HomeMy WebLinkAboutABC - Sams Club 6609Department of Alcoholic Beverage Control
APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S)
ABC 2! I (6/99)
TO: Department of Alcoholic Beverage Control
42-700 Bob Hope Drive
Suite 317
Rancho Mirage, CA 92270
(760) 568-0990
DISTRICT SERVING LOCATION: RANCHO MIRAGE
First Owner: SAMS WEST INC
Name of Business: SAMS CLUB 6609
Location of Business:
State of California
File Number: 434351
Receipt Number: 1545019
Geographical Code: 3318
Copies Mailed Date: December 5, 2005
Issued Date:
MONTEREY AVE & DINAH SHORE DR SEC
PALM DESERT, CA 92211
County: RIVERSIDE
Is premise inside city limits? Yes
Mailing Address:
(If different from
premises address)
702 SW EIGHTH ST
ATTN LICENSING
BENTONVILLE, AR 72716-0500
Census Tract 0449.14
Type of license(s): 21
Transferor's license/name: 328406 / SAMS WEST INC Dropping Partner: Yes No
License Type Transaction Type Fee Tyne Master MLR Pate
21 OFF -SALE GENERAL PREMISE TO PREMISE TRANS NA Y 0 1 2 / 0 5 / 0 5 $100.00
Total $100.00
Have you ever been convicted of a felony? N o
Have you ever violated any provisions of the Alcoholic Beverage Control Act, or regulations of the
Department pertaining to the Act? No
Explain any "Yes" answer to the above questions on an attachment which shall be deemed part of this application.
Applicant agrees (a) that any manager employed in an on -sale licensed premise will have all the
qualifications of a licensee, and (b) that he will not violate or cause or permit to be violated any of the
provisions of the Alcoholic Beverage Control Act.
STATE OF CALIFORNIA County of RIVERSIDE Date: December 5, 2005
Under penalty of perjury, each person whose signature appears below, certifies and says: (1) He is an applicant, or one of the applicants, or an
executive officer of the applicant corporation, named in the foregoing application, duly authorized to make this application on its behalf; (2) that
he has read the foregoing and knows the contents thereof and that each of the above statements therein made are true; (3) that no person other
than the applicant or applicants has any direct or indirect interest in the applicant or applicant's business to be conducted under the license(s) for
which this application is made; (4) that the transfer application or proposed transfer is not made to satisfy the payment of a loan or to fulfill an
agreement entered into more than ninety (90) days preceding the day on which the transfer application is filed with the Department or to gain or
establish a preference to or for any creditor or transferor or to defraud or injure any creditor of transferor; (5) that the transfer application may
be withdrawn by either the applicant or the licensee with no resulting liability to the Department.
Applicant Name(s)
SAMS WEST INC
Applicant Signature(s)
See 211 Signature Page
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CITY OF PALM DESERT
COMMUNITY SERVICES DIVISION
CITY CLERK OPERATIONS
INTEROFFICE MEMORANDUM
TO: BUSINESS::-JcENSOSO DIRECTOR OF BUILDING & SAFETY,
DIRECTOR OF COMMUNITY DEVELOPMENT,
DIRECTOR OF PUBLIC WORKS, COVE COMMUNITIES FIRE MARSHAL,
PALM DESERT POLICE DEPARTMENT
FROM: RACHELLE D. KLASSEN, CITY CLERK
DATE: DECEMBER 15, 2005
SUBJECT: APPLICATION FOR ALCOHOLIC BEVERAGE LICENSE(S) BY
Sam's Club #§609, SEC Motiterev, Avertue/Dinah, Shore Drive. Palm
A copy of the subject ABC License is attached for your review and recommendation to the
City Council for receiving and filing or to one of the other named departments for further
action. Please mark the appropriate response below and return to me by Wednesday,
December i11r 2011111iNo response by this date will be considered a "No Comment."
Responding Department:Sii1t"SS LCrS
Response:
0 No comment - okay to present to City Council.
0 Refer to
(attach additional sheets, if necessary):
Date:
(icc . 1 I, c ooS
— related comments
EV Other — Additional comments (attach additional sheets, if necessary):
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