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APPLICATION - CrLISINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> < BUSINESS LICENSE NO. /� �S-2�'620 / <br /> �'P(iFo'ni'v? <br /> TO BE ZCOMPLETED THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> 4Email::: <br /> ame:ddress: "` �,F' Cross St Address: City: L / State: <br /> Assessor Parcel Number(s): <br /> O <br /> wAinesses at this Address: <br /> usiness at Address: <br /> Type of Business: G� <br /> Type of Organization: ❑ Single Owner ❑ Partnership Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: 2' Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: E/ Applicant First Name: <br /> Applicant Mailing Address: 1,047. Q 1284• <br /> City State ZIP Applicant Phone Na -f;) <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 /> I,affirm,all the ab matin • true and correct Date �yt <br /> Applicant's Signature: (::O l O <br /> FF USE ONLY <br /> G/P Designation:0S/)2-C. Zoning: 9 C7 Use Type: c.if/N��'(t�L'L•I-�L-� �7Y1Y'Z�— [...,- k <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: "fie 6'Jr+ 4—/ . <br /> Remarks: <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> FF\DevSvc\Planning Application Forms\Business License(Revised 05-01-08) Page 2 of 7 <br />