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Liquor License Transfer_Easy StreetABD Licensing - Applicant : Applicant x Transfer Premise • New Premise Location Information Applicant Signature • Dram Cert • Local Endorse County: \�1 State of loea At.COHOLIC BEV R = _ DIVISION Address Line 2: City: Dubuque Dubuque City: !Dubuque Zip: J52001 • About • Alcohol • Tobacco • Links • Contact On- Demand i Keg Registration Help License Search License List Reporting 1' Search User Profile Logoff Applicant LC0032616, Easy Street, 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: 'Easy Street, LLC (Sole Proprietorship, Partnership, Corporation, etc.) Name of Business (D /BIA): Easy Street Address of Premise: 431 Rhomberg Ave. Zip: 52001 Business Phone: (563) 556 -2409 Cell I Home Phone:' r Same Address Mailing Address: 1431 Rhomberg Ave Mailing Address Line 2:' Contact Name:'Jason Winter Phone: 1(563) 556 -2409 Email Address: I)ay bird600 @yahoo com -.2o 90 It Prev Next s; Follow us with RSS, Facebook or Twitter RIM Contact Us Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Ankeny, IA 50021 Tot 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. 36 State:) lama PPPPage 1 of 1 https:// eicensing .iowaabd.com/Applicant.aspx 03/11/2011 ABD Licensing - Transfer Premise Page 1 of 1 Help 1 License Search License List On- Demand ! Keg Registration Reporting Search Applicant ) Transfer Premise • New Premise Location Information Applicant Signature • Dram Cert > Local Endorse State al luwa ALCOHOLIC BEVLRA ,$ DIVISION • About • Alcohol • Tobacco • Links • Contact User Profile Logoff Transfer Premise LC0032616, Easy Street, 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. Name of Applicant: Name of Business (D /B /A): Address of Premise: Address Line 2: City: Prev Easy Street, LLC Easy Street 431 Rhomberg Ave. Dubuque New Premise Address: 130 main street New Premise Address Line 2: 1 City: 1 Dubuque ✓ Temporary Transfer (24 hours through 7 days) Beginning Date: 1 t: Permanent Transfer Beginning Date: 103/01/2011 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: 1 Iowa Copyright ©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved. County: Dubuque Zip: 52001 Zip: 152001 Ending Date: 1 Next 'A https://elicensing.iowaabd.com/TransferPremise.aspx 03/11/2011 aD Licensing - New Premise Location Information ! Help License Search I ( License List * Applicant • Transfer Premise T New Premise Location Information q Applicant Signature : Dram Cert • Local Endorse 13 12 Ki Prev Next li State of Iowa ALCOHOLIC BEVLRAS DIVISION On- Demand R,portin • About • Alcohol • Tobacco • Links • Contact New Premise Location Information LC0032616, Easy Street, 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: Keg Registration Search 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 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: 106/05/2011 MM /DD/YYYY To: 103/01/2011 MM /DD/YYYY applicable): Dates shall correspond with requested outdoor service areas. On- Premise Applicant's Only: (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 • Privacy Policy User Profile Copyright ©2009 State of Iowa Alcoholic Beverages Division, All Rights Reserved. Logoff Page 1 of 1 https: / /eicensing. iowaabd. com /NewPremiseLocationlnformation .aspx 03/11/2011 ABD Licensing - Applicant Signature • Help License Search • Applicant • Transfer Premise : New Premise Location Information n Applicant Signature Dram Cert 1 Local Endorse r License List Sea On- Demand Keg Search Registration User Profile I Logoff Re•ortin• JJ Prev State of Iowa ALCOHOLIC BEVFRCES DIVISION • About • Alcohol • Tobacco • Links • Contact Applicant Signature LC0032616, Easy Street, 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: (Jason Winter Date: 103/01/2011 MM /DD /YYYY Tentative effective date: 103/01/2011 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 MM /DD/YYYY Page 1 of 2 https: / /eicensing. iowaabd .com /ApplicantSignature.aspx 03/11/2011 ABD Licensing - Applicant Signature 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. Page 2 of 2 https: / /eicensing. iowaabd .com /ApplicantSignature.aspx 03/11/2011 ABD Licensing - Dram Shop Certification Page 1 of 2 • Help License Search ; s Applicant a Transfer Premise } New Premise Location Information Applicant Signature a Dram Cert s Local Endorse License List 1' On- Demand Keg Registration 1 j User Profile Logoff Reporting I Search I Dram Shop Liability Certificate of Insurance LC0032616, Easy Street, Dubuque Complete the information below and click SUBMIT to endorse this Renewal application. Reason for re- submittal: This is to certify: Illinois Casualty Co Policy Number: LL81581 Assured: Easy Street. LLC DBA: Easy Street Address: 431 Rhomberg Ave Address Line 2: City: I Dubuque Policy Effective Date: 106/06/2010 To: Thru: (- Outdoor Service Endorsement F Policy Information Verified (if incorrect please contact the licensee) Address: 130 main street Address) Line 2: City: 'Dubuque `,\\ State of Iowa ALCOHOLIC BEVLRAQS DIVISION State: Iowa E Outdoor Service Endorsement Policy Effective103 /01 /2011 Date: • About • Alcohol • Tobacco • Links • Contact POLICY INFORMATION TEMPORARY TRANSFER ENDORSEMENT MM/DD/YYYY To: f' State: I lowa Zip: I Thru: f: MM/DD/YYYY CHECK LIST Z 152001 Expiration Date: 106/05/2011 MM/DD/YYYY Expiration Date: I MM/DD/YYYY The above - mentioned policy of insurance (hereinafter policy) contains coverage to comply with the provisions of Iowa Code -.J section 123.92 and all regulations of the Iowa Department of Commerce, Alcoholic Beverages Division. The policy may be canceled by the Company of the Assured giving 30 days notice in writing to the Alcoholic Beverages Divis at its office, Ankeny, Iowa. The 30 days notice will commence from the date notice is actually received by the division. Signature: F Date: 103/01/2011 MM /DDIYYYY Follow us with RSS, Facebook or Twitter J https: / /elicensing .iowaabd.com /DramShopCert.aspx 03/11/2011 ABD Licensing - Dram Shop Certification Page 2 of 2 MEI 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. b Li https: / /elicensing .iowaabd.com /DramShopCert.aspx 03/11/2011 258TUC?BFU [1685] L C