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APPLICATION-BUSINESS LICENSE <br />SAN JO AQUIN COUNT Y CO MM UNIT Y DE V ELOP M ENT DEP A RT MENT <br />B USI N ESS LI CE NSE NO. (6 L -1 g 0 Q iS"] <br />Previous Bus ine ss at Address: <br />Des cr iption of Business Opera tion:: <br />Type of Organ izat ion: 0 Sin gle Ow ne r 0 Pa rtn ers hip 'ta Corpora t io n 0 Ot h er: <br />A ppli ca nt First Nam e : <br />A pp lica nt Pho ne No: <br />Sewage Disposal: [j;ll Public 0 Septic System <br />W ill there be any sa le of fi rearms? 0 Yes l:l!t No <br />NOTE : AN Y CHANGE OF OCCUPANCY MAY ~REQUIRE BUILQING IMPROVEMENTS AND .!\!.E CESSARY BUILDING PER MITS . <br />I , affirm , und e r penalty of perj ury that all the above information is tru e and correct <br />I , th e Owner/Agent agree, to defend , indemnify, and hold harmless the County and its <br />ag ents , of f icers and employees from any claim , action or p roceeding against the County <br />aris i ng from t h e Owti e ent's project. <br />AP PROV ED <br />Fire Warden <br />Pu bl ic Wo rks <br />M.H.C .S.D. <br />Li ce nse App rov ed Fo r : <br />Rem arks: <br />Da te : <br />Occ. Grp. <br />Accep ted as Complete : <br />F /Appli cations Forms&Hando uts /Pian ni ngApplications/B us i ness Li ce nse (Revised 02-24-15 ) <br />Page 2 of 6 <br />B t -t 7 o oo c; { <br />Da te : <br />6 (1~/tg