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Department of Alcoholic Beverage Control State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE <br /> ABC 211(6/99) <br /> TO:Department of Alcoholic Beverage Control File Number: 660995 <br /> 3021 REYNOLDS RANCH PKWY Receipt Number: 2919478 <br /> STE 150 Geographical Code: 3907 <br /> LODI,CA 95240 Copies Mailed Date: August 1,2024 <br /> (209)371-6761 Issued Date: <br /> DISTRICT SERVING LOCATION: LODI <br /> First Owner: MIKASA BISTRO INC <br /> Name of Business: MIKASA JAPANESE BISTRO <br /> Location of Business: 15138 HARLAN RD <br /> LATHROP,CA 95330-9754 <br /> County SAN JOAQUIN <br /> Is Premises inside city limits Yes Census Tract: 0051.19 <br /> Mailing Address:(If different <br /> from <br /> premises address) <br /> Type of license(s): 47 Dropping Partner: Yes_ No <br /> Transferor's license/name: 509713 / MIKASA JAPANESE BISTRO INC <br /> License Tyne Transaction Tyne Master Secondary LT And Count <br /> 47-On-Sale General Eating Place PER Y <br /> License Tyne Transaction Description Fee Code Dul) Date Fee <br /> Application Fee PERSON TO PERSON TRF NA 0 08/01/24 $1,470.00 <br /> Application Fee ISSUE TEMPORARY PERMIT NA 1 08/01/24 $100.00 <br /> Application Fee FEDERAL FINGERPRINTS NA 2 08/01/24 $48.00 <br /> Application Fee STATE FINGERPRINTS NA 2 08/01/24 $78.00 <br /> 47-On-Sale General Eating Plac ANNUAL FEE P20 0 08/01/24 $1,185.00 <br /> Total $2,881.00 <br /> Have you ever been convicted of a felony? No <br /> Have you ever violated any provisions of the Alcoholic Beverage Control Act,or regulations of the <br /> Department pertaining to the Act? No <br /> STATE OF CALIFORNIA County of SAN JOAQUIN Date: August 1,2024 <br /> Applicant Names) <br /> MIKASA BISTRO INC <br /> S <br />