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Liquor License Transfer of Services_Rotary Club of Dubuque\BD Licensing - Applicant Applicant Transfer Premise > New Premise Location Information > Applicant Signature a Dram Cert • Local Endorse State of Iowa ALCOHOLIC BEVLRA S DIVISION • About • Alcohol • Tobacco • Links • Contact Help License Search ; License List OReportn- Demand ing Keg Reglstration Search User Profile I Logoff ; Applicant BW0092633, Rotary Club of Dubuque, Dubuque After completion click on the NEXT link to continue to the next screen, or the BACK link to return to the previous screen. The navigation links on the top may also be used to move around the application. Name of Applicant: 'Rotary Club of Dubuque (Sole Proprietorship, Partnership, Corporation, etc.) Name of Business (D /B /A): (Rotary Club of Dubuque Address of Premise: 1135 W 8th St. Address Line 2: I City:( Dubuque County: Dubuque j Zip: 152001 Business Phone: 1(563) 589 -2234 Mailing Address: IP 0 Box 813 Mailing Address Line 2: I City: (Dubuque Zip: (52004081 r Same Address Contact Name: 'Mike Loveless Phone:1(563) 584 -9235 Follow us with RSS, Facebook or Twitter • h1 Contact Us Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Ankeny, IA 50021 Toll Free 866.IowaABD (866.469 2223) Local 515.281.7400 • Terms and Conditions • Privacy Policy Copyright 02009 State of Iowa Alcoholic Beverages Division. All Rights Reserved Cell/Home Phone: I State: I Iowa Page 1 of Email Address: (mloveless @lovelessins com ■L Prev Next '3 ittps: / /elicensing .iowaabd.com /Applicant.aspx 05/07/201( \BD Licensing - Transfer Premise Page 1 of " s Applicant • Transfer Premise T New Premise Location Information s Applicant Signature s Dram Cert • Local Endorse Name of Applicant: Name of Business (D /B /A): Address of Premise: Address Line 2: City: New Premise Address Line 2: 1 Prev State of Iowa ALCOHOLIC BEVLRAcaLS DIVISION Dubuque City: 'Dubuque • About • Alcohol • Tobacco • Links • Contact On- Demand Keg Registration Help License Search . License List L Rep Search 1 User Profile Logoff Transfer Premise BW0092633, Rotary Club of Dubuque, Dubuque After completion click on the NEXT link to continue to the next screen, or the BACK link to return to the previous screen. The navigation links on the top may also be used to move around the application. Licenses may be transferred from one location to another, but only within the boundaries of the current approving Local Official.The Transfer Application 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. Rotary Club of Dubuque Rotary Club of Dubuque 135 W. 8th St. New Premise Address: 1A.Y. McDonald Park, Dubuque, IA 52001 (: Temporary Transfer (24 hours through 7 days) Beginning Date: 106/09/2010 ✓ Permanent Transfer Beginning Date: 1 Follow us with RSS, Facebook or Twitter Contact Us Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Ankeny, IA 50021 Toll Free 866.IowaABD (866.469.2223) Local 515.281.7400 • Terms and Conditions • Privacy Policy State: I Iowa Copyright ©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved County: Dubuque Zip: 52001 Zip: 152001 4/ Ending Date: 106/10/2010 Next )ttps: / /elicensing. iowaabd.com /TransferPremise.aspx 05/07/201( \BD Licensing - New Premise Location Information Page 1 of Help License Search • Applicant 1. Transfer Premise s New Premise Location Information } Applicant Signature • Dram Cert • Local Endorse License List -1 On- Demand Li Reporting 14 State at Iowa ALCOHOLIC BEVLRA a S DIVISION tJ Prev Next 1}3 • About • Alcohol • Tobacco • Links • Contact Keg Registration Search User Profile Logoff New Premise Location Information BW0092633, Rotary Club of Dubuque, Dubuque After completion click on the NEXT link to continue to the next screen, or the BACK link to return to the previous screen. The navigation links on the top may also be used to move around the application. # of Bathrooms: Number of floors where alcoholic beverages will be sold, served, consumed and stored. Indicate how you have control of premises (Permanent Transfers Only): ✓ Own f Lease Submit to the Local Authority a signed copy of the lease /rental agreement for the license period or signed final sales contract or warranty deed. Submit to the Local Authority a sketch on 81/2 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. If Applicant has Outdoor Service Area Privilege, please include in the sketch its relationship to the licensed premises. Outdoor Service Area Dates (if From:l06 /10/2010 MM /DD /YYYY To:106/09/2010 MMIDD/YYYY applicable): Dates shall correspond with requested outdoor service areas. On- Premise Applicant's Only: z I Yes Is the premise furnished with tables and seats to accomodate a minimum of 25 persons at one time? Follow us with RSS, Facebook or Twitter Contact Us Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Ankeny, IA 50021 Toll Free 866.IowaABD (866.469.2223) Local 515.281.7400 • Terms and Conditions ittps: / /eicensing. iowaabd. com /NewPremiseLocationlnformation .aspx 05/07/201( BBD Licensing - New Premise Location Information Page 2 of • Privacy Policy Copyright ©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved. ittps: / /eicensing. iowaabd. com /NewPremiseLocationlnformation .aspx 05/07/2011 \BD Licensing - Applicant Signature Page 1 of Help • License Search License List 7. Applicant s Transfer Premise 7 New Premise Location Information a Applicant Signature 7' Dram Cert Local Endorse Prev State of lo'wa ALCOHOLIC BEVLRAU DIVISION • About • Alcohol • Tobacco • Links • Contact On- Demand Reporting Keg Registration Search User Profile Applicant Signature BW0092633, Rotary Club of Dubuque, Dubuque Complete the information below and click Finish to complete the application Note that the license fees will only be withdrawn from accounts after the ABD approves the license. This application must be completed by a person listed in the Ownership Section. I hereby declare that all information contained in the Application is true and correct. I understand that misrepresentation of material facts in the Application is a crime and grounds for denial of the license or permit under Iowa law. I further understand that, as a condition of receiving a license, the licensed premises is subject to inspection during business hours by appropriate local, state and federal officials. NOTE: The Applicant's Name must match one of the owner's names from the Ownership screen. Applicant's Name: 'Amy Weber MM /DD/YYYY Date: 104/14/2010 Tentative effective date: 106 /09/2010 Please print a copy of this page for your records before clicking the "FINISH" button. Follow us with RSS, Facebook or Twitter Contact Us Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Ankeny, IA 50021 Logoff MM /DD/YYYY ittps: / /eicensing. iowaabd .com /ApplicantSignature.aspx 05/07/201( kBD Licensing - Applicant Signature Page 2 of Toll Free 866.lowaABD (866.469.2223) Local 515.281.7400 • Terms and Conditions • Privacy Policy Copyright ©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved. ittps: / /eicensing. iowaabd .com /ApplicantSignature.aspx 05/07/2011