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RECEIVED <br /> °Paul"' F, FIECEIVED AUG 1bPPLICATION - BUSINESS LICENSE <br /> c [ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> AUG 1 1 2009 SAN JOAQUINCQUNTY S <br /> (�FFICEQFEMER WOWRCENSENO. I dd <br /> roA�' C <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: <br /> Business Address: /a W Cross St 6d , <br /> DBA Mailing Address: 100-7 �d. C/5-2- � City: �c I', State: CA ZIP:C/S� (7 <br /> Phone#: Zoct 6 y a Assessor Parcel Number(s):C's c)�. 3 <br /> Email: ' d' .+..i rr✓ <br /> Other rusi;essa al this Address:'- e Cma )r; --- <br /> Previous Business at Address: <br /> Type of Business: <br /> Type of Organization: ❑ Single Owner ❑ Partnership Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: ^ a-4� Applicant First Name: S), 2 v-� <br /> Applicant Mailing Address: 6 aX I o <br /> City ) I State GA, ZIP c�Sa Applicant Phone No: ,209 C,2_ ;;k SS <br /> Water Supply: ❑Pu lic 2r� -site Well Sewage Disposal: ❑ Public >fteptic System <br /> Will there be any sale of firearm ❑ Yes No <br /> NOTE: ANY CHANGE OF OCALIPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> 1,affirm,all the above i rmation is true and correct Date: <br /> Applicant's Signature: <br /> STAFF USE ONLY <br /> G/P Designation: Zoning: Use Type: r 61-' '0K ,6o-[JW5 -L <br /> DEPARTMENT APP OVED DENIED 6WF <br /> Development Services Planner Name: Vj <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: tl}� rl..(� Ula F i 'D <br /> Remarks: F...� L-'IS hr 5 <br /> e,(ri t c/ 06 ,6 33 <br /> Occ.Grp. <br /> Accepted as Complete: I Date: <br /> F:\DevSvc\Planning Application Fonns\Business License(Revised 03-09 09) Page 2 of 7 <br />