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Liquor License Transfer_Rotary Club of Dubuque\BD Licensing - Applicant Page 1 of : State of Iowa ALCOHOLIC BEVLRAQ, DIVISION • About • Alcohol • Tobacco • Links • Contact Help 1 License Search License List On- Demand Keg Registration User Profile Logoff I Reporting j Search Applicant Transfer Premise New Premise Location Information Applicant Signature Dram Cert tcc- 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 (DIBIA):'Rotary Club of Dubuque Address of Premise: 1135 W 8th St Prev Next 't' ctfi, Address Line 2: I City:I Dubuque County: I Dubuque Zip: 152001 Business Phone: 11563) 589 -2234 r Same Address Mailing Address: IP 0 Box 613 Mailing Address Line 2: I City: 'Dubuque Zip: 1.52004081 Contact Name: (Mike Loveless Phone:1(563) 584 -9235 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 Condit■ons • Fnvacy Policy Copyright ©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved Cell / Home Phone: I State: I Iowa Email Address: Irnloveless)love!essins corn i,-(, ' ��n �. v..✓I '``' I L /. L . , , ` 1 r 1 „ �� k-2 . . r.),< J �� ittps: / /elicensing .iowaabd.com /Applicant.aspx 09/10/201( \BD Licensing - Transfer Premise Page 1 of State of Iowa ALCOHOLIC BEVLRA ,S DIVISION • About • Alcohol • Tobacco • Links • Contact j On- Demand : Keg Registration Help License Search License List User Profile Logoff , Reee _porting Search :. Applicant ' Transfer Premise New Premise Location Information Applicant Signature Dram Cert I f)! al Ei.dars Transfer Premise BW0092633, Rotary Club of Dubuque, Dubuque After completion click on the NEXT Zink 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. Name of Applicant: Name of Business (D /B /A): Address of Premise: Address Line 2: City: Prev Rotary Club of Dubuque Rotary Club of Dubuque 135 W. 8th St. Dubuque New Premise Address: 1600 Century Drive New Premise Address Line 2: !Kruse Warthan City: I Dubuque J State: Iowa a Temporary Transfer (24 hours through 7 days) Beginning Date: 110/16/2010 (' 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 lowaABD (866.469 2223) Local 515 281 7400 • Terrns and Conditions • Privacy Policy Copyright ©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved County: Dubuque Zip: 52001 =1 Zip: 152001 Ending Date: 110/17/2010 Next ittps: / /eicensing. iowaabd .com /TransferPremise.aspx 09/10/201( \BD Licensing - New Premise Location Information Page 1 of Applicant Transfer Premise New Premise Location Information Applicant Signature Dram Cert Local Endorse 12 I1 State of Iowa ALCOHOL IC BEVLRA S DIVISION • About • Alcohol • Tobacco • Links • Contact — On-Demand .. ._� On- Demand q. Keg Registration Help License Search License List ! { User Profile Logoff Reporting , Search 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): C Own ( 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:110/17/2010 MM /DD/YYYY To:110/16/2010 MM /DD/YYYY applicable): Dates shall correspond with requested outdoor service areas. On- Premise Applicant's Only: I Yes J Is the premise furnished with tables and seats to accomodate a minimum of 25 persons at one time? 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 tttps: / /eicensing. iowaabd. com/ NewPremiseLocationlnformation .aspx 09/10/201( 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 09/10/2011 kBD Licensing - Applicant Signature Page 1 of • Help License Search Applicant Transfer Premise New Premise Location Information • Local Endorse License List Prev State of Iowa ALCOHOLIC BEVLRAU DIVISION On- Demand Reporting Tentative effective date: 110/16/2010 Follow us with RSS, Facebook or Twitter • About • Alcohol • Tobacco • Links • Contact Contact Us Keg Registration I Search Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Ankeny, IA 50021 Toll Free 866.IowaABD (866.469.2223) User Profile Logoff Applicant Signature BW0092633, Rotary Club of Dubuque, Dubuque • Applicant Signature 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 • Dram Cert 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: 108/22/2010 MM /DD /YYYY Please print a copy of this page for your records before clicking the "FINISH" button. ittps: / /elicensing.iowaabd .com/ApplicantSignature.aspx 09/10/201( BBD Licensing - Applicant Signature Page 2 of : 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 09/10/201(