HomeMy WebLinkAboutAgenda Report - December 16, 1992 (57)CITY OF LODI .. couni
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AtsfLfG1lTOTot AtCQiiOLIC 09YBRAGE LfCET MS)
To: Deportment of Alcoholic Beverope Control
1901 Broad"
Socrornemso. Cath. 95818 ..:rl
.e..o.c• u.v.w..oce.w..
The wrdersipned hereby appJ+es for
licenses described as fall* -s-
1. TYPE(S) OF LICENSE(S)
FILE NQ
: T 2 0.: f _ t b .....
Applied Ynd" Sec- 24044
Effective Dote•. I5 -IL" -
RECEIPT NO
--
GEOGRAPHICAL
CODE _ ..,c
Dote
Issued
?. NAME(S) OF APPLICANT(S)Temp.
Permit
Effective Date:
Kf It�i Stanir Y
3_ TYPE(S) OF TRANSACTION(5)
FEE
L)C-
TYPE
Anrl:r,l �r
si_UO
4. None of Business
Kira~, Flowers
S. Location of Business -Number and Some
527 W. Lodi Av.-.
Gey and zip Code County
LEv2r 95240 xan Jaxivi::
TOTAL
S
d. If Premises Licensed. 7. Are Premises Heide
Sha.. Type of License I'ic1 City Limits? yes
8. Moa ins Address (if d Fkn a it from. S)--Numbe, and Street n...Pt r►«I.t
Sages
9. Hove you ever been convicted of a felany? T0. Have you ever violated any of the provisions of the Alcoholic
Beverope Control Act or regulations of the Deportment per.
tong to the Act?
IT. Explain o "YES" answer is ?tams 9 or 10 on on ottochment which shop be deemed port of this application.
12. Applicant agrees (a) that any monager employed in on -sale licensed premises will hove all the qualifications of o licensee, and
(b) thor he will not v?otde or cousa or permit to be violated any of the provisions of the Alcoholic Beverage Control Act.
13. STATE Of CALIFORNIA County of -------- i4ll h i%r-'---------------- Date -------------------
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14. APPLICANT
S*N HERE - - ----- - - --- ----_-
--------------------------------------------------------------
APPLICATION BY TRANSRROR
15. STATE Of CALIFORNIA County of -------------------------------------- Dote----------------
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)A Nome(s) of Llcensee(s) 17. Signoture(s) of Licensees) 18. License Numbers)
19. Location Number and Servet City and Zip Code County
Do Not Write Below This Line; For Department Use Only - --- - - - - --
ArIoched: C] Recorded notice,
C] F-Iduciory pop-,
--- --------------------------------------------- - COPIES MAILED - 1i--` -7t-------------------------------
. o+.... r
(] Renewal: Fee of --------__ Paid at ------------------------------ Office on ------------------ eceipt No. ,----._----------- ..___.