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APPLICATION FOR CATERING <br /> ENDORSEMENT TO LICENSE <br /> IMIM RECEIVED <br /> NEBRASKA LIQUOR CONTROL COMMISSION <br /> 301 CENTENNIAL MALL SOUTH : i 2 8 2018 <br /> PO BOX 95046 License v , t; t;i <br /> PHONE 402)47 09-046 Class: K ''LNTROL -FAX:(402)471-2814 License COMMISSION <br /> website:www.lcc.nebraska.eov Number: <br /> • Application fee$100.00,refundable if application is denied§53- • The holder of a catering license may deliver, sell, or dispense <br /> 124.12(2b); alcoholic liquoubeer for consumption at events that hold n <br /> • Check needs to be made payable to the Nebraska Liquor Control Special Designated License (SDI.) issued pursuant to section <br /> Commission or you may pay online at: §53-124.11; <br /> www.ne.gov/go/NLCCpayport; • SDL must be received 10-working days prior to the date of each <br /> • Processing time is approx. 45-60 days from receipt of event. This count does not include weekends,holidays or the <br /> application by the Nebraska Liquor Control Commission; date of the event-Please check the SDL calendar for due date; <br /> • Per Neb. Rev. Stat. §53-134(7),a copy of this application will • Only twelve (12) SDLs will be issued at any one specific <br /> be forwarded to your local governing body for recommendation. location that could otherwise hold a liquor license. Rules and <br /> After approval by the local governing body, there is a 10-day Regulations Chapter 2-013.06. This (12) count includes all <br /> holding period by the NLCC for citizen protest; license holders that would go to this particular location. It is not <br /> • Annual Renewal Fee of S100 is payable when renewing primary (12)licenses per caterer. <br /> liquor license§53-124.12(1); <br /> LICENSEE <br /> C` (�al��f` tgnattre of AUTWORIZED LICENSEE REPRESENTIVE <br /> (Do not sign until in the presence of the Notary Public) <br /> TRADE NAME <br /> >'�iCketel c,4n, Gw;ecA <br /> -O hhes VI e w Go G Printed Name of AUTHORIZED LICENSEE REPRESENTIVE <br /> PREMISES ADDRESS <br /> 2 Z l4 So�.lam 1� 54 ` ^d ' State of Nebraska,County of <br /> CITY ZIP/CODE The foregoing instrument was acknowledged before me this: <br /> GrCOLI d. %Li\I Pe- cool lel 20 i8 <br /> J (Date) I� <br /> CONTACT PERSON By: /"l ( QLIShetuIZ. LOr e_ck. <br /> f7,l ` ec,e Name of person signing document in front of Notary <br /> /C/a-e_/ <br /> PHONE NUMBER r S ......., '" tutu <br /> Notary Public ignature <br /> 3e t -3 dp— 700 <br /> �SGENE MI NOTARY•State of PORTER 1 <br /> EMAIL MICHELLE R.PORTER <br /> Me Cora&pipAilieb 21,2021 <br /> 1J;ecks-croye 6,,a , 1.Loxi <br /> PAYMENT TYPE lL ��/o�1/ _ I I AMOUNT: ____ BAP Jill, iJ.1JiiJJJ r1� I 1 4 10 <br /> ///�p / in 1 0,i ;1765 10,17 <br /> Rd.(4 &7 / &/f Received: / f 1�- t ,17 <br /> r <br />