Laserfiche WebLink
G/;4120 09. 0 FAX 2094683163 SJC_CDMM_DEV jc0p)? <br /> oU3/GOB <br /> 1 ;= <br /> TIFL_......'.'. - <br /> U/ 6 APPLICATION — BUSINESS LICENSE <br /> tr I'SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> o F 7 LuC, <br /> F.-IVF BUSINESS LICENSE NO. `��2- <br /> T0; 3FE C0I_.PLET8b'BY'TWE'APPLICANT.PRIQR TO FILING TN.� <br /> Businessrinformation <br /> Business Name: o r <br /> BusinessAddress: Cross St <br /> 0 <br /> DBIA Mailing Address. c 1 t City State: ZIP: O(o <br /> Phone g: _ a( _ Assessor Parcel Numborw. <br /> Email: — t 3 t- Li ao - 1(—U-C=. <br /> Other Businesses at this Address: ct� <br /> Previous Business of Address: <br /> Type of Buslness: •`,� �� u� ��� <br /> Type o/Organization: ❑ Slnyie Owner ❑ Partnership Corporation ❑ Other. <br /> Estimated Number of Full Time FmptoyeesEslimaled Number of Pan Tune or Seasonal Employees: <br /> Applicant Last Name. ��w,. Applicant First Name'. <br /> Applicant Mailing Address t \ <br /> Cj <br /> CllyrZ" Slate 'i-Q TIA Appllcant Phone No! q <br /> Water Supply: []Public On-like Well Sewage Disposal, 0 Public Septic System <br /> WIII there be any sale of firearms ❑ Yes x No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> I, affirm,all tho above information is true and correct Dale: o <br /> Applicant's$19nalure <br /> STAFF USE ONLY <br /> G/PDesignalio Toning: 40 -- UsaType- <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services .- Planner Name: io•ao•d <br /> Building Inspection <br /> Environmental Heallh Div 10 2-7 G , <br /> Fire Warden <br /> Public Works <br /> M.H.C.S D. <br /> License Approved For. Ir �- <br /> U COQ 7 <br /> Occ Grp <br /> Accepled as Complete Da(c: <br /> F iDevSvc%Planning Application Formsv3u%ine.re license(aev sr-o 0e.7 1.07) Page 2 of <br /> Pw 19V__A� c OVA�� <br />