HomeMy WebLinkAboutAgenda Report - September 2, 1987 (95)CITU COUNCIL MEETING
1987
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ALCOPOLIC FFFSMAGB EKDMI(Si .
To: Department of Alcoholic Betreroge Control
1901 Broadway
Sacramento, Calif. 95818 StOCkt
'. tmsnllcrsavrtscs.oano»1
The undersigned hereby appim for
Ticenm deuribed as follows:
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'-1..TYPE(S) .OF UCENSE(S)
fFiE NO.
ON SME )ate kND W -DT'
- . E'irj`D,, • PWE
'Applied under Sec 24044 0
Effective Date: tib' m Trfd
RECEIPT 140.
'
GEOGRAPHICAL
.CODE ani
Date
%sued
2. NAMEMF
S) OF APPLICANT(S)
Temp. Permit
3L-52154
Effective Dote: 9-2-87
GAELLTAM, Maria Rose
3. TYPE(S) OF TRANSACTION(S)
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FEE
UC.
TYPE
y
Per to Per
2t
S
150.00
e
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4. Nome of Business
XZ= Villa Gour t
5. Location of Business -Number and Shwe!
7 'lot—h School Street
City and Zip Code County
Lodi, Ca. 95240 _San cac in
TOTAL
S
150,00
If Premises Licensed, 7. Are Premises Inside
Show Type. of License 41 City Limits? YPS
8. Mailing Address (if different from 5) -Number and Street (T—P) i►•.. )
S.
P Ll1r
icted of a Felony? 10- Have you ever violated any of;the provisions of, the Alcoholic9. Have you ever been conv< `
t Beverage Control Act or regulations of the Deportment per-
toining t the Act? ,,.
11. Explain o "YES" onswer to items 9 or 10 on on attachment which shell be deemed port of this opphcotioil.
12. Applkord agrees (a) shot any manager employed in:On•sale licensed premises wilt 'hove'", all the qualifications Of;O licensee
(b) that he will not violate or. cause or permit to be wolotad any of the provisions of the- Alcoholic Control'Ac►:
13. STATE OF CALIFORNIA County 'of --------' ------D°!e____�Z --------
Und.r. p.nettr of p•r/+r'r. .ash p•rsee ..Mw "s~,s evwas b.te•r,<•r»6.s—4'sera: 11) ». is sl.. avnl:w.a. a aw�ol x.e opvl <on». a an .cer .��
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14. APPLICANT
SIGN HERN
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