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Department of Alcoholic Beverage Control State of California <br /> APPLICATION FOR ALCOHOLIC BEVERAGE LICENSES) <br /> ABC 211(6/99) <br /> TO:Department of Alcoholic Beverage Control File Number: 613636 <br /> 31 E CHANNEL ST Receipt Number: 2617658 <br /> ROOM 168 Geographical Code: 3907 <br /> STOCKTON, CA 95202 Copies Mailed Date: December 17,2019 <br /> (209)948-7739 Issued Date: <br /> DISTRICT SERVING LOCATION: STOCKTON <br /> RECEI���D <br /> First Owner: SINGH,SIMERJIT <br /> Name of Business: CHICAGOS PIZZA WITH A TWIST DEC 19 2019 <br /> Location of Business: 159 E LATHROP RD ENVIRONMENTAL HEALTH <br /> LATHROP,CA 95330 PERMIT/SERVICES <br /> County: SAN JOAQUIN <br /> Is Premises inside city limits? Yes Census Tract: 0051.19 <br /> Mailing Address:(If different 8313 MEDEIROS WY <br /> from SACRAMENTO,CA 95829 <br /> premises address) <br /> Type of license(s): 41 Dropping Partner: Yes_ No_ <br /> Transferor's license/name: 581586 / LATHROP CHICAGO'S PIZZA LLC <br /> License Type Transaction Type Master Secondary LT And Count <br /> 41-On-Sale Beer And Wine-Eating P PER y <br /> License Type Transaction Description Fee Code Dup Date Fee <br /> Application Fee STATE FINGERPRINTS NA 2 12/17/19 $78.00 <br /> Application Fee PERSON TO PERSON TRF NA 0 12/17/19 $335.00 <br /> Application Fee FEDERAL FINGERPRINTS NA 2 12/17/19 $48.00 <br /> Application Fee ISSUE TEMPORARY PERMIT NA 1 12/17/19 $100.00 <br /> 41-On-Sale Beer And Wine-Eat ANNUAL FEE NA 0 12/17/19 $455.00 <br /> Total $1,016.00 <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: December 17,2019 <br /> Applicant Name(s) <br /> SINGH,SIMERJIT <br />