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- <br /> ca <br /> �,.;�1� - <br /> a¢g"' gFPVICF APPLICATION — =BUSINESSLICENSESAN JOAQUIN COUNTYCOMMUNITY DE`�/�j BUSINESS LICENSE N <br /> 9�rFOR� <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE AP <br /> Business Information <br /> Business Name: ' r <br /> Business Address: - �` Cross Sl ,L\.� <br /> ,RPLICATION Mailing Address: City: —Phone _'",'�' c'— Assessor Parcel N mber( <br /> Other Businesses at this Address: ._�, . ry' <br /> Previous Business at Address: ^ <br /> Type of Business: , <br /> �(�f <br /> Type of'Organization: QZ Single Owner ❑ Partnership ❑ Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: Estimated Number of Part Tim r Seasonal Employees: <br /> Applicant Last Name: t (-��� Applicant First Name: <br /> Applicant Address: <br /> City aZ— Stater? ZIP y'' Applicant Phone No: _ �O <br /> Water Supply: ❑Public On-site Well Seviage Disposal: ❑ Public JR Septic System <br /> Will there be any sale of firearms? ❑ Yes No <br /> NOTE: ANY CHANGE CC ANC Y REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> Applicant's Signature: I <�� �,�j- Date: . I <br /> STAFF USE ONLY <br /> G/P Designation: Zoning: — Use Type: to A 7:1),r-lft <br /> DEPARTMENT APPROVED DENIED .DATE <br /> Development Services v Planner Name: <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden <br /> Public Works <br /> Solid Waste <br /> Euforcenldnt Officer <br /> License Approved For: y In vp pK c- ,/ v Kai, <br /> < L t cc <;r <br /> fed t�5 i�e55e5 l <br /> Remarks: <br /> 30 - I Liu - 13 S C, is n;l h <br /> Accepted as Complete: Dale: <br /> F:\DevSvcWianninq Application FormsWusiness License(Revised 12-31-02) Page 3 of 8 <br />