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-4cf .t <br /> P'g'lH`'•o APPLICATION — BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> < BUSINESS LICENSE NO. O�(OOOSj <br /> '4t)co'ai'`7 <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information' <br /> Business Name: a 5M l ON <br /> Business Address: Cross St F �;-- <br /> DBA Mailing Address: rat 0, 1 r I City: 5'Ts oI'I - State: CA ZIP:g5,20 <br /> Phone#:(Ao,l ) 4419 --qV08, Assessor Parcel Number(s): O <br /> Email: 5OLit4A 4P1 IQ Y <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Type of Business: 12 L c✓ �l E <br /> Type of Organization: Single Owner ❑ Partnership ❑ Corporation Other: <br /> Estimated Number of Full Time Employees: p7 Estimated Number of Part Time or Seasonal Employees: •o-- <br /> Applicant Last Name: CletwF111, Applicant First Name: <br /> til Applicant Mailing Address: -7.11 0• 5-r <br /> City 5'r C!c 4-64 State eA • I ZIPa o Applicant Phone No <br /> Water Supply: []Public ❑ On-site Well Sewage Disposal: ❑ Public Septic System <br /> Will there be any sale of firearms? ❑ Yes "o <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 Date: <br /> Applicant's Signature: eh Acwv� <br /> STAO USE ONLY <br /> GIP Designation: I t— Zoning: 1— Use Type. V C� -- <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: . p�•�, <br /> Building Inspection <br /> Environmental 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 01-18-08) Page 2 of 8 <br />