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SAN JOAQUIN COUNTY Control No. <br /> Date License Issued <br /> BUSINESS LICENSE APPLICATION B. L. No. 9� <br /> PRtM Receipt No. <br /> a? Qom Fee1 Yr.Q 3 Yr. <br /> - c < <br /> I IIPtIP� '�" <br /> Business Name: P Phone: !44<4— <br /> Business Address: A 1c),9!�/ ��� gS�OS <br /> Other Business at Address: <br /> Assessor Parcel Number(s): <br /> Mailing Address: 221 / / <br /> Type of Business 1,n/� S11 1< �— j7 4;e-.056,,1 <br /> t <br /> Will there be any retail sales of pistols, revolvers or other concealable firearms? ❑ Yes XNo (It yes, Sheriff's Office <br /> review is required.) <br /> j' Type of Organization: ❑ Single Owner, b�Partnership, ❑ Corporation <br /> Estimated Number of Employees: / Full time, Part time or Seasonal <br /> Owner(s) Name; ,-MCP f.Ap��4I'A , / .al. <br /> Owner(s) Address: ,,21t, �jro�.. Q T S UTIII ITIES <br /> Manager's Name: WATER: Public ® Well ❑ <br /> Previous Business at Address: Sanitary: Public ❑ Septic fD <br /> Other Local Business Address(e <br /> �. <br /> Applicant's Signaturd:����'%� - Date: 3- / � <br /> STAFF USE ONLY <br /> i Zoning: ' ' Section No.: ') ' --' `i General Plan: <br /> Department Approved Denied By '.i' Date <br /> Planning Division ❑ <br /> Building Division <br /> ❑ ❑ <br /> 4 Fire District ❑ ❑ V � <br /> Public Works 0 ❑ r- •�_ - I `' 1 <br /> Environmental Health Div. [4 ❑ � <br /> Air Pollution Control Dist. ❑ ❑ <br /> Sheriff (firearm sales only) ❑ ❑ <br /> License Approved For: <br /> f <br /> i <br /> Remarks: <br /> Accepted as complete on: -_ By: <br /> Copies: WHITE-Planning. BLUE-Building. GREEN-Fire District, GOLDENROD-Public Works. PINK-Ermsomental Health ON, CANARY-APCD PLANNING 21 191901 <br />