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p9p fy <br /> -..� . @gIO� BUSINESS LICENSE <br /> SAN JOA �MTUNITY DEVELOPMENT DEPARTMENT <br /> JU" 56$IIYC'(M{�1 ZS LICENSE NO. <br /> c'•- .L� Z)AN JUAUl-qN UUUNIY <br /> <r FOC <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business informati n <br /> Business Name: Mo-callY\ <br /> Business Address: +.p Cross St <br /> DBA Mailing Address:10979City: I State: CA ZIP: <br /> Phone A '70 S Assessor Parcel Number(s): `]b_ <br /> Email F S O M - <br /> Other Businesses at this Address: (_-' <br /> Previous Business at Address: <br /> Type of Business: <br /> Type of Organization: A Single Owner ❑ Partnership ❑ Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or S sonal Employees: <br /> Applicant Last Name: PH Applicant First Name: Ap <br /> Applicant Mailing Address: '0 <br /> city S-kVC'kL1b1 I State CAZIP Applicant Phone No: 707- 1IJ <br /> - 9 <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 /> 1, affirm,all the above information ij jrue and correct Datie/�: ']nC <br /> Applicant's Signature: <br /> STAFF USE ONLY <br /> G/P Designation: C✓ Zoning: v Use Type: <br /> �N <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: •��,O <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. <br /> Remarks: C) <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F9DevSvOPlanning Application Formsteusiness License(Revised 08-30-06) Page 2 of 7 <br />