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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: 661623 <br /> 3021 REYNOLDS RANCH PKWY Receipt Number: 2925714 <br /> STE 150 Geographical Code: 3906 <br /> LODI,CA 95240 Copies Mailed Date: August 23,2024 <br /> (209)371-6761 Issued Date: <br /> DISTRICT SERVING LOCATION: LODI RECEIVED <br /> First Owner: MIKASA GOURMET FOOD INC <br /> Name of Business: MIKASA ASIAN CUISINE& SUSHI BAR AUG 2 6 2124 <br /> Location of Business: 2610 S TRACY BLVD <br /> STE 110 ENVIRONMENTAL HEALTH <br /> TRACY,CA 95376 PERMIT/SERVICES <br /> County SAN JOAQUIN <br /> Is Premises inside city limits Yes Census Tract: 0052.09 <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: 525502 / MIKASA KITCHEN INC <br /> License Tvne Transaction Tyne Master Secondary LT And Count <br /> 47-On-Sale General Eating Place PER Y <br /> License Type Transaction Description Fee Code Du p Date Fee <br /> Application Fee PERSON TO PERSON TRF NA 0 08/23/24 $1,470.00 <br /> Application Fee FEDERAL FINGERPRINTS NA 2 08/23/24 $48.00 <br /> Application Fee STATE FINGERPRINTS NA 2 08/23/24 $78.00 <br /> 47-On-Sale General Eating Plac ANNUAL FEE P40 0 08/23/24 $1,450.00 <br /> Total $3,046.00 <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 23,2024 <br /> Applicant Name(s) <br /> MIKASA GOURMET FOOD INC <br />