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on4S N•.� APPLICATIO — BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMM9WY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO.A- <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO rFILINd THE APPLICATION <br /> Business Information <br /> Business Name: C 0 v,, j f' e W eld ert ,/ <br /> Business Address: M9 N 9(0 jVV6 Pf'/e cross St <br /> 149111 8roaow uE City: oG kov, State: CPt zIP:`1S"ZO5 <br /> Phone#: Cj L161 3086 113 - 6-o ;-3 <br /> Email: u d C PpvN It16N161�P,I5Su ( .COM <br /> otn Non16 <br /> No1J� <br /> usmess: vv7M 1 h 5applie <br /> Type of Organization: ❑ Single Owner ❑ Partnership Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: 5 Estimated Number of Part Time or Seasonal Employees: <br /> dw tle.5IC 1 /YIXAT— <br /> ess: 00.Bo/c /SSS <br /> City 0§WZjr A 7-2.SS-6sSS <br /> Water Supply: '@ Public ❑ On-site Well Sewage Disposal: 0 Public Septic System <br /> s? ❑ Yes A No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> I, affirm,all the above information is true and�correct DateE— <br /> Applicant's Signature: Af'C✓ <br /> STAFF USE ONLY <br /> G/P Designation: Zoning: Use Type: V <br /> DEPARTMENT APPROVED DENIED Qnt D E <br /> Development Services Planner'Name: _ <br /> Building Inspection <br /> Environments!Health Div <br /> Fire Warden <br /> Public Works <br /> M.H.C.S.D. <br /> Sheriff(Junk Dealers Only) <br /> License Approved For. <br /> Remarks: <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F'\DevSvc\Planning Application Forms\Business License(Revised 05-01-08) Page 2 of 7 <br />