HomeMy WebLinkAboutApp for Alc Bev 2Department of Alcoholic Beverage Control State of California
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
ABC 211 (6199)
TO: Department of Alcoholic Beverage. Control Flle Number: 516671
1940 CHURN CREEK RD Receipt Number: 2085125
5TE 215 Geographical Code: 0400
BEDDING, CA 96002 Copies Mailed Date: November 8, 2011
(530) 224-4830 Issued Date:
DISTRICT SERVING LOCATION: BEDDING
First Owner:
Name of Business:
Location of Business:
County:
Is Premise inside city limits?
Mailing Address:
(If different from
premises address)
Type of license{s}: 02
Transferor's license/name:
Dropping Partner: Yes No /~~
License Type Transaction Type Fee Type Master Dun Date Fee
02 - W inegrawer OIiSG1NAi. FEES G1,5K Y 0. 11 /08111 $100.00
02 -Winegrower ATfNUAL FEE GL51C Y 0 11/08/11 $64.00
NA STATE FINGEItP1ttNTS NA N 1 11/08/11 $39.00
NA FEDERAL FINGERP1tINTS NA N 1 11/08/1 I $24.00
Total $232.00
Have you ever been convicted of a felony? No
Have you ever violated any provisions of the Alcoholic Beverage Control Ac#, or regulations of the
Department pertaining to the Act? Na
Explain any "Yes" answer to the above questions an 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 petTnit to be violated any of the provisions of the Alcoholic
Beverage Control Act.
STATE OF CALIFORNIA County of BUTTE Date: November 8, 2011
Under penalty of perjury, each person whose signature appears below, certifes and says: (1 } He 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
Itnows the contents thereof and that each of the above statements [herein 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) far which this application is made; (4) that the transfer
application or proposed transfer is not made to sa[isfy the payment of a loan yr to fulfill an agreemenE entered into more than ninety (9D) days preceding the day
on which the transfer application is filed with the Department or to gain or establish a preference tp ar For any creditor or transferor or Eo defraud or injure any
creditor of transferor, (5) that the transfer application may be withdrawn by either the applicant or the licensee wi[Ir no resulting liability to the Department.
Applicant Name{s)
FOX, GARY PAUL
Applicant Signature(s)
l~oaRa a~ su~strrsoas
UI~OVII.L~, CAUFORNfA
FOX, GARY PAUL
BANGOR RANCH VINEYARD & WINERY
5768 LA FORTE RD
BANGOR, CA 95914
BUTTE
No
Census Tract 0033.00
6288 BROADWAY TERRACE
OAKLAND, CA 94618-2100
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