Liq Lic Transfer Irish FestALCOHOLIC
BEVERAGES
DIVISION
State of Iowa
TRANSFER APPLICATION
Thomas J. Vilsack Governor of Iowa
Sally J. Pederson Ueatenant Governor
LYnn M, Walding Administmto~
Licenses may be transferred from one location to another, but only within the boundaries of the current approving Zocal
Official. The Transfer Appllcadon and all supporting documentation shall be approved by the Local Official and
forwarded to the Iowa Alcoholic Beverages Division before the event takes place. All selling and serving of alcoholic
beverages must cease at the original licensed location during the period of the transfer. .NOTE: If requesting a
permanent transfer, an amended license will be forwarded to the Local Official. If requesting a temporary transfer, a
letter of permission will be forwarded to the Local Official.
License Number: L~ O0 gO S25
Address of Proposed Premise:
(Dates mustfaliwithin license period).
rtificate oJ
~nporary Transfer (24 hours th~. ough 7 days):
BeginnlngDate: ~-i~ Ending Date: OC'J~' ~1o~-I
F1 Permanent transfer (more than 7 days): Beginning Date:
Dram Shop Liability Certificate 'o, Inanranco Dates: From: ~Y~¢\ t .~_~ thru:
(Certificate dates shall correspond with requested transfer dat&s.. .~ttach copy of Dram Sh
Insuranc& Accord Certificates not accepted)
www. IowaABD.com
Iowa Alcoholic Beverages Division, 1918 SE Hulsizer Road, Ankeny, Iowa 50021 515.281.7430 866.IowagBD 866.469.2223
4. p~S~. iNFo~ATiON.
All Applicants:
4-2.
Number of bathrooms.
Number of floors where alcoholic beverages w/Il be sold, served, consumed and stored.
Pagi~ 2
4-3. Indicate how you have control of the premises (Permanem Transfers only): [] Own ~Lease
Submit signed copy of the lease/rental agreement for the license period or signed £mal sales contract or warranty deed.
4-4. Attach a sketch on8 ~½ x 11" white' paper of the proposed premises' showing' all areas and floors where alcoholic' beverages
will be sold, served, consumed and stored. Indicate all entrances and exits, location of bar, back bar and bathrooms. It
Applicam has Outdoor Service Area Privilege, please include;in the sketch its relationship to the licensed premise.
4-5. Outdoor Service Area Dates (ifapplicable): Fr~m: ()Gq.~ ~,k. To: ~ [.~ ~.
4-6. Attach original Dram Shop Endorsement. Dates shall correspond with requested outdoor service area dates. (Accord
Certificates are not accepted)
On-Premise Applicants Onl~:
4-7. [] Y [] N Is the premise fin'nished with tables and seats to accommodate a minimum of 25 persons at one time?
Off-Premise Applicants Onll~:
4-8. ~5~ i0 :(~(~0 (Class C Beer Applicants only). Square footage o£the entire retail sales area of the business, including area of
~ walk-in coolers that are accessible to the public. This includes all areas where non-alcohol products are also
sold. Do not Include areas that are not access~le to the public (offices, bathroom, kitchen, storage areas, etc.).
4-9. (Class E Liquor Applicants only). Square footage of the antire interior area of the bnllding including, but not
limited to, all areas used in the storage, distribution, warehousing, display, wholesale and retail sale of
merchandise, offices, bathrooms, break rooms, etc.
The Transfer Application shall be signed by a person listed in the Ownership Section of the original license Application.
Stamped signatures are not acceptable.
l hereby declare that af~ infoun., atio~_q,~tained in the Application is true and correct.
Applicant's Signatttref7 Date Print Applicant's Name
This document is subfect to Iowa's Open Record law. Informaaon contained in the Application may be disclosed withoutpr~or
notice to orpermtssion from the Applicant. See_ Iowa Code cbs. 22 and 123. See also 185 Iowa Administrative Code. ch. 18.
atrr oV%y. '}
I hereby cerfi~ that the Transfer Application was submitted to:
DUBUQUE CITY COUNCIL
on
~Approved [] Denied*
[] Approved [] Denied*
City Council or County Board of Supervisors
It is recommended that the Transfer be:
Outdoor Service Area (if applicable):
Date
Name of City or County Signature of City or County Official
*If the Application is denied, attach a separate sheet identifying specific reasons for the denial
Daytime Phone
FOUNDERS INSURANCE COMPANY
ENDORSEMEI~ NO 1
YOU~ POLICY IS EXTENDED TO COVER A SPECIAL EVENT O1~/: 10/12J02TO
10f13/02
MURPHY PARK
SOU'x't~ GRANDYL~W STREET
DUBUQUE, IOWA 52005
EFFECTIVE DATE: 10!1~/02 TO
10f15/02
The DECLARATIONS, ~SURI~G AGREEME~FS, D~ATIONS,
EXCLUSIONS, a~td CON]DJ.'I.'IONS Of this policy otherwise rem~ir~ unchanged.
89/09~2 09:44 LEISURE ~ERU DEPT a 5E~ 589 0890 N0.049 ~1
LEISURE SERVICES DEPARTMENT, PARK DIVISION
CITY OF DUBUQUE, IOWA
RECEIPT NO.
PAVILION RESERVATION
We have the gcented privilege to use the below mentioned place for the time specifie~, The undersigned, assume ell res~or~ibillty forth
prope~ care of f'rxtures and contents in the.piece mentioned, while assigned to said pert*~, end a~¢ees to reimburse the Dubuque Leisure
Se.trioDe Department for any and ell d~,mages to building or contents while so assigned. These SlOe~al Orivileges are grained to
undersigned pa~*ty with the undere~en~lln~ 1;h~ alt perk rules and.regulations will be .etri~l¥ obeyed, ' Ughts must be tumc-d out, and all
refuse placed in provided c~fltainm's before leavitt.
PLEASE USE REC¥CUNG CONTAINER(S) LOCATED IN EACH PARK!
NAME IRISH FESTIVAL 2002
ADDRESS
ATTN DOHN FINN ,..
DUBUQUE IA :
PEOPLE
AMlr REC'D $216,00. by3LR
'PARK .... ., MURPHY
PAVILION ENCLOSED SHELTER, 0REN__A_[_R_&_ BENNETt
RESERVATION DATE OCTOBER 11, 12 & 13 200'
TIME A:M. A.M,
P.M, P,M.
~,~_DING. ~ BY SPECIAL PERMIT
AT RIVERFRONT, LOG CABIN AND BENNETT PAVILIONS; $50.00 DEPOSIT REQUIRED.
AMPLIFIED MUSIC IS ALLOWED ONLY WITH APPROVAL OF PARK DIVISION MANAGER.
RESERVATIONS WILL SE HELD FOR ONE HOUR AFl'ER SCHEDULED ARRIVAL.
NO KEG SEER ALLOWED IN CITY PARKS EXCEPT BY, SPECIAL WRITTEN PERMIT.
ELECTRICITY AVAILABLE AT ALL PAVIUONS (15 amp ou~et$).
C] 1, OPEN AIR SHELTER
C] 2, TERRACE ROOM
I-I 3. NORTH VERANDA
FI. 4. SOUTH VERANDA:
i-1 5. INDIAN ROOM
C~ 6, BRIDGE EAST ROOM
C] 7. PROMENADE BRIDGE
[] B. LOG CABIN
[] g. SHIRAS MEMORIAL
O 10. BRIDGE ANNEX NORTH ,,
[] 11, BRIDGE ANNEX SOUTH
I-I 12. RIVER FRONT P~,VILION - INSIDE
r-I 13. RIVER FRONT PORCHES
~ 14,
[3 15.
.C) lS,
C) 17.
rn 21
[] 22;
rn 2~.
C] 24.
rq NORTH PORCH
ri SOUTH PORCH
Fl EAST PORCH
C~ WEST PORCH
EAGLE'S VIEW
TRI-STATE vIEw
BAND SHELL
JACKSON PARK
MURPHY ENCLOSED SHELTER
MURPHY OPEN AIR SHELTER
MURPHY BENNETT PAVILION
· FLORA BRICK OPEN AIR SHELTER
FLORA OPEN 'AIR SHELTER
FLORA STEEL OPEN AIR
WASHINGTON PARK GAZEBO
DUB,;, QUE, lA
...................... D_~?.Dj!p_D_ ........................................................
ItENT OF OF BEVfi,',RAG£']T~A[LER~..~ \"1~'- ,lDO