HomeMy WebLinkAboutAgenda Report - September 28, 1988 (79)i
Do Net Write Above This Vths—!or Heodgtforters OfFiro On1y._•y. ;,_�:_,... _.�
APPLICA7lON FOR ALCOHOLIC BEVERAGE UCENSE(S)
To: Deportment of Alcoholic Beverage Control
1901 Broadway Stockton
Sacramento, Calif. 95818
/OrfTRIC� fCRYrMG LOC�TrOH/
The undersigned hereby applies for
licenses described as fol)o1vs:
1. TYPE(S) OF LKENSE(S) "
FILE NO.
on sale Ceneral
tlitej P1c30P
Applied under Sec. 24044 Cl
Effective Date: =GSA' c1=
RECEIPT NO.
GEOGRAPHICAL
CODE 3902
Dote
Issued
2. NAME(S) OF APPLICANT(S)
Temp. Permit
Effective Date:
__..
3:°TYPE(S) OF TRANSACTIONS) ---r
:. ...::.FEE
LIC.
TYPE
Per to Per
1,250.04
47
A. Name of Business
5. Location of Business—Number and Street
360 S. !'xl.i AVPnui-
City and Zip Code == County
SaUx Lodi, 95240 San JCaauin
TOTAL_S
1,250.00
6. If Premises Licensed, 7. Are Premises Inside
Show Type of License 47 City Limits? YP_S
8, Mailing Address (if different from 5)—Number and Street (TemPl (P.;m)
10123 Live Oak i?a d, Gait, Cil 95632 D'rm -
9. Have you ever been convicted of a felony? 10. Have you ever violated any of the provisions of the Alcoholic
Beverage Control Act or regulations of the Department per
-1, taining to the Act?
on on attachment which shall be deemed part of this application.
11. Explain a "YES" answer to items 9 or 10
12r { ll the caToof liceAPPlicant agrees (a) that an rnona er employed ed in'on-sale licensed premiies will have acnsee,.and
i (b) that he will not vio:are or cause or permit to be violated any of the provisions of the Alcoholic Beverage{ontrol Act
13. STATE OF CALIFORNIA County *of 11 3�=t3-Lill ---- --- Date -----------
1
Und,, p•nelty of pe,i_y, tech P �mraMn <�grwtvre appeo<s brio , <erhhQ and wTo it) He 4 be oppli< 1, or onr of he ppliconrr, or on t••evh Le
off r of d.• oppik co.poro,ion, Me ,;,,ego�nq appnco+ion, duly wbo,ir•d + mak• rhn oopn<onon o Nr brholf; (T) Thor he hos read rM fes
going opplieorion and I— 'he co ,mr^ f .r leo^ and +ho, each and oit of be rtalem h h rein d s (3) 1" pew h rho h Ppl <
pphcont, ho y direct u rndic•cr eh• opplicenr't or opplkonri burin be condo +d der he 1 r•O / h h 'hit Pplrc e it d
(4) rh t rh rro t p lkoli.. o, Wo" -d 1 -If. it not mod ro —,;.f,h * Perm• r f 'leo ) Poffli q ema++t 1 d r ih n i •ly ,190)
[ ' do" preced'nq the day en which +M hontf•e pppl <oeion i> filed M rM m•nt a to 94v « robl hop ! •« f led;'- T e i o q 10
defraud a ;.j- -q. cre
ny. ditor of 1r>n.f•ror; (S). the, the rrenrf•, Ppl tion Y be wirhd a n by eNher he oPPi cont « rhe hcenue, w rh rrrvlr g 1rab7liry b
rhe 13•porrmmt.
14 APPLICANT t
SIGN HERE. L1�- -- 3 ; i j tits-- -- --' -- -
3
APPLICATION BY TRANSFEROR
15. STATE OF CALIFORNIA County of ---- — -------------
-- 7
under p•rw11r of . w iwy. each P..... ber.. rignotw• oppeoi b•f ce.nf end wY I l) Ne. M •nr•e 1 a r e o1fi< f rh < poral 1 4 n ee
„�rwm.d m IM .f«p ng he f oppl:<oho dolt'. Mo.:ted'ro mak shit h f.r. app) non on behalf; iIi Mor he }h •by, mak PPC hon b v errd _
_ all r. •u ins IM n cited t.r.•n (r) deo ib•d below o,d to �h rfsr urm• r I"oPPir<anf and: e. 1«onon; d. Dred on theuPPeT_ Pot of:"
..Ih. oPDI cot.on T
}orm,.'rf _h h f r--epp,o d by theairs,«:.(3) shot rM rron>f r;.opPl nen or P,oposed ho 1 it nor mode to ronrfy rhe pay M of leo o to ivtFtt i
gree,n•nt ..,_d rr.re Mon ,, Joys w d rrg theday h h 'betr f ppi.c f fled h th thpo t 1 to q o robl sh [rn�s. -
r -Pref r to' or, for ally, ce•dctor of ,onr{ t,kf d
,oppbceni or M• t • wish fc1h De
(ting 1 blNr D."!"
..
Do Not Write Below This Line; For Department Use Onlg
' Fidud rs
Q a+1 ----___ _ P°Pe J 3-16—$87. x
_ __ COPIES MAILED
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