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FCOPY <br /> pnu),ry APPLICATION - BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> MAR 2 6 2008 <br /> I BUSINESS LICENSE NO. <br /> NVIRONMENT HEALTH <br /> .c4trcoa, c <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: J. R SjmRlot Cg=any <br /> Business Address: 4863 Carpenter Road Cross St Mariposa Road <br /> DBA Mailing Address: 4963 Cgirpenter Road City: tnnStale: PA ZIP: <br /> Phone#: (209) 941-4456 Assessor Parcel Number(s): 17905010 <br /> Email: janene.kattner@simplot.com <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Tye of Business: C�7�I� �� I fes/•f y�-•� <br /> ® � . <br /> Type of Organization: ❑ Single Owner ❑ Partnership Corporation ❑ Other. <br /> Estimated Number of Full Time Employees: 6 Estimated Number of Part Time or Seasonal Employees: 0 <br /> Applicant Last Name: �� E,- Applicant First Name: 1�n <br /> Applicant Mailing Address: P.O. BOX 27 . <br /> Cay Boise IState ID zip 8370 Applicant Phone No: (208) 389-7313 <br /> Water Supply: ❑Public k] On-site Well Sewage Disposal: ❑ Public Septic System <br /> Will there be any sale of firearms? ❑ Yes ® No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> I, affirm,all the aboveinform i is true and correct Date: <br /> J. R. Simplot Co y d/b/a S lot Grower Solutions November 7•g, 2007 <br /> Applicant's Signature: <br /> GRAY YOUNG, Asistant §_F{FFF ONLY <br /> G/P Designation: Zoning: IUse Type: <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services 49Planner Name: <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden <br /> Public Works <br /> M.H.C.S.D. <br /> License Approved For: <br /> Remarks: [--> •`�S•22j <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F-DevSv6Planning Application FormsiBusiness License(Revised 89-12-07) Page 2 of 7 <br />