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ayln APPLICATION - BUSINESS LICENSE <br /> y SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. OQ Oo1 ley <br /> rF0 <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: ,5 d E .S <br /> Business Address: 10 8-fjq /V w 99 CTI <br /> St 7 (��� �()/j \ L tV <br /> DBA Mailing Address: SODD � City: L5 vnj ( State: Cl) ZIP: <br /> Phone* 7 - 74 3 - ,S 5 Assessor Parcel Number(s): p (0 .- p7 O -O N <br /> Email- 00 <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Type of Business: r^y' ,\L<Y RECEIVED <br /> Type of Organization: Single Owner ❑ Partnership ❑ Corporation ❑ Other: bAN IN COUNTY <br /> Estimated Number of Full Time Employees: `, Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: A i.,L Applicant First Name: r A m <br /> Applicant Mailing Address: © g a.- <br /> City I Slate C ZIP 1591 Applicant Phone No: 25—L461 - <br /> 61 - 99 - y - 9SS <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 informs ' is true and correct Date: <br /> Applicant's Signature: r <br /> STAFF USE ONLY <br /> G/P Designation:e 641. Zoning: �,� Use Type: ).s 5 o L)2�'4- 5 CA1/+-q l�s(iyS> <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: /' c� �'-L 0 4 <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: <br /> Remarks: <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:\DevSvc\Planning Application Forms\Business License(Revised 03-09-09) Page 2 of 7 <br />