HomeMy WebLinkAboutapp alc beverageDepartment of Alcoholic Beverage Control State of California
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
ABC 2l l (6199)
TO:Department of Alcoholic Beverage Control File Number: 52079$
1900 CHURN CREEK RD Receipt Number: 2106409
STE 215 Geographical Code: 0400
BEDDING, CA 96002 Copies Mailed Date: April 11, 20x2
(530} 224-4830 Issued Date:
DISTRICT SERVING LOCATION: BEDDING BLi`?T ~~r-~~-y
First Owner: KARA, SHIRAZ A~~ ~ ~ zt~~2
Name of Business:
Location of Business: 4855 LINCOLN BLVD OROti~LE, C_-Lr ~pR~Z,,
OROVILLE, CA 95966
County: BUTTE
Is Premise inside city Iimits? No Census Tract 0030.00
Mailing Address:
(If different from
premises address)
Type of license(s): 20
Transferor's license/name: 391784 1 BEAVERS MARKET LLC Dropping Partner: Yes_ No
License Type Transaction T e liee Type Master Dup . Date Fee
20 - Dff--Sale Beer And Wine ANNUAL FEE NA X 0 04/11/12 $254.00
20-OfiSale Beer And Wine PERSON-TD-PERSDNTRANSFER NA Y 0, 04/11/12 $50.00
NA FEDERAI, FINGERPRINTS NA N 2 04111/I2 $48.00
NA STATE FINGERPRINTS NA N 2 0417 I/I2 $78.00
Total $430.00
Have you ever been convicted of a felony? No
Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the
Department pertaining to the Act? No
Explain any "Yes" answer to the above questions en an attachment which steal! be deemed part of this application.
Applican# agrees (a) that any manager employed ila an on-sale licensed premises will have all the quali#ications 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: April 11, 2012
Under penalty of perjury, each person whose signature appears below, cerlifics and sags: (l } I-le is an applicant, or one of the applicants, or an executive 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 the contents thereof and that each of the above statements therein made are true; (3) that no person other than the applicant or applicants has any direct
or indirect interest in the applicant or applicant's business to be conducted under the license(s) for which this application is made; (Q) that the transfer
application or proposed transfer is not made le satisfy the payment of a loan or to fulfill an agreement entered into more than ninety {9D) days preceding the day
on which fire transfer application is filed with the Department or Eo gain or eslabJish a preference io or for any creditor or transferor or to defraud or injure any
creditor of transferor; (5) that the transfer application may be withdrawn by tither the applicant or the licensee with no resu![ing liability to the Department.
Applicant Name(s)
SHIRAZ
Applicant Signature(s)
See 211 Signature Page
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