State of California
Department of Alcoholic Beverage Control Gavin Newsom, Governor
SUPPLEMENTAL DIAGRAM
Instructions to Applicant:
Draw a sketch of the area on which the licensed premises is or will be located Show adjacent structures and nearest cross streets. If this is an event for a daily license, catering authorization, event authorization or miscellaneous use, show the area where sales and consumption of alcoholic beverages will occur. Post a copy of this diagram with Daily License, Catering Authorization or Event Authorization where the event is held. Sales and consumption of alcoholic beverages must be confined to the area designated in the diagram and supervised to prevent violations of the Alcoholic Beverage Control Act.
1. APPLICANT NAME (Last, first, middle) 2. LICENSE TYPE
3. PREMISES ADDRESS (Street number and name, city, zip code) 4. NEAREST CROSS STREET
DIAGRAM
ISTFIOOR OF ¡alcanoi
DESTROO
CIVIL CENTER senving
area
INSIDE BUNDIG
DESIGHATED
ALCONDL
COLSWAPTION U STREET
AREA
1.. OVER 21 ONLT AREA
• Dos!
HERHRT
isth stReet
I have read the above instructions and I declare under penalty of perjury that the above diagram is true and correct.
APPLICANT SIGNATURE DATE SIGNED
FOR ABC USE ONLY
CERTIFIED CORRECT (Signature) PRINTED NAME INSPECTION DATE ABC-253 (rev. 07/19) ATTACHMENT 1