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HomeMy WebLinkAbout(0074) AA-19-003 Application.pdfBequest to the City Council for ALCOHOL DISTANCE APPEAL APPLICATION (Please Print or Type) Name of LITTLE GERMANY RESTAURANT Location6737 CAMP BOWIE BLVD FORT WORTH TX 76116 F;atabi)ihment Legal Description RIDGLEA HILLS ADDITION 131tae N 6 LoVTr A -A 0waeroffistshlisbment MANUEL BENJAMIN GONZALEZ O,raerSignature � Owner Address 3720 MARK PLACE Cite FOR WORTH Zip 76116 Owner Fftone No 817-730-3883 7�a.iab �0 817799.979676 Entail melisaa.soliS1212 a@gmail.com Name ofSeboolorCbwvh <>mo n pion fttrom the estahiishn tat RICHARD MILBURN ACADEMY -'FORT WORTH Has the Scbool, Cbureb, ete. been contacted or do you know of any opposition to this request' VeSX Non Is Alcohol ("oltsumlitiow C)N PRF MISE:'X or OFF PREMISE 0 Type orTARC Llcenws) . BEER & WINE LICENSE - BG776538 FAMILY STYLE RESTAURANT 235 FT 1300 FT CrERMAN FOOD Type of Sttbxck titeasitrrzitiat l Uistanse Rcgnested 31 6giidit+g kawY Yr,sjQ Nsy] 1 Baildistttttvtierltt tsrnnaieNATIONAL RETAIL PROPERTIES LP LcssarSigtiatnre LiIiarAddres3 .450 S ORANGE AVE SUITE 900 _ANO, _32801y p t esutrs etraae No. 407-660-3685 2.. Ph No �€meil ingrid. irvin@nnnreit.eom Appbeaut Namc fit oilier than Owner) N/A Applksol Address .N/A City NIA ........�.__ .�_� dip Applicant Phone No.. NIA _ 2'd Ph Na Eronil NIA ALCOUOL DISTANCE APPEAL PROCESS & 'REQUllil iv EN'T& Q lloilding iaspector, lKert MrGowea (617-392-7834),.Rejcvion Letter and Nteasurcments required PRtbk TO 51'13,'t4rl-FING. Processing time is approximately 8 peels, and the, request wilt be heard at the appropriate City Councimearitor, fiearingr art htlel at Pity halt on Tuesdays. and the applicant is rrgnircd to be prssent. rJ SummeryAf hard3bip antllor:rca3on for requesting a DISTANCE APPLAL is recommended. Staff to provide Early Notifications to surrounding 110A's: Schools. etc., within a ., mile buffer ofsubjetr property. 0 StalTwill notify all property owner, neighbors, within a 30W bulier of subject property. {You may contact Coundl Members prior to the.Lev ing to see if lhe} approve or have received opposition for you rcase at h tlyttiurt,vortbteuas:ein•.) •� The "Speaker Request" form mum be turned in no laic than IS minutes prior to tbt: start ofthem" ting To register to speak before the meeting, visit c(wocil agerald. ; . ca11817-3a12 5130, tar rax 8) 7-392-bl%, )*3 �aiicstsratt F2� I{rce:tts�t Late jtenring 13�re' Ca.Fe 4 t bde 134 .StNi0.08 By: L Y AA 17-_ City. of:Fort Worthi,* etas, Municipal Building, 200 T-0as Strect. Eort'4t°orth, TX, 76102 Planning & Development Department $17-392-2733 * 817392-8190 * Si-1-39I-M26 12-11147 RMATEXAS PUI3U t,C;i;c)'3[_S 6785 Camp Bowie Blvd. Fort Worth, TX 76116 Richard Milburn Academy (817) 731-7627 8/19/19 To Whom It May Concern: Richard Milburn Academy does not believe the business, Little Germany, at the old Dennys location, will have a negative effect to this campus by selling alcohol on their premises. We look forward to having another good restaurant on Camp Bowie Boulevard, Regards, Susan Richey M.Ed., LPC Principal Richard Milburn Academy — Fort Worth 6785 Camp Bowie Blvd. Suite 200 Fort Worth, TX 76116 P: 817-731-7627 ORT V�ORTH CITY OF FORT WORTH,TEXAS ALCOHOL PERMIT LOCATION VERIFICATION INSTRUCTIONS: Applicant is to complete all requested information down to the double line and also attach a copy of the completed T.A. B.C. application form. Name of Applicant:_ � 'LW II Name of Business: '(TT Application Address: Legal Description of Property: Is there or has been a T.A.B.C. license on the property by#e? Yes If Yes, when does it or did It expire? �G/ Phone: �V(q - -�l--0--)- c1I Kq- In addition to the sale of alcoholic beverages, please provide an accurate statement of all other business or entertainment activities to be conducted at the application address: f j TICE: Approval of the processing.form does not imply that the location/building is in compliance with all applicable ordinances. This form is only for distance check and zoning use. Consult with the Department of Development, lower level of City Hall, regarding all other requirements before investing any time or money. FOR CITY USE ON Y wf r(#rXrRXfwfirfHX#.....#ififaf*+Y+AX+fX+#tfrtRrwttttrMNr#+ Date Received: `� Mapso No.:-hy Council District: Zoning on the pr party: V Is the location 97c,�ri J�/� )'®/ ���Olu� within 300' of a Church? Yes o Public school? Yes VNo _ Public hospital? Yes Noi Private school? Yes .� Nu-X If Yes give address and date the use was established Is the location within 1 000'feet of a private school protected by resolution? Yes— Nox Comments: BUILDING INSPECTORS CERTIFICATION 1 hereby certify that I have personally inspected the property described above and'my comments are: 1. The use as described by the apant Is allowed in this zoning( Yes` (by right; by legal nonconforming_) No — Yes Yes No _./ Yes_No�( 2. The locatio is within 300' of a church, public school or public hospital? 3. This location is within 1,000' of a private school protected by resolution? 4a. If the zoning allows this use and the distance check complies, check the Yes box to the right and continue processing. b. If zoning does not allow this use, check the No box, clear the paperwork and stop he processing. c. If the zoning allows this use but the distance does not comply, check the No box, clear the paperwork, and forward to the Director for review. Verified by: Signature and Printed Name) Director's Comments: OK to issue Yes to No Z Date!. S-:5A f• OK to issue: Yes Q No ❑ Director's Signature: Date: (This approval not needed if the above box is marked YES) #w#if#*:#+fXX#t#'txff fif**fiXYwfX4Mf*fi+Yfwi#iR##fkff Rki#if+ii*}#Rfwwfiff}wY#i}}f�fv#aw tf}*4 i�4f*y+f#fiwfwf#ilk}w+#ir}X}f#+YXXi}yi}##}iAX#+Xa 4Xt#iYXY#Xw�* T&B.C. application processed by: Clerk, City Secretary pX Rev 8/02 �z I P4�! Prib) S -a d ,QL FORTWORTHO., Alcohol Distance Check Not a valid permit until status is ISSUED Permit: AD19-00155 j Status: Pending Permit Technician: Address: 6737 CAMP BOWIE BLVD Legal Description: RIDGLEA HILLS ADDITION Block 6 LotAA. Mapsco: 74N Insp District: 21 Description of Work: ADC Proj/Business Name: LITTLE GERMANY RESTAURANT Application Date: Date Issued: Council District: 3 Zoning: CB -GC Applicant: JAIME VIELMA, Property Owner: EYM DINER OF DFW LLC 450 E JOHN CARPENTER FWY STE 1 IRVING„ TX 75062 Alcohol Distance Check 1 $50,00 Total Fee $50.00 Balance $0.00 Non Conforming Use: Approved By: I hereby affirm that the information contained herein is true and correct to the best of my knowledge, and agree to conform to all regulations of the City of Fort Worth as described in the Fort Worth Municipal Code. I understand that failure to comply with these provisions may result in the revocation of this permit. Signed: Sexually Oriented Business (Initials) Yes No Date: Local permit or license fees may apply to a business that sells alcoholic beverages in the City of Fort Worth. Please check with the Revenue and Collections Division of Financial Management Services to inquire about applicable fees. Signed: Date: TO SCHEDULE INSPECTIONS CALL (817) 392-6370 FF NT- -. E.,I Eft i'r_ CAW dpyll� yy�SS CAMP Bowl, ems" 6800 Fi FTI LL: OverlaoMrict 6733 6717 1 a 67" C 037 EFiUJARE COMMUt FITNE'* TEAM FO. 9]UTH PARK SU 67n STEWAI 6717 ITP LK RWER This product is for informational purposes and may not have been prepared fororbe 0.0 0 0.01 0.0 Miles suitable for legal, engineering, or surveying purposes. The City of Fort Worth assumes no responsibgity for the accuracy of said data. NCTCOG ORTHOPHOTOGRAPHY LeL,end Zoning Outline Overlay Districts ❑ <Null> 21047 ® AO APZ1 APZ 2 CIRCLE PARK ■ Cz DOWNTOWN URBAN ■ I-35W CPMRAL I-35W NORTH I-35W SOUTH TCU I TUP1 TUP2 TUP 3 TUP 4 TUP 5 TUP 6 ■ TUP7 PARCELS Lots Council Districts 02 F1 3 4 ❑5 I] 6 ❑ 7 0 S Ug — Arterials _ Freeways Streets — Tarrant County Streets Parks Lakes 0 City Limit 0 Extraterritorial Jurisdiction (ETJ) FORT WORTH® 8/2119 8:55 AM 1: 729 �r- �� TEWALCOHOL[C _ BEVERAGE COMMISSION ON -PREMISE PREQUALIFICATION PACKET L-ON (12/2017) i,bn3I�es3 I.- lst t s propectyiH r1't1goF;>orvn/; i e,Ifa;1Ir y6xt� Iurb:,-ilatI+ fsr�8rg .ef, umc6�d f' tsbn'i'ct.1mt t�.S.f'iil erl fi t3oiI ,R.. �.crO tst ecy, sea1r ` 9II ;o l youare preuitl b Sencton701r 3t�#t7ot;bn+w 11 tr41rm)a;G{.2i}l1s;3IqIe', wCpSo`,o"rh. h1.a1Q ,eial:rs1` lg.l,c3�ry !',{ tarv�7C6rpNtt''1e,4i :t ep +rimlu_:nla Wlrul9nrrr;e!o 7�'4r�a£ te.II,ei::Ilfduaf,'i, , I„i:flr a l '1#'1.yhsrt.'lle!q sleiI,ir,+r�3�+J , ruAa _rp - lay.o.iuc;oic.ilk yp�n' oedafi: u{IrI re .ti''yg;hontTpt�r,Ao.:;o::r,;,B oce rfntoye* 381 utoar. Geit y1T!nrkhr�atr; pti.hCIro' a`itnt e(`c'A ua a #I sill n ,dm'a! All sfa utory and rule �eferencesi f enf oned 16A. is applicationlGrefer to and' cap,bg found rn the Alcohot�c Beverage :' ,Texas I r d I, rl 5 i CI „ ..y ( I �,, F' �,I Code or Rules located :orb our, ►ieksit www fa6c'texals govl/aWs/code antl;l mites asp ,,,.. � . , , 3 � � r " _ x. , P ` L u '� f -i�5, rs- $^'�#i 1 f•rfMd+vi .5=a,c, . `� a,; .., 1. Application for: ❑ Original ❑ Add Late Hours Only License/Permit Number ❑ Reinstatement License/Permit Number Change of Licensed Location License/Permit Number 2. Type of On -Premise License/Permit E BG Wine and Beer Retailer's Permit ❑ LB Mixed Beverage Late Hours Permit ❑ BE Beer Retail Dealer's On -Premise License ❑ MI Minibar Permit ❑ BL Retail Dealer's On -Premise Late Hours License ❑ CB Caterer's Permit ❑ BP Brewpub License ❑ FB Food and Beverage Certificate ❑ V Wine & Beer Retailer's Permit for Excursion Boats ❑ PE Beverage Cartage Permit ❑ Y Wine & Beer Retailer's Permit for Railway Dining Car ❑ RM Mixed Beverage Restaurant Permit with FB ❑ MB Mixed Beverage Permit ❑ O Private Carrier's Permit — For Brewpubs (BP) with a BG only 3. Indicate Primary Business at this Location Pil Restaurant ❑ Sporting Arena, Civic Center, Hotel ❑ Bar ❑ Grocery/Market ❑ Sexually Oriented ❑ Miscellaneous 4. Trade Name of Location — LITTLE GERMANY RESTAURANT 5. Location Address 6737 CAMP BOWIE BLVD City County State Zip Code FORT WORTH TARRANT TX 76116 6. Mailing Address City State Zip Code 6737 CAMP BOWIE BLVD FORT WORTH TX 76116 7. Business Phone No. Alternate Phone No. E-mail Address 682-224-2601 817-909-9676 melissa.solis1212@gmail.com 8. Type of Owner Fn] Individual ❑ Corporation ❑ City/County/University ❑ Partnership ❑ Limited Liability Company ❑ Other ❑ Limited Partnership ❑ Joint Venture ❑ Limited Liability Partnership❑ Trust 9. Business Owner/Applicant MANUEL BENJAMIN GONZALEZ / LITTLE GERMANY RESTAURANT 10. Are you, the applicant a veteran -owned business? 0 Yes No 11. Are you, the applicant a Historically Underutilized Business (HUB)? ©Yes (�)No Page 1 of 5 Form L-ON (12/2017) r1s=1ndicated on per ito}yQUrbsineslypey i ,thermdlv r r i' 1 I> a , `a '; '' " �}aO#ich Milll 'r� , Arii`rl,s � iteALabiht, , y Partnership/Ail,Pai#nrs,F_Nenturers„r'rv,; 1 r ,'. r L�rnrtedpartpershi Generai Partners „,.,. ��11I r , �[ tT'{::,1 t K47t,• Trust/ r{ r , Al f' tus#ee{sj :1 C P,r Corporation/All,Offiaers�� �, � �, i 9i I ry ;Ctiy�' County rst r/f3f coal r 1 , ,r l , '' I'� - , ,�. , 'J- .!. ,. ..!. a r, ,.,.I _, 40a .. r, �,�, 1.. .hi„_, Last Name First Name MI Title GONZALEZ �MANUEL B OWNER Last Name I First Name MI Title Last Name First Name MI Title t 13. Willyourbusiness be located within 300 feet of a church or public hospital?oYes @No NOTE 'For churc es o :r ub �chos itals:imeas ..'„,,�I.,Itl , t �t;: ,,.,, .. I.; �,,,{=�,, � ����,�a��t reFfro'front oor to fnonti'doori�a/on #hey �hc.. P.a, .,, ,.a :�I ,n �,, .r ro e the streetfronts ' ' ,., ..k ,1J1 Fr .. a:h,iE{>k ,1.!"tiW 7df F� ... 1..:. rt 1 'll j� ' �:i ., l{ 1, a -.,1 ntlln a,tl�reC I 'Id;11 ',i,. t +F # 4 I, n, 41 tf.... (' I !r .hl�rres''of ,r r"' Ru f :�5 ,lin®I`acrbss-'intersections c , „-n , 1. "i, I,I'. ,,, ,.:, I n i'fi ,I '1, Will your business be located within 300 feet of any private/public school, day care center or child care 14. facility? OYes @ No If "YES," are the facilities located on different floors or stories of the building?Yes 0 No r,:p'. ,4' �rii l4i a;l ,+,1,1h` ,h �' NOTE. "rivate! Ubli sch'oo/ +'da "care i oenters 'and ,'c ild l' �r' "rey°' aril' ies `rrrea'sure in, a `direct iin+die, nearest:,' s, Yni ,!'For ,.; n p ? prr ,i li ;c�,��,, lhir j ,, !} , „U ).rli{} i' ua ar,.,,io-.: Cy�,tt,,al.� ri �., : dfi .e,.. 1 ,.r j.. { !clay,) care6 or,ch�ldt fao�lgyr prop®dy I�r�e of the, place of r, r prope[tyylrne ;ofIther,schgoi, center, rrare� nearest a' �++, :ck1••; ,+ I .a'y„:'r . r„i r�l,'lh�r,i; !I , ! , -.,I P ,1;u r.f,.i 11 I, Ji'#..fr k h 9d .� 1c3�+••., `?14. 4. ! r t A�;;i� 1d' 1 t ,1.1},.;t(, 1 a l;:'{Is ? ,I 1 i„ 1 a,directlir a across intersections l 4 u ,1, i , *ry,,rrll a.!e ,.,dl,:� I . ,ip t:N ti { m. )'.,I 111 ��'�:�i!'� , �h'f }'Y. , i2 ,cZ L�Ij 1 t I (.Itr ,h I}i t,l;(,dIF Ifl] ri :J�1�i i ' s st'` ew�ihrrt!QO;a;'ata°care''c nferorlii�carofac�! as/on' „bs; NOTE F r mu flstory budding bus tie e y f ff y` r :{, , . Fi ,.. tl it 'li„ {, h; hl:p7,1 , I„ u�l,,"{ "i ,,.,' ,_+:a,il.r�� , .,.;-1 11 a,r,.+ t t,��Y;, I' ilh,'Ik� r,14k i;ynl u,'1?,'{ s 11 r,{a t�l 'll �9, ,.1'i �54 v,{ !{'�',>:, Ra't,, 9 d ({ I+ „ , ;the factl�t�es are lbcated, oR {difterenfloor�,fgfthe,b, ring', 77s , ,� , , ; r'r, } (t S �t i{1JP I,, h. ,I't:ry{t�,It�i. it ,fl k^' N_iA •-; .rrj�ar r3 a -..; ( 4: 1.., m'i rt iih'�lila, !Itfl {G {, l!"i r,.4 .�4F;h., r, „elf located ovethe',fifthrsto of a m{ lirsfo r',bu�ldirig measurs1,anfa cl/rectatlin rfrom fhe property hn'e o`f, the ;AA !Y t, I 4�{ � �„ ,I { x, 4 j j . , .�' ; ' ,Illfi..r� }In', "4• },, ':!, ._ .1i1 :o "nvate!`ubbc school to, pro erty'line of�your place of business in dltact,'irne`across�r�tersectrons �erf�cally up 1,�1, �. Ii �}'1„ the bu�ldrng atlithe,,property I if the Ibas�, of bite }floor on WnIcn,tiyour bu mess is !i �u'.f 15. Will your business be located within 1,000 feet of a private school?oYes Q No 16. Will your business be located within 1,000 feet of a public school? ©Yes i� No Exact Date (MM/DD/YYYY) nder Section 11.391 and 61.381, enter the exact date the 60- As7sign 17. Daposted at your location. r � p 18. IF YOUR LOCATION IS NOT WITHIN THE CITY LIMITS, CHECK HERE ❑ I, the applicant, have confirmed I am not located in the city limits of any city and therefore all city certificates are not required. Page 2 of 5 Form L-ON (12/2017) 1NA,RNING � Secbo 10�+�69of the Texas'�fi cohoUc' i�eYerage,` Cdde �si:a#es �, a zr1arson ho 3�makrgqs a false statelrenk or false ; !representation In,an a Ucationifnra ermit of hcense,orIrna $tafehaetif�re brt�'+or"other`Instrane t}to be�itled,wdh=the Co( mission ano F`n � ;.rl ,i. ,: r��t::{; .7 L i, i.: i�4 r,r_ II.Ux ::s::.f i1�.:;9tP.t 4ai :::< f`i; ... in.�7n11 ?irtit'•T,:.. �, l.i 7:.1 . F;t,1 ._il: ;,r a,:�; _x .,o-.,.' Ili IT required fo be sworn commrfs an,offense� unlshable by impnsor�menfi met el'Ce](as De aftment o� Cnml�al Justloe (or not (ass than 2 �: n.!'.uii I, tJNDER,PENIILT}' OF LAiN;HEBY,3k1YAR"fHJ{T 1 �IA1iE1iItEAhl�LLh�HR NFORMd710N_i? OltDi [}irN �w�G�4t?P,1.ICf4TtQN'11NtI��bN1! plY11CHMENiS ANDi,', fih`1N�ORNI17tUN iS;TRUE_ANp CAMAll(IpIIAi f,l7 `$Bt"O�I tNHt4APPCiCA�I101� GA1�.#$t1LT IN'r MYAPpLICAfION:B It�G>DEN18DA D1.0111iCRIMINA l�EkR�`E8;�1f�b�A�A1NS�WIALS�TAUt#iCFtlZir(rTNEr A5AL ,HOE�Ca�>rV�11tECaMINIS51oN, rOt1SERLt;L�GALMEANSTO,VERIF'YTIIIN[�IIATiON'�PIibV11DD 1"h V��{r�'�u���, �>>, �,1`�„a.� "��ri, NAME MANUEL BENJAMIN GONZALEZ HE E VY/// W TITLE OWNER Before me, the undersigned authority, on this day of . �,, 20 L /, the person whose name is signed to the foregoing application personally appeared and, dui sworn b m�,' a-tes under oath that he or she has read the said P Y PP Y Y application and that all the facts therei t forth are true and correct. SIGN HERE r i►RYW B, JAIME VIELMA OTARY PUBLIC Notary Public, State of Texas S E A L •'? Notary ID # 13051649-6 p+c° My Commission Expires January 29, 2020 I hereby certify on this day of , 20 , that the location for which the license/permit is sought is inside the boundaries of this city or town, in a "wet" area for such license/permit, and not prohibited by charter or ordinance in reference to the sale of such alcoholic beverages. SIGN HERE TEXAS City Secretary/Clerk City SEAL FtWIi j h I hereby certify on this day of , 20 , that the location for which the license/permit is sought is inside the boundaries of this city or town, in a "wet" area for such license/permit, and not prohibited by charter or ordinance in reference to the sale of such alcoholic beverages. Election for given location was held for: ❑ legal sale of all alcoholic beverages ❑ legal sale of all alcoholic beverages except mixed beverages ❑ legal sale of all alcoholic beverages including mixed beverages ❑ legal sale of beer/wine (17%) on -premise AFTER Sept. 1, 1999 ❑ legal sale of beer/wine (14%) on -premise BEFORE Sept. 1, 1999 OR IF ABOVE DOES NOT APPLY: Be advised the location must have had two election passages per Section 25.14 or Section 69.17 of the TABC Code. One for beer and wine off -premise and one for mixed beverage. ❑ legal sale of beer and wine for off -premise consumption only AND EITHER: ❑ legal sale of mixed beverages OR ❑ legal sale of mixed beverages in restaurants by food and beverage certificate holders (applicant must apply for FB with BIG or BE) SIGN HERE TEXAS City Secretary/Clerk City SEAL Page 3 of 5 Form L-ON (12/2017) hereby certify on this day of 20 , that one of the below is correct: ❑ The governing body of this city has by ordinance authorized the sale of mixed beverages between midnight and 2:00 A.M.; or ❑ The governing body of this city has by ordinance authorized the sale of beer between midnight and A.M.; or ❑ The population of the city or county where premises are located was 500,000 or more according to the 22"d Decennial Census of the United States as released by the Bureau of the Census on March 12, 2001; or ❑ The population of the city or county where premises are located was 800,000 or more according to the last Federal Census (2010). SIGN HERE TEXAS City Secretary/Clerk City SEAL I hereby certify on this day of , 20 , that the location for which the license/permit is sought is in a "wet' area for such license/permit, and is not prohibited by any valid order of the Commissioner's Court. SIGN HERE COUNTY County Clerk SEAL hereby certify on this day of , 20 , that the location for which the license/permit is sought is in a "wet" area and is not prohibited by any valid order of the Commissioner's Court. Election for given location was held for: ❑ legal sale of all alcoholic beverages ❑ legal sale of all alcoholic beverages except mixed beverages ❑ legal sale of all alcoholic beverages including mixed beverages ❑ legal sale of beer/wine (17%) on -premise AFTER Sept. 1, 1999 ❑ legal sale of beer/wine (14%) on -premise BEFORE Sept. 1, 1999 OR IF ABOVE DOES NOT APPLY: Be advised the location must have had two election passages per 25.14 or 69.17 of the TAB Code. One for beer and wine off -premise and one for mixed beverage. ❑ legal sale of beer and wine for off -premise consumption only AND EITHER: ❑ legal sale of mixed beverages OR ❑ legal sale of mixed beverages in restaurants by food and beverage certificate holders (applicant must apply for FB with BG or BE) SIGN HERE County Clerk SEAL COUNTY Page 4 of 5 Form L-ON (12/2017) hereby certify on this day of , 20 , that one of the below are correct: ❑ The Commissioner's Court of the county has by order authorized the sale of mixed beverages between midnight and 2:00 A.M.; or ❑ The Commissioner's Court of the county has by order authorized the sale of beer between midnight and A.M.; or ❑ The population of the city or county where premises are located was 500,000 or more according to the 22°d Decennial Census of the United States as released by the Bureau of the Census on March 12, 2001; or ❑ The population of the city or county where premises are located was 800,000 or more according to the last Federal Census (2010). SIGN HERE County Clerk SEAL COUNTY This is to certify on this day of , 20 , the applicant holds or has applied for and satisfies all legal requirements for the issuance of a Sales Tax Permit under the Limited Sales, Excise and Use Tax Act or the applicant as of this date is not required to hold a Sales Tax Permit. Sales Tax Permit Number Print Name of Comptroller Employee Print Title of Comptroller Employee SIGN HERE SEAL Outlet Number FIELD OFFICE Page 5 of 5 Form L-ON (12/2017) 3 �NL0110Fc� TEXAS ALCOHOLIC BEVERAGE COMMISSION Liu v Hr{r[t, Aa ww R !'maM, f 1... NJa LOCATION PACKET FOR RETAILERS L-L (03/2018) his Location packet (L L)„should be compete re%ailersasybmittiXig an4;originl, reins a emenfi, and/or ,by,all harige oflacatlon appli,c'ation�� Thls{;pack®t(L L),;along wltfilthe;�Pr®qu`aificationRa'cket'(L-ON} ory;(L-OFF} must be u4mltted40 0` IOCaI?TABCr`c y r anal rule references,menfigned m this aidplicatron refer toa and bttaund rn the Alcoholic Beverage Ti,statutory 4Cai iTexas Code,or f;'ules located.onRour websrte :>rwvs+ fagc texas gov/lawslcode ,antl!rules'asp„ 1,r, . ;rr . '.'',, ,.; . 1. Application for: ❑ Original ❑ Reinstatement License/Permit Number _ ✓0 Change of Licensed Location License/Permit Number BG776538 2. Trade Name of Location LITTLE GERMANY RESTAURANT 3. Location Address 6737 CAMPBOWIE BLVD FORT WORTH TX 76116 4. Business Entity Name/Applicant LITTLE GERMANY RESTAURANT / MANUEL BENJAMIN GONZALEZ 5. Federal Employer Identification Number (FEIN) 27-4174678 6. Do you currently hold an active license/permit issued under the above FEIN? • Yes No If "YES," provide your most recently issued license/permit number. BG776538_ If "NO," you must complete the Business Packet (L-B). 7. If you hold a current and active license/permit under the above FEIN has there been a change in the ownership or business structure since the submission of your last application? Oyes @No If "YES," you must complete the Business Packet for Reporting Changes (L-BRC) in its entirety. 8. Does the applicant own the land and building at this proposed licensed location? ©Yes (j) No If "NO," please complete Owner of Property (L-OP). NOTE: Be prepared to provide additional information such as a copy of your lease if requested. 9. If operating under a lease at this location, indicate: Expiration date(s)/Options 07/16/2024 Monthly rental amount $6500 Other fees and payments to landlord 0 10. Are you operating under any concession, service or management agreement(s) that contain terms for services or management beyond property rental? 0Yes (D No If "YES," complete Sublessor (L-SL), indicate the following, and attach copy of agreement(s): Expiration date(s)/Options Monthly fee $ If you have a sublessor that differs from the management company enter sublessor name below and complete Form L-SL. Sublessor Name 11. Do you or anyone else at the location operate under a franchise agreement? 0Yes @ No If "YES," as required under Section 109.53 do you maintain exclusive control of ALL phases of the purchase, sale, service and brands of alcoholic beverages? 0 Yes QNo Page 1 of 3 Form L-L (03/2018) 12. Do you share the premises with another business entity? ©Yes G) No If "YES," indicate the tradename(s) of business(es) and sales and use tax number(s) for other business(es): Trade Name Sales & Use Tax Number 13. Are there any agreements, excluding questions 9, 10 & 11, which involve alcohol in any way? Q Yes @No If "YES," attach a copy of agreement. 14. Provide first 12 months of projected sales data. Sales Year (YYYY) 2019 Alcoholic Beverage Sales $25,000 Food Sales $125,000 Other Sales $ Total Sales $150,000 15. Is the proposed location in a hotel or motel? 0 Yes • No 16. Will the license/permit embrace the entire location address? QYes © No If "NO," attach a diagram of your premise as required by Section 11.49. Be advised the location will be inspected prior to approval of your application. 17. Enter the total amount of investment from all sources for this location. $20,000 Please be prepared to provide copies of all documents related to the financing of this location. 18. List any person, firm, or corporation that has advanced or will advance any money, that holds any mortgage or encumbrances against the assets of the proposed business location, or that has signed or co -signed, guaranteed or financially assisted this business location for which you are seeking a license/permit. If a partnership or corporation, list entity along with partners/officers. SSN or FEIN Issuing State/DL No. Date of Birth (mm/dd/yyyy) Amount Name, Corporation, Partner/Officer Terms SSN or FEIN Issuing State/DL No. Date of Birth (mm/dd/yyyy) Amount Name, Corporation, Partner/Officer Terms SSN or FEIN Issuing State/DL No. Date of Birth (mm/dd/yyyy) Amount Name, Corporation, Partner/Officer Terms (If more space is needed, attach additional page.) Page 2 of 3 Form L-L (03/2018) 19. Making measurements from the door where the public enters your establishment to the nearest property line of a private/public school, will this location be within 1,000 feet of a private/public school? O Yes Q No If "YES," written notice of this application must be given to the school officials and a copy of the notice must be provided with this application as required by Section 109.33(c). 20. Is any property line of your premises within 300 feet of a residential address or established neighborhood association? OYes Q No If "YES," and if you are applying for an On -Premise License/Permit, and if a Food and Beverage Certificate is not applied for, notify each residential address and established neighborhood association. Submit a copy of the completed notice along with a list of all addresses notified; as required by Section 11.393 and 61.38 NOTE. A Sample of the notice can be found in Exhibit ll1 of the Application Guide for Retailers. 21. Will your business be located within 300 feet of residence, church, school, day care or social service facility when measuring in a straight line from the nearest point ofle prop,e�; y line of the proposed location to the nearest point of the property line of any of these facilities? � Yes W No If "YES," will 75% or more of the applicant's actual or anticipated gross revenue from the sale of alcoholic beverages? O Yes O No If "YES," to both of the questions; you must notify all tenants or property owners of your intent to apply for an alcohol beverage license/permit within five days of the filing of an original application. Has such notice been given as required by Section 11.52? O Yes O No 22. Do you, the applicant, intend to sell your alcoholic product directly to other retailers? OYes Q No 23. Do you, the applicant, intend to sell your alcoholic product to wholesalers/distributors? OYes (D No 24. Will you, the applicant, be engaged in the business of brewing and packaging malt liquor, ale or beer in quantities sufficient to operate a brewpub not later than 6 months after the date of issuance of the original license? O Yes O No EACH. ' IC NSEE OR P. ERMi �y E SIiAI. '7 HA1% ,FOCCLi151 `CCU ,, 1p r`.CY'igf�D CON I OL Off` } EiEN,1 i�Ct iL1C NSE1711:Q:Clltl ION WI I H I, { rl !m.':; ,mY. ',,,i7' ,. aj t Ir„ . �: �.i�, „J, 4er. r,: rn f,�. ., ,h: a, xlr . ",I r; I.,:n.{3, rN,,,f,111 n!'••7, „ttn4Aa,;N,1,, `k v,...l .r ,N 3n W,r... l,e 1 _ro'f RESPECTTO THEri�`ALE OF i4LCt1HOLIC'BEVERi4GE$'a r A�,Y+ARRANGEMENT I, AT .gU�RENDERS°SUd , is ROLaO THE EMPLOYEES,' {�. �,. 6i, i,.i -4:; ,.:,:,� ,, ,� ! ,t ,.:..r �l . i '1,. -,.11 i !,-::,,.r;n +,, ,.a ... 41 G ,gr'fP? r,'a.=.q�::+:.d d.,l. P,REMISES,'.OR{BUSINESS',INCLUDIN4+f'ROFITS! D LOSSES�{TO RERSONSaQtHER fH�� E L�GEI�SEER f'ER1jA E IS{UNLA1hIFUL" j`. I y.I.,....: � ..�: 7... .l a..,:,ury ,.; , j 11� , , - °l, {,�.+r /4 l,jG ��:.�i1„- .,,:w,+,,, t{!rl,:.,r,,,,a4,y.} „a��i!9�alad!v'�.,,.,a�,..,.4...»...�,1,+,,,'r1,,''+1ra!�a.,{,. W' I G. iSeotl'o "«` Il (69zof "e�Texes!:A co of c1 Beve '1 '±,Code' s gte� #" ,;a., a �'o'n tb `m�k u,al al i atetehient or'fe sere resentatio 'in an ARN N na l th 1, h I �9 i Yt „ v, A. i �"a. x _ , 3 ' „�, ,._„�,{rs,..,f±„t..ida„r,�,�n� ...,,,�!.!> >r,i-,,,t•rri,,,.,�,anx ,r,r,,,,!{{,x>,��.. {�!t.iN.,�r,t,,a�,.,��1,. #r.J�a�, �,�,Fret.-.�_,_�..a_�t,,,,,#,h��*ir...�� Irayn iR�Ucationfora' ermit or7icenseor.,tln; statement„re .ort, or7((aher{ nstcy, enfitoFbe bled w�th>tt7e_Gommision and rewired to ;be sVuor,commds an;; 1�,1 +i1M1 { „ill ........... ... ,�1?;1, r9 i .I!ViT V�vJ9 if{ offense u ishabl Ib Jim nsonfitent �n the Texas qe arkment of.Gnm�nal... 8lfor°naf less,thanl2 nor,mon: than�iIlu e8T5 '� r, . r, ! z y, ;, „�{,j�' ,^'�BY,{SIGNINGYOU�J�R�'SW'Ei�RING�Td�ALI�.fi���,ORMA'TiIONI;AND'ATTACH T ROVID „ ,.tARE� ORR8G7"!''� ' �' PRINT MANUEL BENJAMIN GONZALEZ SIGN E TITLE OWNE14 Before me, the undersigned authority, on this d day of L/ I , 20 , the person whose name is signed to the foregoing application personally appeare nd, duly sworn by me, states under oath that he or she has rea a said application and that all the facts therein set .forth are true and correct. r rA!Pyo., JAIME VIELMA HLRE Notary Public, State of TexasNOTARY PUBLIC N kl Notary ID # 13051648-6 "'+� My Commission Expires SEAL P. lanuarv�o �mn__ _ Page 3 of 3 Form L-L (03/2018) 3. Type of Owner no Individual ❑ Corporation ❑ City/County/University ❑ Partnership ❑ Limited Liability Company ❑ Other ❑ Limited Partnership ❑ Joint Venture ❑ Limited Liability Partnership ❑ Trust Last Name GONZALEZ First Name MANUEL MI B Title OWNER Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Last Name First Name MI Title Page 1 of 1 Form L-OIC (01/2018) o TEXAS ALCOHOLIC 9 BEVERAGE COMMISSION OWNER OF PROPERTY L-OP (05/2018) 1. Trade Name of Location LITTLE GERMANY RESTAURANT 2. Indicate if owner of property is: Q Owner of Land and Building 00wnerofLand 0Owner of Building O Owner of Boat Note: If land and building are owned by different entities, complete Form L-OP for each entity. 3. Wholesaler's (W, X) and Manufacturer's (G, Z, B, D) — Is the wner o remise information used for a storage permit (L, K) or Manufacturer's Warehouse License (MW)? OYes No 4. Owner of Property (Individual or Business Entity) NATIONAL RETAIL PROPERTIES, LP 5. Federal Employer Identification Number (FEIN) for Owner of Property 59-365-1850 SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner SSN Issuing State/DL No. Date of Birth (mm/dd/yyyy) Full Legal Name of Individual, Partner, Officer (Last, First, Middle) Title/Owner Page 1 of 1 Form L-OP (05/2018)