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r! '�fmi N — BUSINESS LICENSE <br /> r.' <br /> SAN JOAQUI G M ITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. F3L_- G am') <br /> o4[fFaV+;��Y• MIY JU/1i/tN;N a <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: T 5 v-0M� , LL. c� - (� 1 <br /> Business Address: 1 7 -S w � Cross St C�Q,v.,T Jw p <br /> DBA Mailing Address: �{S - Lk 9s=�e �City: "r' State: V ZIP: O <br /> Phone# d. - 7 Q U Jo v Assessor Parcel Number(s): - 060 I L <br /> Email: <br /> Other Businesses at this Address: <br /> Previous Business at Address: ` q,yh1Z <br /> Type of Business: to <br /> Type of Organization: ❑ Single Owner ❑ Partnership Corporation ❑ Other <br /> Estimated Number of Full Time Employees: a. - Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: ,r a.er Applicant First Name: C,�\2 <br /> Applicant Mailing Address: `{SO S'. ytil. is . 'J`:� -.)_Vj <br /> City J,r— I State WA ZIP ftSUOI Applicant Phone No: aS3 b9t9 - e n1J - <br /> Waler Supply: Mpublic ❑ On-site Well Sewage Disposal: Public ❑ Septic System <br /> Will there be any sale of firearms? ❑ Yes No K <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 /> - 17- 0(b <br /> Applicant's Signature: ... <br /> STAFF USE ONLY <br /> G/P Designation: G/G. Zoning: G. -G Use Type: tr I Saps -Combtl� r'7 <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services - Planner Name: <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: �S �, G.Y� I- --1 <br /> Remarks: (- - 2� <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F\DevSvc\Planning Application Forms\Business license(Revised 12-24-07) Page 2 of 8 <br />