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r <br /> APPLICATION - BUSINESS LICENSE <br /> a•�t+. <br /> c� °y SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. <br /> Ctkif�+�' <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: vos.1 <br /> Business Address: ' Cross St ^'A <br /> DBA Mailing Address:' ^� city: LO A <br /> State: l ZIP J <br /> Phone#: C 10 Assessor Parcel Number(s): 6 �3 <br /> Email: VM <br /> Other Businesses at this Address: (`1111111/5 201Mkid <br /> Previous Business at Address: M\I- <br /> Type of Business: <br /> Type of Organization: ❑ Single Owner ❑ Partnership ❑ Corporation {3:Dther. <br /> Estimated Number of Full Time Employees: 2, Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: Applicant First Name: ' (� <br /> Applicant Mailing Address:', QDV� AN r� d �7 1 <br /> City State ZIP 2 Applicant Phone No: 2 3 1.'—C) Ci-l-1 <br /> Water Supply: <br /> []Public On-site Well Sewage Disposal: ❑ Public A Septic Systern <br /> Will there be any sale of firearms? ❑ Yes .�t,No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> I, affirm,all the above iuPrfikation is true and cor ct Date: / <br /> Applicant's Signature: 1 D / 2 / lM <br /> 11 1 STAFF USE ONLY <br /> G/P Designation: A I Zoning: Use Type: <br /> pFireWarden <br /> EPARTMEN APPROV D DENIED QftT <br /> ent Services Planner Name: O o V <br /> spection <br /> ental Health Div <br /> rks <br /> Solid Waste <br /> Enforcement Officer <br /> M.H.C.S.D. <br /> License Approved For: hf 5 5 e \ L 0 K� D ¢ L <br /> h L h <br /> Remarks: <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:\DevSvc\Planning Application Forms\Business License(Revised 08-30-06) Page 2 of 7 <br />