HomeMy WebLinkAboutAlcoholic Beverage License Application - Deer Creek Cafe BU-11-E COUNT',
Department of Alcoholic Beverage Control State of California ADMINISTRNx101,
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
IAY 15 2017
TO:Department of Alcoholic Beverage Control File Number: 58141.7 OROVILLE,CALIFORNIA
1900 CHURN CREEK RD Receipt Number: 2428333
STE 215 Geographical Code: 0400
REDDING, CA 96002 Copies Mailed Date: May 11, 2017
(530) 224-4830 Issued Date:
DISTRICT SERVING LOCATION: RE,DDING
First Owner- PITTS, CHRISTY MARIE
Name of Business: DEER CREEK CAFE
Location of Business: 15474 FOREST RANCH WY
FOREST RANCH, CA 95942
County: BUTTE
Is Premise inside city limits? Yes Census Tract 0016.00
Mailing Address: PO BOX 746
(If different fi-om FOREST RANCH, CA 95942-0746
premises address)
Type of license(s): 41
Transferor's license/name: 569357 1 BEAUDRY,JASON MICHAEL Dropping Partner: Yes_ N
License Type Transaction Type Fee Type Master Dup Date Fee
41 -On-Sale Beer And Win( ANNUAL FEE NA Y 0 0511 l/17 $350.00
41 -On-Sale Beer And Win( PERSON-TO-PERSON TRANSFER NA Y 0 05/11/17 $150.00
NA FEDERAL FINGERPRINTS NA N 2 05/11/17 $48.00
NA ISSUE TEMPORARY PERMIT NA N 1 05/11/17 $100.00
NA STATE FINGERPRINTS NA N 2 05/11/17 $78.00
Total $726.00
Have you ever been convicted of a felony? No
Have you ever violated any provisions of the Alcoholic Beverage Control Act, of-regulations of the
Department pertaining to the Act? No
Explain any"Yes"answer to the above questions on an attachment which shall be deemed part of this application.
Applicant agrees (a) that any manager employed in an on-sale licensed premises will have all the qualifications
of a licensee, and (b) that he will not violate or cause or permit to be violated any of the provisions of the
Alcoholic Beverage Control Act.
STATE OF CALIFORNIA County of BUTTE Date: May 11, 2017
Under penally or perjury,each person whose signature appears below,certifies and says:(1) Fie is an applicant,or one of the applicants,or all extcutive
officer of the applicant corporation,named in the foregoing application,duly authorized to make this application on its behalf-,(2) that he has read the
foregoing and knows flit contents thereof and that each of the above statements therein made are lruc;(3) that no person other than the applicant or
applicants has any direct or indirect interest in the applicant or applicanPs business to be conducted under the license(s)for which this application is made;
(4) that the transfer application or proposed transfer is not made to satisfy the payment of a loan or to fulfill an agreement entered into more than ninety
(90)days preceding the day on which the transfer application is filed with the Department or to gain or establish a preference to or for any creditor or
transferor or to defraud or injure any creditor of transferor;(5) that the traunsfer application may be withdrawn by either the applicant or the licensee with
no resulting liability to the Department.
Effective duty 1,2012,Revenue andTaxation Code Section 7057,Antllnl'IZBS the State Board of Equalization and the I'rwnchise Tax Board to
share taxpayer information with Department ol'Aleoholic Beverage Control.The Department may suspend,revoke,and refuse to issue a license
if the licenseeLs name appears in the 500 largest tax delinquencies list.(Business and Professions Code Section 494.5.)
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Applicant Name(s) Applicant Signature(s)
PITTS,CHRISTY MARIE
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