HomeMy WebLinkAboutApp for Alcoholic Bev LicDepartment of Alcoholic Beverage Control Sta#e of California
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE{S}
ABC 211 (6199)
TO:Department of Alcoholic Beverage Control
1900 CHURN CREEK RD
STE 215
BEDDING, CA 96002
(530) 224-4830
File Number: 515803
Receipt Number: 2080201
Geographical Code: 0400
Copies Mailed Date: October 12, 2011
Issued Date:
DISTRICT SERVING LOCATION: BEDDING
First Owtaer:
Name of Business:
Location of Business:
County:
Is Premise inside city limits?
Mailing Address:
(If different from
premises address)
Type of license(s): Ox
Transferor's licenselnarrte:
CLINE, NEAL WAKEN
DOG CREEK WINERY
9975 GARDEN CREEK RD
DURHAM, CA 95938-9b92
BUTTE
No
BOARD OF SUPERVISORS
OROVILLE, CALIFORNIA
Census Tract 0015.00
Dropping Partner: Yes No
License Type Transaction Ty>7e Fee Ty~e Master Dup Date Fee
02 -Winegrower ANNUAL FEE GLSK Y 0 I OII Ill l $69.00
02 -winegrower ORIGINAi. FEES GLSK Y 0 1011 I/ I 1 $100.00
NA FEDERAL FINGI:RPAINTS NA N 2 10111/I 1 $48.00
NA STATE FINGERPRINTS NA N 2 10/11/11 $7$.00
Tata] $295.00
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
Departmen# pertaining to the Act? No
Exptain any "Yes" answer to the above questions on an attachment which shall be deemed part of this app]ication.
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 Da#e: October 11, 2011
Under penalty of perjury, each person whose signature appears below, certifies and says: (1 } He is an applicant, or one ofthe applicants, or an executive officer
affhe 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 Ehe 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; (4) that the transfer
application or proposed transfer is not made Eo satisfy the payment of a loan or to fulfill an agreement entered into more than ninety (9D) days preceding the day
on which the transfer application is fled with Ehe Department or to gain or establish a preference fo or for any creditor or transferor or to defraud or injure any
creditor of transferor, {5) that the transfer application may be withdrawn by either the applicant or Ehe licensee with no resulting liability to the Department.
Applicant Name{s) Applicant Signature(s)
See 211 Signature Page
~CL1NE, NEAL WAKEN
Cc ~~5