Laserfiche WebLink
TO BE'COMPLE1a.rD'BY THEAPPLICANT PRIOR T'u . "ING THE APPLICATION <br /> i <br /> Business Information <br /> Business Name: Ln',d 4 i k/ I DBMif different): <br /> Business Address: A)• 13 1W HD <br /> Lt/'q V S T• S7uc rv-1 �t SZ� <br /> Omer Businesses at this Address: ).1 G z. <br /> �G Z 4 Z Assessor Parcel Numbere): S Z 3 <br /> Phone: . / <br /> Mailin Address: /� G ,(J, g,fa.4au119,< <br /> Type of Business: S ^,C—C5-, iJ S J <br /> /2 V 2 <br /> Tvoeof0 anization: 951n le Owner ❑ Parthershio ❑ Coroorabon ❑ Other. <br /> Estimated Number of Full rime Emolo ees' Z I Esdmated Number of Part rime or Seasonal Emolovees: O <br /> Business Owneds)Name: 14 X27- /L e.e OGK <br /> Business Ownerlsl Address: <br /> Marta ers Name: r 0 'e . 'N R N <br /> V <br /> Previous Business at Address: 47,07 -EO 159(—1-- e-rd'e 7" L414 V <br /> Omer Local Business Locations lAddressl: fv ✓or <br /> `Neer Suooty: _Public = On-site Well I S e Disoosal: 4 i'rublic ❑ 9eodc System <br /> 'Niil mere bs anv retail sales of oismis.revolvers or ower concealable firearms? ❑ Yes Or'No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> Acolicanfs sionature: I Date: <br /> STAFF.usE 64LY , <br /> General Plan Cesicnaton: L L. Zoning: <br /> DEPARTMENT APPROVED DENIED 3Y I DATE <br /> Deyemoment services I I 01-SlyG <br /> Building Inspection <br /> Environmental Health Div I I d�iCG(.(L(r ✓�.ILG � I c�� <br /> Fire District I F <br /> Air Pollution Control Dist <br /> Office of Emergene/Services <br /> Enforcement C•'.fflcer <br /> Sheriff(firearm sales only) <br /> Ucense Actroved For. av, <br /> Remarks: iii'—*C rV S,AAeLA,s Uft - e*o--XJ-- ewtI*-NrMA7&-"as"U— <br /> ���(]��S �I.I/'ES r� ("�/ �'�rf.'L"YL(A a QA(.�, r/S.Q' e 5 � •N G � i <br /> Accepted as Comment: Date: <br /> PA_BLLG Rev.August 6, 1996 <br />