Laserfiche WebLink
.� ookv�,- q---40-0 <br /> oPauln. APPLICATION — BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: -Tw1� TLA-U-Ma— <br /> Business Address: N, 0,kWIAOS j%-JC I Cross Sl W <br /> DBA Mailing Address: 2V5,P.on �QQV(,A"E . C%y: iwn) stare:�f1- zIP:gS <br /> Phe#: y Oc,&c)3-7W(0 `�T Assessor Parcel Number(s): 0 00 - (p <br /> Email: 3-t$ T f2.- I 4 q6twulA 1 , V.. <br /> Other Businesses at this Address: <br /> Previous Business at Address: pytgt'Ww1Cll—sI�P <br /> Description of Business Operation:: Lciii.V„ <br /> Type of Organization: X Single Owner ❑ Partnership ❑ Corporation ❑ Other. <br /> Estimated Number of Full Time Employees: J O Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: Se Applicant First Name: I.0 i <br /> Applicant Mailing Address: 29js (J, R.Q. I.ArV <br /> city AJ F State ZIP Applicant Phone No: Zp - jaQ3-R$ <br /> Water Supply ❑Pubik On-site Well Sewage Disposal: ❑ Public Septic System <br /> Will Mere be any sale of firearms? ❑ Yes No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> 1,affirm,under penalty of perjury that all the above information Is true and correct Date: Ii/ it /it <br /> 1,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: <br /> T F USE ONLY <br /> GIP Designation: Zoning: Use Type: + ('t' [tA/- mach. J <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: j <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden(yy <br /> Public works <br /> M.H.C.S.D. <br /> License Approved For: S <br /> Remarks: �y '� �i <br /> L[O ct.OGrp. <br /> Accepted as Complete: Date: <br /> F9D"S5v Planning Application FormslBusiness License(Rwiwo 0l-25-10) Page 2 of 7 <br />