HomeMy WebLinkAboutAgenda Report - May 6, 1981 (49)F
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ArTa9pQTAti' fFOR" ALCOMOLIC SEYMAGR LICINSE(S) 1. TYPEN
S) OF UCENSE(S) FILE O.
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To, Deportment of Alcoholic 11eW0096. CoMro� FEE NO. R j=
1215 O Street
Sacramento. cow. 93E1 $ d "Li DIM a 1f=
GEOGRAPHICAL x
FLCiJ CODE MW
z The 0 Red he
►ebr aPPf»s for Dale
r described as fonowse homed
_ = Temp. Permit
X 44MWOF ANT(S)
Applied ander See. 21044 ❑
4 • A POM ]/Ce Effective Data Zonk� Effective Date
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3 TYPE(5) OF TRANSACTIONFEE UC.
>14fMt1 S) TYPE
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,elhni utlar16
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w IMAM" G� 7M.
of, VVSWAW
A: ionv(twinew-Nwa�r and Skeet 3 ,
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P County
and Zi Code Cam S
ss RECEIPT NO. / t r L TOTAL 14941.ftm
6 "iE'f'rertlites Utensed r *rt 7. Are Premises Inside s r
--5hoerTjye aF license City Limits? YM ,
Il`"Malrq Addr�fs+ fol different from S) -Number and Skeet ftw sJ (re-)
--tfoviyotr 4rw been cofadcted-of_a.feionyt 10. Have you ever violated any of the provisions of the Alcoholic ; r
Beverage Contra Act or regulations of the Deportment :per• ' =
toining to the Act?
=� 11.. Etlplaie a -yW answer to items 9 or 10 on an attachment which shall be deemed part of this application. )
eery Anenepet_ es "employed'in oa-saw licensed premiswill have off 41M VIDW4000"-of a:. icNnee-and
(b) that he will not violate or cause or permit to be violated any of the provisions of the Alcoholic Be"roge tontro171c1 r
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13. STATE OF CAUFOMA County of _.....__ Do»_.
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14APPLICANT >1R� i A 70OW, W-
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SIGN HERE Jars _._ ........ - ------------.[ ---'---------l'h
. .... • ..
APPLICATION BY TRANSFEROR
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13. STATE OF CALIFORNIA County of Dote..
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y 1@. license Num s)�`
I& Nam*(%) of licensee(9 17. Signature(s) of Licensees) . ter(
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19. location Number and Street
City and Zip Code County's
i�
Do Not write Below This Line; For Department Use Only
19. location Number and Street
City and Zip Code County's
Do Not write Below This Line; For Department Use Only
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Attached: ❑ Recorded notice,
❑ Fiduciary papers,
❑ . ..... ........ ....... ....... ..
COPIES MAILED / .. ._
-aS e a i
_. _...
❑ Renewal: Fee of ....... .. _Paid at..- ._ - ... ............ ... _
_ Office on Receipt No.
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APR 2 0 3961..•
AMC 211 10.711
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