Laserfiche WebLink
r <br /> P APPLICATION — BUSINESS LICENSE <br /> �;;rj SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. 8L— 1-70-9Z9 I <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: --VL•0 <br /> Business Address: 6 g,., I 01-- <br /> DBA <br /> 1DBA Mailing Address:�{ CRY"' State: ( ZIP: I 03 <br /> Phone#: 7„s;f- J93/-0oz4Assessor Parcel Nu ber(s): I I- je <br /> Email: a <br /> Other Businesees at this Address: <br /> Previous Business at Address: YInnJ e.I I C f r - r, <br /> Descdptlon of Business Opomtion:: n.0-r r\k ,A eL 't r 4 r � rizo i J c 4 vq <br /> Type of OrgaNzalion: D Single Owner 8 Parbwmhlp ❑ Corporation D Other. <br /> Estimated Number of Full Time Employees: Estimated Number of part Time m Seasonal Employees: <br /> Applicant Lest Name: 6tN W Applicant Flnd Name: W&L41 4M <br /> Applicant Melling Address:,900 E FSS o iM CA S3 <br /> City /Z• Slate C,¢ ZIP Applicant Phone No: 709j•- C31—Do Z•Ce <br /> Water-Supply: NPublic D Onalte Well Sewage Disposal: (0 Public D Septic System <br /> Will there be any sale of firearms? D Yes ® No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> I,affirm,under penalty of perjury that all the above information is true and correct Date: <br /> I,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and Its <br /> agents,officers and employees from any claim,action or proceeding against the County <br /> arising from the Owner/Agent's project <br /> Applicant's Signature: Jzi� la a <br /> STAFF USE ONLY <br /> GIP Designation: Zoning: Use Type: <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name:( <br /> Building Inspection <br /> Environmental Health Div LV - 5Uq <br /> Fire Warden Ax M <br /> Public Works <br /> M.H.C.S.D. w <br /> Ucenee Approved Far. •j•!y S L.L O -15 ) G^ /n }e - 4 <br /> Remarks: t7 {�, <br /> Oco.Grp. <br /> Accepted as Complete: Date: <br /> F/ApplicationsfonnsBHandouts/PlanningAPPfice6onsBusiness License(Revised 02-24-15) <br /> Page 2 of 6 <br />