Loading...
Liquor License Transfer_Camp Albrecht Acres, OctoberfestkBD Licensing - Transfer Premise Page 1 of : Help License Search a Applicant Transfer Premise a New Premise Location Information Applicant Signature 3 Dram Cert s Local Endorse License List On- Demand Reporting Keg Registration Search Mps://elicensing.iowaabd.com/TransferPremise.aspx State of Iowa ALCOHOLIC BEVLRA $ DIVISION • About • Alcohol • Tobacco • Links • Contact User Profile Logoff Transfer Premise BW0093469, Camp Albrecht Acres of the Midwest, Dubuque After completion click on the NEXT link to continue to the next screen, or the BACK Zink 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. New Premise Address Line 2: 1 �t Prev Name of Applicant: Name of Business (D /B /A): Address of Premise: Address Line 2: City: Camp Albrecht Acres of the Midwest Camp Albrecht Acres of the Midwest patio and grassy area located between 350 and 400 E. 3rd Str Dubuque New Premise Address: 1405 Main Street City: 1 Dubuque State: 'Iowa Temporary Transfer (24 hours through 7 days) Beginning Date: 109/18/2010 t"` Permanent Transfer Contact Us • Terms and Conditions • Privacy Policy Beginning Date: 1 Follow us with RSS, Facebook or Twitter Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Ankeny, IA 50021 Toll Free 866.IowaABD (866.469.2223) Local 515.281.7400 Copyright©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved. County: Dubuque Zip: 52001 Zip: 52001 Ending Date: 109/19/2010 Next ls] 09/07/201( kBD Licensing - New Premise Location Information Page 1 of <' Help License Search A. Applicant • Transfer Premise 3 New Premise Location Information ' Applicant Signature • Dram Cert • Local Endorse License List State of Iowa ALCOHOLIC BLVERAQS DIVISION On- Demand Reporting • About • Alcohol • Tobacco • Links • Contact Keg Registration Search User Profile Logoff New Premise Location Information BW0093469, Camp Albrecht Acres of the Midwest, 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. 6 i # of Bathrooms: 1 Number of floors where alcoholic beverages will be sold, served, consumed 1 - - - I and stored. Indicate how you have control of premises (Permanent Transfers Only): ( Own C 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:l , MM /DD/YYYY To:l applicable): Dates shall correspond with requested outdoor service areas. On- Premise Applicant's Only: I Yes Is the premise furnished with tables and seats to accomodate a minimum of 25 persons at one time? Q Prev Next 0 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 I MM /DD/YYYY ittps: / /eicensing. iowaabd. com /NewPremiseLocationInformation .aspx 09/07/201( kBD Licensing - Applicant Page 1 of : Help License Search • Applicant • Transfer Premise • New Premise Location Information I. Applicant Signature s Dram Cert z Local Endorse License List On- Demand Reporting State of Iowa ALCOHOLIC BEVLRAQS DIVISION Keg Registration Search • About • Alcohol • Tobacco • Links • Contact User Profile Applicant BW0093469, Camp Albrecht Acres of the Midwest, 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: 'Camp Albrecht Acres of the M (Sole Proprietorship, Partnership, Corporation, etc.) - - -- - -- - - - - -- Name of Business (D /B /A):'Camp Albrecht Acres of the Midwest Address of Premise: 'patio and grassy area located between 350 and 400 E. 3rd Str Address Line 2:1 City:1 Dubuque County: Dubuque 1 - Zip: 152001 Business Phone:1(563) 552 -1771 C Same Address Mailing Address:114837 Sherrill Road Mailing Address Line 2:1 City: 'Sherrill Zip:152073 Contact Name: 'Terry Mozena Logoff Phone: 1(563) 542 -2866 Email Address:'tmozena @mchsi.com Prev Next 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 Copyright ©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved. Cell / Home Phone:1(563) 542 -2866 State:) Iowa ittps:// elicensing .iowaabd.com /Applicant.aspx 09/07/201( \BD Licensing - Applicant Signature Page 1 of Help License Search • Applicant • Transfer Premise 1. New Premise Location Information s Applicant Signature } Dram Cert 2- Local Endorse License List Kt Prev State of Iowa ALCOHOLIC BEVLR4$ DIVISION On- Demand Reporting • About • Alcohol • Tobacco • Links • Contact Keg Registration Search Applicant Signature BW0093469, Camp Albrecht Acres of the Midwest, 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: Terry Mozena MM /DD/YYYY Date: 109 /02/2010 Tentative effective date: 109/18/2010 Please print a copy of this page for your records before clicking the "FINISH" button. .!!nn 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) User Profile Logoff MM /DD/YYYY lttps: / /elicensing.iowaabd .com/ApplicantSignature.aspx 09/07/201( \BD Licensing - Local Authority Endorsement Help License Search i Applicant • Transfer Premise ' New Premise Location Information x Applicant Signature s Dram Cert 3 . Local Endorse License List On- Demand Reporting License has been endorsed. State oI Iowa ALCOHOLIC BEVLRAU,S DIVISION Keg Registration Search • About • Alcohol • Tobacco • Links • Contact User Profile Local Authority Endorsement BW0093469, Camp Albrecht Acres of the Midwest, Dubuque Complete the information below and click SUBMIT to endorse the Transfer. Local Authority: Daytime Phone for Local Authority: ( License Approved r License Denied Reason For Denial: LICENSE INFORMATION City of Dubuque 1(563) 589 -4122 Effective Date: 09/1 8/2010 Expiration Date: 09/ 1 Fire inspection completed: Health inspection completed Yes t No C Yes (? No r CHECK LIST COMMENTS Signature: r Date: 09/09/2010 ; MMIDD/YYYY 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 e Privacy Policy Logoff Copyright ©2009 State of Iowa Alcoholic Beverages Division. At Rights Reserved. Page 1 of ittps: / /eicensing. iowaabd .com /LocalAuthEndorse.aspx 09/09/201(