Laserfiche WebLink
DTartment of Alcoholic Beverage Control <br />APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) <br />ABC 211(6/99) <br />State of California <br />TO: Department of Alcoholic Beverage Control <br />31 E CHANNEL ST <br />ROOM 168 <br />STOCKTON, CA 95202 <br />(209) 948-7739 <br />File Number: 635389 <br />Receipt Number: 2705774 <br />Geographical Code: 3900 <br />Copies Mailed Date: <br />Issued Date: RECEW E D <br />DISTRICT SERVING LOCATION: STOCKTON <br />First Owner: SAFE WAY INC <br />Name of Business: SAFE WAY STORE #0055 <br />Location of Business: 19555 S MOUTAIN HOUSE PKWY <br />MOUNTAIN HOUSE, CA 95391 <br />FEB 1 8 2022 <br />ENVIRONMENTAL HEALTH <br />PERMIT/SERVICES <br />County: SAN JOAQUIN <br />Is Premises inside city limits? Yes Census Tract: 0052.23 <br />Mailing Address:(If different PO BOX 29096 <br />from MAIL STOP #6515 <br />premises address) PHOENIX, AZ 95038 <br />Type of license(s): 21, 86 Dropping Partner: Yes No <br />Transferor's license/name: 484369 / BIASETTI, LUCIANO <br />License Type <br />86 - Instructional Tasting License <br />21 - Off-Sale General <br />Transaction Type <br />ORI <br />PER/PRM <br />Master Secondary LT And Count <br /> <br />License Type Transaction Description Fee Code Dup Date Fee <br />Application Fee DBL TRF: PREMISES AND PERSON NA 0 02/15/22 $1,250.00 <br />86- Instructional Tasting License ANNUAL FEE NA 0 02/15/22 $390.00 <br />86- Instructional Tasting License ORIGINAL FEES NA 0 02/15/22 $300.00 <br />21 - Off-Sale General ANNUAL FEE NA 0 02/15/22 $814.00 <br />Total $2,754.00 <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: February 15, 2022 <br />Applicant Name(s) <br />SAFEWAY INC