Form 135 - Supplemental Form For Application Within 300' Of Campus
Download a blank fillable Form 135 - Supplemental Form For Application Within 300' Of Campus in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 135 - Supplemental Form For Application Within 300' Of Campus with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1SUPPLEMENTAL FORM FOR APPLICATION
WITHIN 300’ OF CAMPUS
NEBRASKA LIQUOR CONTROL COMMISSION
TH
301 CENTENNIAL MALL SOUTH, 5
FLOOR
PO BOX 95046
LINCOLN, NE 68509-5046
PHONE: (402) 471-2571
FAX: (402) 471-2814
Website:
PROPOSED PREMISE INFORMATION
Applicant name: ______________________________________________________________
Premise name: ________________________________________________________________
Premise address: ______________________________________________________________
City: ________________________________________________________________________
Type of business: ______________________________________________________________
Include a description of the justification for the waiver explaining how the proposed location
complies with the findings listed:
The impact of retail sales of alcoholic liquor for consumption on the premises on the
academic mission of the college or university
The impact on students and prospective students if such sales were permitted on or near
campus
The impact on economic development opportunities located within or in proximity to
the campus
CAMPUS INFORMATION
Name of College/University: ________________________________________________
Address of College/University: ______________________________________________
City: ____________________________ County: ________________________________
DISTANCE FROM AFOREMENTIONED CAMPUS __________________ FEET
Waiver will not be granted without written approval from the governing body of the college or
university or its designee if the physical location of the property which is the subject of the
requested waiver is (a) surrounded by property owned by the college or university including any
public or private easement, street, or right-of-way adjacent to the property owned by the college or
university or (b) adjacent to property on two or more sides owned by the college or university
including any public or private easement, street, or right-of-way adjacent to the property owned by
the college or university.
FORM 135
REV JULY 2015
PAGE 1
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form Id 4853a - Child Development And Care (cdc) Program Application Additional Space For Application - Michigan Department Of Education
Legal
Application Form For Work Permit - Ministry Of Defence/ Ministry Of Internal Adminsitration
Business
Application Form For Payroll Deduction - Office Of The Secretary Of State - State Of South Carolina
Legal
Related Categories
Parent category: Legal