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Liquor License Transfer_National Mississippi River Museum, Taste of DubuqueABD Licensing - Applicant Page 1 of 1 okcant Transfer Premise New Premise Location Information Applicant Signature Dram Cert Local Endorse - Ti tovo& State of loaa ALCOHOLIC BEVEji,S DIVISION • About • Alcohol • Tobacco • Links • Contact On- Demand Keg Registration Help License Search License List Reporting _ Search User Profile Logoff Applicant LC0037717, National Mississippi River Museum and Aquarium, 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. Name of Applicant: 'Dubuque County Historical So (Sole Proprietorship, Partnership, Corporation, 050 Name of Business (DIB /A): !National Mississippi River Museum and Aquarium Address of Premise:1400 E 3rd Street Address Line 2:1 City Dubuque County: 'Dubuque J Zip:152001 Business Phone:1.563( 557 -9545 ? Same Address Mailing Address:1350 E 3rd Street Mailing Address Line 2: City: 'Dubuque Zip: 152001 Contact Name: 'Alan Stache Phone: 1 ;563) 557 -9545 Email Address: 'astache @nvermuseum corn Prev Next Follow us with RSS, Facebook or Twitter 111® Contact Us Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road, Ankeny, IA 50021 Toll Free 866 (owaABD (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:' State:' Iowa https: / /elicensing .iowaabd.com /Applicant.aspx 07/08/2011 ABD Licensing - Transfer Premise Page 1 of 1 stn1e at loos ALCOHOLIC BEVE.RACALS DIVISION • About • Alcohol • Tobacco • Links • Contact Help License Search License List On- Demand Keg Registration User Profile Logoff Reporting _ Search Applicant T' anster Premise New Premise Location Information Applicant Signature Dram Cert Local Endorse Transfer Premise LC0037717, National Mississippi River Museum and Aquarium, 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: Dubuque County Historical Society Name of Business (DIB/A): National Mississippi River Museum and Aquarium Address of Premise: 400 E. 3rd Street Address Line 2: City: Dubuque r � ( County: Dub V /l. 52001 New Premise Address. 1501 Bell Street - City of Dubuque Festival Grounds New Premise Address Line 2: 1 City: 'Dubuque IC Temporary Transfer (24 hours through 7 days) Beginning Date: 108/06/2011 Ending Date: 108/06/2011 Beginning Date: 1 Prev Next I. Follow us with RSS Facebook or Twitter (' Permanent Transfer Contact Us J Iowa Alcoholic Beverages Division 1918 SE Hulsizer Road Ankeny IA 50021 Toll Free 866 IowaABD (866 469 2223) Local 515 281 7400 • Tenms and Conditions • Pnvary PrT y Copynght , 2009 State of Iowa Alcoholic Beverages Division All Rights Reserved State: 1 1owa Zip: 152001 https: / /eicensing. iowaabd .com /TransferPremise.aspx 07/08/2011 ABD Licensing - New Premise Location Information Page 1 of 1 Help License Search j License List On- Demand Keg Registration Reporting Search Applicant Transfer Premise New Premise Location InformaLon Applicant Signature • Dram Cert • Local Endorse New Premise Location Information LC0037717, National Mississippi River Museum and Aquarium, 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. 129 12 S\ State of Iowa ALCOHOLIC BEVENALS DIVISION • About • Alcohol • Tobacco • Links • Contact User Profile Logoff # 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: I MM /DD/YYYY To:I MM /DDIYYYY applicable): Dates shall correspond with requested outdoor service areas. On- Premise Applicant's Only: I Yes 1 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 • Privacy Policy Copyright ©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved. https: / /eicensing. iowaabd. com/ NewPremiseLocationInformation .aspx 07/08/2011 ABD Licensing - Applicant Signature Page 1 of 2 • Applicant } Transfer Premise • New Premise Location Information • Applicant Signature Dram Cert • Local Endorse State of Iowa ALCOHOLIC BEVLRA S DIVISION • About • Alcohol • Tobacco • Links • Contact Help License License ; ra On- Demand Keg Registration User Profile ; Logoff Search List Reporting Search Applicant Signature LC0037717, National Mississippi River Museum and Aquarium, 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: ITim Butler 1 t' Prev Date: 107/06/2011 MM /DD /YYYY Tentative effective date: 108/06/2011 MM /DD/YYYY Please print a copy of this page for your records before clicking the "FINISH" button. https: / /eicensing. iowaabd .com /ApplicantSignature.aspx 07/08/2011 ABD Licensing - Applicant Signature Page 2 of 2 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 • Terms and Conditions • Privacy Policy Copyright ©2009 State of Iowa Alcoholic Beverages Division. All Rights Reserved. https: / /elicensing. iowaabd .com /ApplicantSignature.aspx 07/08/2011