HomeMy WebLinkAboutAgenda Report - July 15, 1981 (41)OPYoa N« Wr" Abe" TWO u»-r« On" o.y
' uKICAtICN /OR:`MLCOMOLIE; RYUAG� t10EtISEISI .: f. nms! OF ASKS) FILE NO.
71.
Fo+ D@PeIt"nM of Akdldk Qewrope Coelho, HE NO.
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1415 O Strettt _
�� ' Saaomalta. Calif.9=14-
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Temp. Form"
u HAMEtS). OF APMXANT(S)
:.. Applied under Sea 41011 O
u ► Angsla, Dt>aLiAl t11ic1 DqUaEffecave nate, Ettett)ve Date, _
n?E(S) OF TRANSACTION(S)
FEE LIC.
TYPE
MR IMSM JC60D 41 wiz
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Location of-desiness-Nwnber and Sweet `
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..,Fri+ To"i Kettacom IAWW
a x City and Zi Code County o
10a Sae .fssca2'lil RECEIPT NO. �,3 TOTAL S �p
If Premises Lkensed. 7. Are Premises Inside
wX Slaw Type of Liunse Gy limits? 7Wii
` b---a Moiling. Address (if di4erenb from-S)-Number and SIreN t►«w! f>+«�,)
_ }Sax 41Pam "
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9. How you ever been convicted of a felony? 10. How you ever violoted any of the provisions of the AkohoRo a "
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Beverage Control ro
AcY or putotiom of the Deportment Deportment
coining to the Act? NO * Yµc
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Y 11, Explain a "YES" answer to items 9 or 10 on an attachment which shall be deemed part of this oppGcotion.
s vnll7iove oRMglohcvtom of o ResnsN, a1d 12. Appikat agm (a) that —)L IN_ Geud-,Pra^i>ti z
(b) that M vnH not violate or cause or permit ro bevlo)oted any of the provisions of the Alcoholic Beverage Contra Act
13 STATE OF CALIFORNIA County of c . JOt)cz + _ . Dote. .... b :�- - ..... Fsl`
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' . 14APPLICANT
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-' SIGN MERE
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nvPuunoN BY nlAwsmoe
iS STATE OF CALIFORNIA County oF.--.-----.-- ............. . Date r s1, S
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1Q NmvWs) of Licensees) 17. Signoturo(s) of Umnsee(s) 1& License Nun169risi j
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x ill '<hN `"�• ` X4 )9 ` LOooKon-. Nwnba d Street .. City and Zip Code county.
rb Not Write Belau n&I.bse Fos aryl Uis
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tlacMdl ❑Recorded nke.
':ter t ❑ ov
Fiduciary popes IN.+ r^`.
6-2
❑ --------- - --------------- ---- ----------- --- -.-- ....__... COPIES MAILED ........._...-- ----- _-... ___--...._..
❑, Renewal: Fee of----.... .--...PoW at_... Offiu on..... .. ........... _:.Receipt N0. -•-- --.......:..
LAK 211 N.r•t � • ♦ r pr .
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