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pe.4S�I�L. APPLICATION — BUSINESS LICENSE <br /> r. k1 SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. 0166112, <br /> \FOR <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: <br /> Business Address: Q 8 7 6; ..H 10i H14,00-r7lCross St 141col W 9 <br /> DBA Mailing Address: tv G r1'�7 D State: eA I ZIP: 995/0 <br /> Phone#: 0 4 – . 2 Assessor Parcel Number(s): <br /> Email: FASTEASYIbA <br /> Other Businesses at this Address: h p <br /> Previous Business at Address: Y-p V\ <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: All Applicant First Name: ZVyyj <br /> Applicant Mailing Address: 2© w -e 60 4 <br /> city e0_) o°yr 1 State r ZIP 9 4564 Applicant Phone No: 1325 – 6 1 – <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 above information is true and correct Date. <br /> Applicant's Signature.�—,L <br /> STAFF USE ONLY <br /> G/P Designation: C G Zoning. 2_ G Use Type:fe Ia.IG S• 11SI(Id� OeIMW ENC. <br /> DEPARTMEkIT APPROVED DENIED DATE <br /> Development Services t// Planner Nam 4– r7-6 <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: n l %j dL t)c <br /> o�v. <br /> marks: 1 <br /> - <br /> Occ.Grp. <br /> Accepted as Complete: Dale: <br /> F:\DevSvc\Planning Application Forms\Business License(Revised 08-30-06) Page 2 of 7 <br />