Laserfiche WebLink
APPLICATION - BUSINESS LICENSE <br /> Q. SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. <br /> erFORa <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: 2,4 T.rtc-iZ)12� <br /> Business Address: LAI =FI,A Cross St C � <br /> DBA Mailing Address: i-0 2 1 city: ' j0Lllc7Crj State: G.� ZIP:qiz <br /> Phone#: 20- Lo 717 Assessor Parcel Number(s): 3 <br /> Other Businesses at this Address: STQ(p OrV S�WJL yCf 6'r" 1;gklo <br /> Previous Business at Address: S�t <br /> Type of Business: Qi1)-A — Pf,-c C+— <br /> Type of Organization: ❑ Single Owner ❑ Partnership ❑ Corporation Other. ttu5 W%f-r- <br /> Estimated Number of Full Time Employees: Z Estimated Number of Part Time or Seasonal Employees: (o <br /> Applicant Last Name: "t�IZ Applicant First Name: AN(CL <br /> Applicant Mailing Address: I 0� 7 7.4nJk- f}Wk JY�t Wf <br /> City s-To('k /J I state GA ZIPq.5>.g Applicant Phone No: 2oq—&-7-77$-j <br /> Water Supply: ❑Public ❑ On-site Well Sewage Disposal: Public ❑ Septic System <br /> Will there be any sale of firearms? ❑ Yes No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> A 411 I,affirm,all the above information is true and correct Date: <br /> Applicant's Signature: <br /> ��/o /os <br /> STAFF USE ONLY <br /> G/P Designation: C L Zoning: -V Use Type: <br /> DEPARTMENT APPR VED DENIED DATE <br /> Development Services Planner Name: t't 1,7 4 <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden <br /> Public Works <br /> Solid Waste <br /> Enforcement Officer <br /> M.H.C.S.D. <br /> License Approved For: �, '1. I yrZl" - 4_"11L p J(jp <br /> Remarks: ,(� /,�, V- a• <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:\DevSvc\Planning Application Fonns\Business License(Revised 10-20-05) Page 3 of 8 <br />