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Department of Alcoholic Beverage Control State of California <br /> SUPPLEMENTAL DIAGRAM Gavin Newsom,Governor <br /> Instructions to Applicant: <br /> Draw a sketch of the area on which the licensed premises is or will be located Show adjacent structures and nearest cross <br /> streets. If this is an event,for a daily license, cateritfg authorization, event authorization or miscellaneous use, show the <br /> area where sales and consumption gfalcoholic beverages will occur. Post a copy of this diagram with Daily License, <br /> Catering Authorization or Event Authorization where the event is held. Sales and consumption of alcoholic beverages <br /> must be confined to the area designated in the diagram and supervised to prevent violations of the.Alcoholic Beverage <br /> Control Act. <br /> 1 APPLICANT NAME (Last,first,middle) 2. LICENSE TYPE <br /> Todd Marvin Anderson on-premise 48-428019 <br /> - – - — —---- - - – -- --- <br /> 3. PREMISES ADDRESS (Street numDerand name,ory,vp code) 4. NEAREST CROSS STREET <br /> 18783 E. Hwy 88 Clements, CA 95220 Mackville Rd. <br /> DIAGRAM <br /> CIO, <br /> G�Tr f <br /> GA RAX-r <br /> 70 <br /> �o�S E BA R <br /> 'Ft <br /> Po,0- ►v <br /> 1 have read the above instructions and I dec are under penalty of perjury that the above diagram is true and correct. <br /> APPLICANT SIGNATURE DATE SIGNED <br /> 05/25/2020 <br /> _ FOR ABC USE ONLY <br /> CERTIFIED CORRECT (SlgnaWre) PRINTED NAME INSPECTION DATE <br /> ABC-253(rev. 07/19) <br />