application.
12v. YES ❑ NO
If yes,please explain below or attach a separate page.
Date of Where Description
Name of Applicant Conviction Convicted of Disposition
(mm/yyyy) (City&State) Charge
Sr0Ne r CNA-AJ 07112o 67 17,11.17DN o g SP /4.1
2. Have you or your spouse ever been approved or made application for a liquor license in Nebraska or
any other state?
OYES NO
IF YES,list the name of the premise(s):
3. Do you, as a manager,qualify under Nebraska Liquor Control Act (§53-131.01) and do you intend to
supervise, in person,the management of the business?
ES ONO
Form 103
Rev Jan 2018
Page 4 of 6
( r
Board and Staff Leadership
John Dechant President
Sidney Gnann Executive Director
Nate Bronson Treasurer
Joan Standifer Secretary
Mary Jewell Past President
. Ron Crampton VP Grounds
Sharon McGill VP Grounds
Matt Wegener VP Buildings
RECE VEg,)
NEBRASKA LIQUOR
CONTROL COMMISSION
4. List the alcohol related training and/or experience(when and where)of the person making application.
*NLCC Training Certificate Issued: N (A- Name on Certificate: a
Applicant Name Date Name of program(attach copy of course completion certificate)
(m YYYY)
• *For list of NLCC Certified Training Programs see training
Experience:
Applicant Name/Job Title Date of Name&Location of Business:
Employment:
5. Have you enclosed form 147 regarding fingerprints?
YES ONO
1
Form 103
Rev Jan 2018
PageSof6
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 §53-131.01)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.
Applicant Notification and Record Challenge: Your fingerprints will be used to check the criminal history
records of the FBI. You have the opportunity to complete or challenge the accuracy of the information
contained in FBI identification record. The procedures for obtaining a change, correction, or updating an
FBI ide ' i tion record are set forth in Title 28, CFR, 16.34.
S' nature of Manager Applicant Signature of Spouse
ACKNOWLEDGEMENT
State of Nebraska
County of D Ot�(�1 Q The foregoing instrument was acknowledged before me this
I
6 // by ldf?,v n
i (. / 4
date NAME�OF P NON BEINv ACKNOWLEDGED
Affix Sept
.91(‘//°114-
Notary Pub is signature GENERAL NOTARY-State of Nebraska
AIAINA KOCINA
My Comm.Exp.January 4,2021
In compliance with the ADA,this application is available in other formats for persons with disabilities.
A ten day advance period is required in writing to produce the alternate format.
Form 103
Rev Jan 2018
Page6of6
SPOUSAL AFFIDAVIT OF Office Use RECEIVED
NON PARTICIPATION INSERT
MAY 04 101 I
NEBRASKA LIQUOR CONTROL COMMISSION
301 PO BOX56 4 CENTENNIAL MALL SOUTH •
NEBRASKA LIQUOR
PHONE:(402)4712571046 CONTROL COMMISSION
FAX:(402)471-2814
Website: www.lcc.nebraska.gov
I acknowledge that I am the spouse of a liquor license holder. My signature below confirms that I will
not have any interest, directly or indirectly in the operation of the business (§53-125(13)) of the Liquor Control
Act. I will not tend bar, make sales, serve patrons, stock shelves, write checks, sign invoices, represent myself
as the owner or in any way participate in the day to day operations of this business in any capacity. The
penaltylt guideline for violation of this affidavit is cancellation of the liquor license.
V I acknowledge that I am the applicant of the non-participating spouse of the individual signing below. I
understand that my spouse and I are responsible for compliance with the conditions set out above. If, it is
determined that my spouse has violated(§53-125(13))the commission may cancel or revoke the liquor license.
/el Rji
Signature of NON-PAk1'ICIPATING SPOUSE '1gn.OF f APPLICANT
.S c vtL & a. vi0 514:4/•2 �l�QU1t7
Print Name Print Name ✓
State of Nebraska,County of State of Nebraska,County of l 0 141)
The foregoing instrument was acknowledgedp before me The foregoing instrument was acknowledged before me
this Apra 1 j i o 2I O (date) this }t/1 t ! 1 p20I b (date)
by Susak, k Z4L U by !GUl v/1.4ilt4t-)
Name of person acknowledged Name of person( cknowledged
(Individual signing document) (Individual signing do ument)
)40,1
Notary Public ignature Public Signat e
•
GENERAL NOTARY-State of Nebraska
GENERAL NOTARY- tasks BS
BONNI �6S My C0 � �15,2018
My Comm.Exp.April 15,2018
In compliance with the ADA,this spousal affidavit of non participation is available in other formats for persons with disabilities.
A ten day advance period is requested in writing to produce the alternate format. •
FORM 116
REV NOV 2016
Page I 1
SUBMISSION OF FINGERPRINTS / RECEIVED
PAYMENT OF FEES TO NSP-CID DATE RECE"'EC
•
MAY D 4 2018
NEBRASKA LIQUOR CONTROL COMMISSION
301 CENTENNIAL MALL SOUTH NEBRASKA LIQUOR
PO LINCOLN,BOX 9NE 68509-5046 NE CONTROL COMMISSION
PHONE: (402)471-2571 Office Use Only
FAX: (402)471-2814
Website: www.lcc.nebraska.gov Class:____ . License#:_
Applicant Name: J/0Nek7 �f 6n1 Ft Ai"/
(Corporation,LLC,Partnership or Individual)
Trade Name:
L--J0 S.c y/4 Ot-s-7z
(Doing Business As)
17 cg ”P S V1 a vi vt , f oS y G'r -Corot
Phone Number Contact-mail Address V
DIRECTIONS FOR SUBMITTING FINGERPRINTS AND FEE PAYMENTS:
• FAILURE TO FILE FINGERPRINT CARDS AND PAY THE REQUIRED PROCESSING FEE TO
THE NEBRASKA STATE PATROL WILL DELAY THE ISSUANCE OF YOUR LIQUOR
LICENSE.
• See Application Requirement Guide for listing of Fingerprint Requirements found on our website under
"Licensing"tab in"Applicant Guidlines".
• DO NOT send fee payments to the NLCC—fees MUST be paid directly to NSP.
• Fee payment of$45.25 per person MUST be made DIRECTLY to the Nebraska State Patrol;
It is recommended to make payment through the NSP PayPort online system at www.ne.gov/go/nsp
Or a check made payable to NSP can be mailed directly to the following address:
***Please indicate on your payment who the payment is for(the name of the person being
fingerprinted) and the payment is for a Liquor License***
The Nebraska State Patrol—CID Division
3800 NW 12th Street
Lincoln,NE 68521
• Fingerprints taken at NSP locations will be forwarded to NSP—CID;
Applicant(s) will not have cards to include with license application.
• Fingerprints taken at local law enforcement offices will be released to the applicants;
Fingerprint cards should be submitted with the application.
Please complete information on the following pages for EACH person fingerprinted.
FORM 147
REV JAN 2018
PAGE1
1. Name: J/b VE / Date of Birth: / Last 4 SSN: _
Date fingerprints were taken: 4 31/24 g Location where fingerprints were taken: OMAHA PD
How was payment made to NSP? ❑NSP PAYPORT CI CASH ❑CHECK SENT TO NSP Ck#
My fingerprints are already on file with the commission—fingerprints completed for a previous
application less than 2 years ago YES ❑
2. Name: Date of Birth: Last 4 SSN:
Date fingerprints were taken: Location where fingerprints were taken:
How was payment made to NSP? ❑NSP PAYPORT ❑CASH ❑CHECK SENT TO NSP Ck#
My fingerprints are already on file with the commission—fingerprints completed for a previous
application less than 2 years ago YES ❑
3. Name: Date of Birth: Last 4 SSN:
Date fingerprints were taken: Location where fingerprints were taken:
How was payment made to NSP? ❑NSP PAYPORT ❑CASH CI CHECK SENT TO NSP Ck#
My fingerprints are already on file with the commission—fingerprints completed for a previous
application less than 2 years ago YES ❑
4. Name: Date of Birth: Last 4 SSN:
Date fingerprints were taken: Location where fingerprints were taken:
How was payment made to NSP? ❑NSP PAYPORT CI CASH ❑CHECK SENT TO NSP Ck#
My fingerprints are already on file with the commission—fingerprints completed for a previous
application less than 2 years ago YES ❑
Applicant Notification and Record Challenge: Your fingerprints will be used to check the criminal history
records of the FBI. You have the opportunity to complete or challenge the accuracy of the information
contained in FBI identification record. The procedures for obtaining a change, correction, or updating a FBI
identification record are set forth in Title 28, CFR, 16.34.
I hereby certify that fees of$45.25 per person have been submitted directly to the Nebraska State Patrol—CID
office. The undersigned certifies on behalf of the Corporation,LLC,Partnership or Licensee that it is understood
that a misrepresentation of fact is cause for rejection of this application or suspension,cancellation or revocation of
any license issued.
Name(Print): Title:
Signature: Date:
FORM 147
REV JAN 2018
PAGE 2
0MAHA At
City o Omaha, Ne breaks �o 'Py�
1819 Farnam —Suite LC 1
S.
Omaha, Nebraska 68183-0112 � r• k,- ' � - '^00
Elizabeth Butler (402) 444-5550 �'�` - ev
City Clerk FAX (402) 444-5263 •P
9TFD FEBR`A
May 22, 2018 •
Joslyn Castle Trust, Inc. Application to appoint Sidney M. Gnann
Dba"Joslyn Castle" manager of your present Class "I"Liquor
3902 Davenport Street License location
Omaha,NE 68131
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 June 5, 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 to the Nebraska Liquor Control Commission.
Sincerely yours,
Elizabeth Butler
City Clerk
EB:clj
•
ONiAHA, N�
ofOmaha, J\lebrãs&aCitk-4'?.,
1819 Farnam -Suite LC 1 ..altai +
„ 10 itt
Omaha, Nebraska 68183-0112 iSfrrt i'
Elizabeth Butler (402) 444-5550 „15 _
City Clerk FAX (402) 444-5263 oT
FD FEBR5V
May 22, 2018
Sidney M. Gnann Application to be appointed manager of the present
12848 Jones Street Class "I"Liquor License location for Joslyn Castle
Omaha,NE 68154 Trust, Inc., dba"Joslyn Castle", 3902 Davenport Str.
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 June 5, 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 to the Nebraska Liquor Control Commission.
Sincerely yours,
Elizabeth Butler
City Clerk
EB:clj
4 OMAA, 1y
City ofOmaha fAlebraskg : �� �4
1819 Farnam —Suite LC 1
Omaha, Nebraska 68183-0112 cl
Elizabeth Butler (402) 444-5550 ,
City Clerk FAX (402) 444-5263 Oo
944.0
FEBR.°`
May 30, 2018
Joslyn Castle Trust, Inc. Application to appoint Sidney M. Gnann
Dba"Joslyn Castle" manager of your present Class"I" Liquor
3902 Davenport Street License location
Omaha,NE 68131
Dear Liquor L;icense 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 June 12, 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 to the Nebraska Liquor Control Commission.
Sincerely yours,
Elizabeth Butler •
City Clerk
EB:clj
City of fAlebraskg40 \ cP
egrej
1819 Farnam —Suite LC 1 zf � r;
Omaha, Nebraska 68183-0112 �
Elizabeth Butler (402) 444-5550 .A % . __�,,
City Clerk 0 FAX (402) 444-5263 0 `'`s g�
TD FEWW'
May 30, 2018
Sidney M. Gnann Application to be appointed manager of the present
12848 Jones Street Class "I" Liquor License location for Joslyn Castle
Omaha,NE 68154 Trust, Inc., dba"Joslyn Castle", 3902 Davenport
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 June 12, 2018 . The City
Council Meeting begins at 2:00 P.M. in the Legislative Chamber, (LC-4), Omaha/Douglas Civic
Center, 1819 Famam 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 to the Nebraska Liquor Control Commission.
Sincerely yours,
Elizabeth Butler
City Clerk
EB:clj