RES 2015-0986 - Appoint Renee L Snider manager of Walgreens 6936 „
ECEVE
STATE OF NEBRASKA
7:21
Pete Ricketts 2015 ,JUL -8 PM 3: 33 NEBRASKA LIQUOR CONTROL COMIMSSION
\ I lir -- Governor Hobert B.Rupe
Executive Director
'1/444iicu 1.1!0941 301 Centennial Mall South,5th Floor
CITY CLERK P.Q.Box 95046
nMAHt. NEBRASKA Lincoln,Nebraska 68509-5046
Phone(402)471-2571
Fax(402)471-2814 or(402)471-2374
TRS USER 800 833-7352(TTY)
web address.http.//www.lcc.ne.gov/
July 8, 2015
OMAHA CITY CLERK
1819 FARNAM STREET LC-1
OMAHA NE 68183
RE: Manager Application Renee L. Snider
LICENSE #D-86167, #D-86168, #D-86169, D-86170
Dear Clerk:
Enclosed is a copy of a manat -r application for Renee L. Snider, in connection with the Waigreen's
05143, 05190, 15237, and 06936 all located in Omaha.
Please present this application for manager to your City/Village Council or County Commissioners and
send us the results of their action.
Sincerely,
41.k
)
Jacqueline Rodriguez
Licensing Division
NEBRASKA LIQUOR CONTROL COMMISSION
402-471-2571
encl.
Janice M.WIebusch Robert Batt Bruce Bailey
Commissioner Chairman Commissioner
An Equal Opportunity Employer
MANAGER APPLICATION Office Use
INSERT-FORM ECEIVE
NEBRASKA LIQUOR CONTROL COMMISSION
301 CENTENNIAL MALL SOUTH JUL 2 i-L1-5
PO BOX 95046
LrNeol.N.,NE 68509-5046 NEBfRASKA LIQUOR
PHONE:(402)471-2571
• FAX:(402)471-2814 CONTROL COMMISSION
Website:www.lec.ne.gov
MUST BE:
Citizen of the United States. include cony of US birth certificate naturalization naner or
current US nassnort
1 Nebraska resident. Include cony of voter registration in the State of Nebraska
I Fingerprinted. See Form 147 for further information,this form MUST be included with your
application.
I 21 years of age or older
7".• 4,,r,
Name of Corporation/LLC: Walgreen Co.
86170
Liquor License Number: Class Type (if new application leave blank)
Premise Trade Name/DBA: Walgreens#06936
• 4310 Ames Avenue
Premise Street Address:
Omaha 68111
Douglas
City: County: Zip Code:
(402)453-4530
Premise Phone Number:
Email address: eric.lyles( walgreens.com
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.
htro://www.lec.ne.govilicense seam csearch.egt
•
SIGNATURE REQUI D BY CORPORATE OFFICER/MANAGING MEMBER
(Faxed signatures are acceptable)
0 III I I REVZ223.6
1500016437
Snider Renee
Last Name: First Name: MI:
Home Address(include PO Box if applicable): //926 k) eYetivi liii LcJ
City: a/jun County: 1471c4sle( Zip Code: 623.3
Home Phone Number: ( Z) 617- g559 Business Phone Number: $8.53 9322
Social Security Number: Drivers License Number&State:, , ,
_
Date Of Birth: Place Of Birth: 4,)"ci J 1111E
r /
renee.snider@waigreens.com
Email address:
' • - - "
C YES DNO
P*7
Spouses Last Name: 61i:del First Name: 06,1 CILIA MI:
Social Security Number: , , Drivers License Number&State: . - - 04/1-
Date Of Birth: Place Of Birth:U5 1316e- 6.(77244/
YEAR YEAR YEAR- YEAR
CITY&STATE CITY&STATE
FROM TO FROM TO
ZOIZ &scat 1114-6A /JE 2,01 12eseAt-
.
Lncolek- ,UE 1419? 0314- ty_DIA AJE Zw7 26/e
041 2a)5 za7
RECEIVED
RECEIVED
jUL 2 2015 Form 103
REV IAN 2015
Pap 3 of 6
NEBRASKA LIQUOR JUN 5 2015
CONTROL COMMISSION
NEBRASKA LIQUOR
CONTROL COMMISSION
YEAR TELEPHONE
FROM TO NAME OF EMPLOYER NAME OF SUPERVISOR
NUMBER
199 Ics iJ 014 ncnc /2cRae/ J` X - {ôz)3 - & O
e56 1972 611 -5 iedvi 0
1. 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.
al 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
eflee ,51t,.de( 03/2003 Lnee)n Ait. DUI ,3(4J
en( sn- / 031 16178 j.ncc 14 t 191/11 /st r kim 4
emt S' dgf O3 f JJ5S L;.4 ,vL Dq" is' f.- b� �
a n, r C //999 INA ,vi Q u s rt> ti 7eleji ,14;1
tam( :S'njer !2/ !3 N-W'S7 8:0 I 7X C,t.-
i r 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?
YES ONO
RECEIVED
E tVED Form 103
FUN 5 2015 RFVJAN2015
2Page 4 of 6
NEBRASKA LIQUOR
NEBRASKA LI U rP? CONTROL COMMISSION
CONTROL COMMIS t
i
,
4. List the alcohol related training and/or experience(when and where)of the person making application.
--?*NLCC Training Certificate Issued:teliatg7t.5.3 Name on Certificate: (- "nee c.,, ,C11-.7
Date
Applicant Name (rilm/YYYY) Name of program(attach copy of course completion certificate)
./. MT ill/AI( 03 2013 L46,1 .,Ak &wilt svo;“_.
nre siji_r 0 20a i;',,e. cA SAX/ /7_11/(.1 14-N" r
1 , i
*For list of NLCC Certified Training Programs see www.lcc.ne.govitraininginfo.html
Experience:
Applicant Name/Job Title Date of Name&Location of Business:
Employment:
-RECEIVED
JUN 5 2015
N-E13-R-ASKA LIQUOR
CONTROL COMMISSION
— 5. Have you enclosed Form 147 regarding fingerprints?
YES ONO
CEIV .
JUL 9, , --, Form 103
REV JAN 2015
NEBRASKA I UOOP Page 5"016
CONTROL COlvItwicoOK'
. .. -
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.
S tore of Manager Applicant Signature of Spouse
ACKNOWLEDGEMENT
State of Nebraska
County of 1,1,4Xel"f The foregoing instrument was acknowledged before me this
name ofperson acknowledged
Affix
N Public signature GENEMt N011lY4totr;of lima
CASEY M.AYLWARD
My Comm.a*,Me 8,ftOf9
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.
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1819 Farnam —Suite LC 1 fi v ''
Omaha, Nebraska 68183-0112 �W -r1 'igrq 4,1
0 141-
Buster Brown (402) 444-5550
City Clerk FAX (402) 444-5263 � "'�� 4
9TFD FEBR3-
July 28, 2015
Walgreen Co. Application to appoint Renee L. Snider
Dba"Walgreens 6936 manager of your present Package Liquor
4310 Ames Avenue License location
Omaha, NE 68111
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 August 11, 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
iv
City o Omaha, We bras a -,O� ��
1819 Farnam — Suite LC 1 zWirzi ^,z �
Omaha Nebraska 68183-0112 n 4,1 :r'�` it
Buster Brown (402) 444-5550 ,,/,,o 'y.
City Clerk FAX (402) 444-5263 o 44
9Tk'0 FEBR3�
July 14, 2015
Renee L. Snider Applications to be appointed manager of the
11920 W Beam Hill Road present 20 Package Liquor License locations
Denton,NE 68339 for Walgreen Co. (see attached list)
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 August 11, 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,
4e5A4
I* 4f d64942
Buster Brown
City Clerk
BJB;clj
WALGREEN CO 3701 NORTH 132ND STREET 68164
DBA WALGREENS #03186
WALGREEN CO 9001 BLONDO STREET 68134
DBA WALGREENS #03621
WALGREEN CO 9001 WEST CENTER ROAD 68124
DBA WALGREENS #04443
WALGREEN CO 5038 CENTER STREET 68106
DBA WALGREENS #04974
WALGREEN CO 10725 FORT STREET 68134
DBA WALGREENS #05059
WALGREEN CO 7151 CASS STREET 68132
DBA WALGREENS #05143
WALGREEN CO 2323 "L" STREET 68107
DBA WALGREENS #05190
WALGREEN CO 5062 SOUTH 155TH STREET 68137
DBA WALGREENS #05360
WALGREEN CO 3001 DODGE STREET 68131
DBA WALGREENS #05741
WALGREEN CO 2605 SOUTH 171ST STREET 68130
DBA WALGREENS #05966
WALGREEN CO 15525 SPAULDING PLAZA 68116
DBA WALGREENS #06802
WALGREEN CO 4310 AMES AVENUE 68111
DBA WALGREENS #06936
WALGREEN CO 3121 SOUTH 24TH STREET 68108
DBA WALGREENS #06962
WALGREEN CO 13155 WEST CENTER ROAD 68144
DBA WALGREENS #07272
WALGREEN CO 8989 WEST DODGE ROAD 68114
DBA WALGREENS #07563
WALGREEN CO 225 N SADDLE CREEK ROAD 68131
DBA WALGREENS #07693
WALGREEN CO 5225 NORTH 90TH STREET 68134
DBA WALGREENS #10437
WALGREEN CO 6005 NORTH 72ND STREET 68134
DBA WALGREENS #11205
WALGREEN CO 13510 Q STREET 68137
DBA WALGREENS #13137
WALGREEN CO 2929 NORTH 60TH STREET 68106
DBA WALGREENS #15327
No. 16°'
Walgreen Co., dba "Walgreens 6936", 4310
Ames Avenue, requests permission to appoint
Renee L. Snider manager of their present
Package Liquor License location
08-11-15;cj
RECEIVED
Presented to Council: /
August 1111 2015 - aba: Di:'
>L�l2,4
e D/l' c1 7AT7.E
AUG 1 8 2015 ' Prove
Buster Brown
City Clerk