HomeMy WebLinkAboutApp for Alcoholic Beverage - Dollar General #16170 Department of Alcoholic Beverage Control State of California
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
ABC 211 (6199)
TO:Department of Alcoholic.Beverage Control File Number: 566048
1900 CHURN CREEK RD Receipt Number: 2339623
STE 215 Geographical Code: 0400
REDDING, CA 96002 Copies Mailed Date: January 22,2016
(530)224-4830 Issued Date:
DISTRICT SERVING LOCATION: REDDING DOM SUPEWUM
First Owner: DOLGEN CALIFORNIA LLC JAN 2 5 2pjs
Name of Business: DOLLAR GENERAL#16170
CAUFOMM
Location of Business: SEC MIDWAY AND DURHAM DAYTON HWY '
DURHAM, CA 95938
County: BUTTE
Is Premise inside city limits? Yes Census Tract 0015.00
Mailing Address: 100 MISSION RIDGE
(If different from ATTN: TAX-LICENSING
premises address) GOODLETTSVILLE,TN 37072-2171
Type of license(s): 20
Transferor's license/name: Dropping Partner: Yes N
License Transaction Type Fee Type Master Dep Date Fee
20-Off-Sale Beer And Win ANNUALFEE NA X 0 01/22/16 $254,00
20-Off-Sale Beer And Win. ORIGINAL FEES NA Y 0 01/22/16 $100.00
Total $354.00
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 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.
S'T'ATE OF CALIFORNIA County of BUTTE Date: January 22, 2016
Under penalty of perjury,each person whose signature appears below,certifies and says:(l) 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 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;
(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 tiled with the Department or to gain or establish a preference to or for any creditor or
transferor or to defraud or injure any creditor oftransferor;(5) that the transfer application may be withdrawn by either the applicant or the licensee with
no resulting liability to the Department.
Effective July 1,2012,Revenue and Taxation Code Section 7057,authorizes the State Board of Equalization and the Franchise Tax Board to
share taxpayer information with Department of Alcoholic Beverage Control.The Department may suspend,revoke,and refuse to issue a license
if the licenseeis name appears in the 500 largest tax delinquencies Iist.(Business and Professions Code Section 494.5.)
Applicant Name(s) Applicant Signature(s)
See 211 Signature Page
DOLGEN CALIFORNIA LLC
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