HomeMy WebLinkAboutRFI24-0739 09272024_Daily ABC License Approval SheetKORY L.HONEASHERIFF-CORONER
Daily ABC License Approval Sheet
The Butte County Sheriffs Office has done a preliminary review of the event listed below,and
determined that there are no objections from the Sheriffs Office standpoint.
The next step in the process is obtaining approval from the Butte County Department Services Planning
Division.Please provide this cover letter with your application to the Planning Department for review
and approval.Upon approval,return this cover letter with your application packet to the Sheriffs Office
for final approval and issuance of your license.
iOi/Po'ilV-g-Hoos-€‘Uocjy^,Organization Name:J
K ^^1 V\vU 3OrganizationContactInformation:
(phone #or emoi!)Date of Event:(O ^05 ^
APN/Address:
NOTES:
Department Services Planning Division
Denied:/N /XApproved:(Date)(Signature)(Date)(Signature)
Butte County Sheriff's Office
Denied:Approved:
state of California Department of Alcoholic Beverage Control
DAILY LICENSE APPLICATION ABC USE ONLY
License #Receipt #Fee
Complete ail applicable items.Submit this application to your locai ABC district office w/ith
the required fee (cashier’s check or money order)payable to ABC.Once the daily license
is issued,fees cannot be refunded.Listing of ABC district office is available at
hUps://www.abc.ca.qov/contact/district-offices/.Please visit https://w\vw,abc.ca.qov/abc-
221-instructions/for further instructions.
$
Conditions Requested
□Yes □No
Diagram Requested
□Yes □No
License Type
□B&W □General □SpecialSECTION1.ORGANIZATION AND LICENSE TYPE INFORMATION
Organization Name
OROVILLE MOOSE LODGE
Tax ID
51-70119
Organization Mailing Address
1462 14TH ST OROVILLE,CA 95965
LICENSE TYPE
□Special Daily Beer and Wine ($50.00)
□Amateur Sports Organization
□Charitable
□Civic
□Cultural
□Fraternal
□Political
X □Religious
□Social
□Other:
Daily General ($75.00)
□Political Party/Affiliate Supporting
Candidate for Public Office or Ballot
Measure
□Organization Formed for Specific
Charitable or Civic Purpose
0 Fraternal Organization in Existence over
Five Years with Regular Membership
□Religious Organization
□Vessel per Section 24045.10 B&P
($50.00)
□Special Temporary License ($100.00)
□Television Station per Section 24045.2
or 24045.9 B&P
□Non-profit Corporation per Section
24045.4 and 24045.6 B&P
□Person Conducting Estate Wine
Sale per Section 24045.8 B&P
□Women’s Educational and Charitable
Organization per Section 24045.3 B&P
□Other Special Temporary License
Per Section;
License #:Amount:
SECTION 2.EVENT DETAILS
Total #of Days Hours of Alcoholic Beverage Sales,Service and/or Consumption
To8P.M.
Event Dates
W/12/24
Virtual Event Mark Yes,if the
event is 100%4 P.M.D Yes 0 No virtual
Event Address (Street#,Name,and City)
1462 14TH ST,OROVILLE CA 95965
Event Location Description (Jones Park,Pavilion A,etc.)
MOOSE LODGE
Location Within the City Limit
0 Yes □No
Event Type
□Barbeque 0Dinner
□Birthday □Festival
□Concert GLunch
□Carnival GMixer
□Dance GPicnic
Type of Entertainment
NONE
Event Open to Public
□Sporting Event
□Social Gathering
□Wedding
□Other;
0 Yes □No
Estimated Attendance Security Guard If Yes,How Many
□Yes 0No
Outdoor Event
□Yes**If Yes,a diagram of the
[J0 No event area is required65
REQUIRED
0 By checking this box,you are certifying that you understand the requirements detailed in Business and Professions (B&P)Code Section
25682(c)which state that a nonprofit organization that has obtained a temporary daily license from the department must designate a person(s)to
receive RBS training certification prior to the event,and that designated person(s)shall remain onsite for the duration of the event.
SECTION 3.CONTACT INFORMATION
Contact Person
LYNN MCGINNIS
Phone Number
707 350-5204
Email Address
lodge519@mooseunits.org
SECTION 4.SIGNATURES AND APPROVALS
[attest that I am authorized by the organization named above to make this application on its behalf.
Organization's Authorized Representative Name
LYNN MCGINNIS
Phone Number
707 350-5204
signature Date Signed
c/t/Lii!)●—1 /■Property Owner Approval By (Name)Required
LYNN MCGINNIS
Phone Number
707 350-5204
Date Siqnedture
Law Enforcement Approval By (Name),If applicable Phone Number Signature Date Signed
ABC Employee Signature Issuance DateDistrictOfficeApprovalBy(Name)Phone Number
The above named organization is hereby licensed,pursuant to the California B&P Code Division 9 and California Code of Regulations,to engageinthetemporarysaleofalcoholicbeveragesforconsumptionattheabovenamedlocationfortheperiodauthorizedabove.B&P Code Section
25682(c)requires that a designated RBS-trained person(s)shall remain on site for the duration of the event.Failure to comply with thisrequirementwillresultinimmediatecancellationofthepermit.This license may be revoked summarily by the department If,in the opinion ofthedepartmentand/orthe local law enforcementagency,It is necessary to protect the safety,welfare,health,peace and morals of the
people of the State.
ABC-221 (Rev.11/2023)