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RES 2015-1376 - Appoint Daniel P Raabe manager of Veterans FW Benson 2503 k [� � � L� / / 30 ()�� Y�T�BRASK}\ Pete Ricketts — u,�mm mcmm«� LwmmCom�o COMMISSION � wm�a Executjce Director B»h«�B' 0up« 3u/ Ce nwmna ^muuoum,S*@qoo Lincoln, mcbraska60S0Yso46 Phone(4o2)x7\'us71 Fax(400)u7z'c81«o,(4o2)47/'ca74 Tss USER oouao3-7usc�^Tv September 28, 2OlS web address:uun.//u"°x/,c Ile " OMAHA CITY CLERK 1819FARNAM STREET LC-1 [)&4AHANEOO183 RE: Manager Application Daniel P. Raabe LICENSE #I-25lI9 Dear Clerk: Enclosed is a copy of manager application for Daniel P. Raabe\ in connection with the Veterans F VV Benson 25U3 |Ocatedin ()rnah� / . ' � Please present this application for manager to your Citv/ViU�g� Council or �Ornrn�s�oners d send us the results of their achon. - ' �n Sincerely, Jacqueline Rodriguez Licensing Division NEBRASKA LIQUOR CONTROL COMMISSION 402-47I-257I end. Janice M.vvwbwch Robert Batt ca*"""" onceuoilew | *n Equal onp^*" /w�"plove, �� VFW POST 2503 402-571-2835 p.16 MANAGER APPLICATION office usc INSERT- FORM 3c NEBRASKA LIQUOR CONIROL COMMISSION 301 CENTENNIAL MALL SOUTH PO BOX 95046 LINCOLN,NE 68509-5046 PHONE: (402)471-2571 FAX: (402)471-2814 Webs VAVW Ice 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 in the State of Nebraska v Fingerprinted. See Form 147 for further information, this form MUST be included with your application. ✓ 21 years of age or older CorporatoniELC information Name of CorporationILLC:_ PO SQ 3 Premise information Liquor License Number: 0 2-5 Class Type I (if new applieabon leave blank) Premise Trade Name/DBA: \le-664)s 1-6 .///1-e5- ,6EN-ct,") Pp) 16c,. .1 7503 Premise Street Address. Wo€-1 /1111-,4,1 A is City: 0,42r1,///4 County: oc-A-9 '4\ S Zip Code: hgl3 Premise Phone Number: Cl/42) - F3(77 Email address: aartideralriSleg e P2o3 orvii-fcc Art A t CO 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. Click on this link to see authorized individuals. littp://www.lcc.ne.govilicense search/licsearch.cgi Ct./' • SIGNATURE REQUIRED BY CORPORATE OFFICER / MANAGING MEMBER (Faxed signatures are acceptable) I II II 11111 11 I 1/ ... 1500021841 Form 103 REV JUNE:2315 Pe 2 of 6 VFW POST 2503 402-571-2835 p.9 Manager's information must be completed below PLEASE PRINT CLEARLY Last Name Aot3c- First Name: ---DAk•AVid mi: Home Address(include PO Box if applicable): Ji PitAcruE4 S +• City: 0 6'1 A f-t A Count3,71)0.cf: a4p,S Zip Code: Home Phone Number:(LI-C2S 3 —02A 0 Business Phone Number:(40-23 51 I 5 37 Social Security Number: - Drivers License Number& State: _ • • . I Date Of Birth: Place Of Birth: I Gro--)t- S, 5.• (\k\4- / Email address: U ,kg Cox JtE.Are you you married? If yes, complete spouse's information(Even if a spousal affidavit has been submitted) 2!YES NO Spouse's information Spouses Last Name: icity1-73 . First Name: 1\41: Social Security Number. _ Drivers License Number& State._ _ rkiE Date Of Birth: Place Of Birth:Onia./14 APPLICANT&-SPOUSE MUST LIST RESIDENCE(S) FOR THE PAST TEN (10) YEARS APPLICANT SPOUSE YEAR YEAR YEAR CITY & STATE YEAR CITY & STATE FROM TO FROM TQ --L-11-10-111— 014L Farr I C3 REV JUNE;2015 rage 3 of 6 VFW POST 2503 402-571-2835 p.10 MANAGER'S LAST TWO EMPLOYERS YEAR NAME OF EMPLOYER NAME OF SUPERVISOR TELEPHONE FROM TO NUMBER /977 !do/3 yiY7k4,47...;Cott/CA.64f )3 lit9 C-PliAy et> (402) ,S774,--c9-.co j? 1 72c,14- 111th LOR-0 l 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 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. —I YES NO If yes, please explain below or attach a separate page. Date of Where Description Name of Applicant Conviction Convicted of Disposition (mmiy)vy) (City&State) Charge 2. Have you or your spouse ever been approved or made application for a liquor license in Nebraska or any other state? YES ANO IF YES, list the name of the premise(s): 3. Do you,as a inanager, qualify under Nebraska Liquor Control Act ( 53-131.0 )and do you intend to supervise, in person,the management of the business? ES I NO 7onn 103 REV JUNE 2015 Fake 4 or 6 , , VFW POST 2503 402-571-2835 p.11 4. List the alcohol related training and/or experience(when and where)of the person making application *NLCC Training Certificate'Issued: Name on Certificate: Date y) Applicant Name ( Name of program (attach copy of course completion certificate) mrn/y,a *For list of NI,CC Certified Training Programs see www,lcc.ne,9.ovitraininzinfo Ir.rnt Experience: Applicam Name f Job Title Date of Name&Location of Business: Employment: 5. Have you enclosed Form 147 regarding fingerprints? ig YES ENO Form REV'U1'4E2015 Page S a 6 VFW POST 2503 402-571-2835 p.12 PERSONAL OATH AND CONSENT OF INVESTIGATION The above individual(s), bein2 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. Signature of Manager Applicant Signature of Spouse ACKNOWLEDGEMENT State of Nebraska County of 0 C I a The foregoAistronent was acknowledged before me this j—/ /5 by Ro.:cf-i,aeek, ocri 1r' -er :late name of pson ac<nowledged (.."-.) I Affix N tary Public signature GENERAL NOTARY,State of Nebraska UNDA M. DOLINSKY My Comm.Exp /1/08/2015 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 formate; ' Form 103 REV il"NIF,20[5 Page 6 of 6 • „ - . INTER-OFFICE COMMUNICATION September 30, 2015 TO: Robin Lemieux, Police Records FROM: Carman Johnson, Liquor Clerk SUBJECT: Liquor Applications PLEASE RETURN BY: OCTOBER 15, 2015 CITY COUNCIL HEARING DATE: OCTOBER 27, 2015 VETERANS F W BENSON 2503 8900-04 MILITARY AVE DBA VETERANS F W BENSON 2503 DANIEL P RAABE, DOB 05/24/50, 14819 SPRAGUE STREET, OMAHA, NE 68116, SS #504-54-7667, NE DRIVER'S LICENSE #G 59015479 KATHLEEN F RAABE, DOB 05/22/52, 14819 SPRAGUE STREET, OMAHA, NE 68116, SS #508-62-1098, NE DRIVER'S LICENSE #G01 255451 City of Omaha £1[thrasIa01174;^)° k!' OMAHA N� 1819 Farnam — Suite LC 1 t tip Omaha, Nebraska 681 83-01 1 2 � 1 � Buster Brown o a: apo (402) 444-5550 City Clerk FAX (402) 444-5263 o -` 47WO PESO.' October 13, 2015 Veterans F W Benson 2503 Application to appoint Daniel P. Raabe Dba"Veterans F W Benson 2503" manager of your present Class "I" Liquor 8900-04 Military Avenue License location Omaha, NE 68134 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 27, 2015 . 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, Buster Brown City Clerk BJB:clj Ciiy of OmaFta oMAHA N f1[thrasha 1819 Farnam — Suite LC 1 ., Omaha, Nebraska 681 83-01 1 2 A� r'� Il ,, Buster Brown (402) 444-5550 o�'!✓ '` " City Clerk iO FAX (402) 444-5263 o -t 0? R��'4 ry FEB October 13, 2015 Daniel P. Raabe Application to be appointed manager of the 14819 Sprague Street present Class "I" Liquor License location for Omaha, NE 68116 Veterans F W Benson 2503, dba"Veterans F W Benson 2503", 8900-04 Military Avenue 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 27, 2015 . 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, Buster Brown City Clerk BJB:clj gef No. /5 7l Veterans F W Benson 2503, dba"Veterans F W Benson 2503", 8900-04 Military Avenue, requests permission to appoint Daniel P. Raabe manager of their present Class "C" Liquor License location. 10-27-15;cj L RECEIVED Presented to Council: October 27, 2015 - Approved (y-p Buster Brown City Clerk