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HomeMy WebLinkAboutApp for Alcoholic License - Our PlaceDepartment of Alcoholic Beverage Control State of California APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) ABC 211 (6199) TO: Department of Alcoholic Beverage Control File Number: 487833 1900 Churn Creek Rd. Receipt Number: 1756435 Ste. 215 Geographical Code: 0400 Redding, CA 96002 Copies Mailed Date: March 17, 2010 (530)224-4830 Issued Date: DISTRICT SERVING LOCATION: REDDING First Owner: SAGEPAMELASUE Name of Business: OURPLACE Location of Business: 15523 NOPEL AVE FOREST RANCH, CA 95942 County: BUTTE Is premise inside city limits? No Census Tract 0016. Mailing Address: PO BOX 784 (If different from FOREST RANCH, CA 95942-0784 premises address) Type of license(s): 41 Transferor's license/name: / Dropping Partner: Yes__ No License Type Transaction Tyne Fee Type Master Dun Date Fee 41 ON -SALE BEER AND ORIGINAL FEES NA Y 0 03/17/10 $300.00 41 ON -SALE BEER AND ANNUALFEE NA Y 0 03/17/10 $350.00 41 ON -SALE BEER AND STATE FINGERPRINTS NA N 1 03/17/10 $39.00 41 ON -SALE BEER AND FEDERAL FINGERPRINTS NA N 1 03/17/10 $24.00 .Total $713.00 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 premise 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: March 17, 2010 Under penalty of perjury, each person whose signature appears below, certifies 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 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 filed with the Department or to gain or establish it preference to or for any creditor otransferor or to defraud or injure any creditor of transferor; (5) that the transfer application may be withdrawn by either the applicant or the licensee with no resulting liability to the Department. Applicant Name(s) App�Tc'r{ t Signature(s) SAGE PAMELA SUE