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J <br /> ti! <br /> APPLICATION - BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> f' BUSINESS LICENSE NO_LLQ-_ 1V_� <br /> r'q.i F ogN�p <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: C' r SIla Q <br /> PUII <br /> Business Address: 42- Cross St W <br /> DBA Mailing Address: 471 C 1 ,v City: State: CA ZIP: ZD <br /> Phone tt: 20 - bb-?_c3ij Assessor Parcel Number(s): - 111 - 13 <br /> Email: <br /> Other Businesses at this Address: <br /> Previous Business at Address: S W G <br /> Type of Business: n <br /> Type of Organization: ❑ Single Owner ❑ Partnership Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: 7 Estimated Number of Part Time or Seasonal Employees: NOO E <br /> Applicant as Name: •r Applicant First Name: S <br /> Applicant Mailing Address: I V <br /> City COC State Poll ZIP S74 Applicant Phone No: <br /> Water Supply: []Public On-site Well Sewage Disposal: ❑ Public LKSeptic 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,afNrin,all the above rmation is true and ct Date: <br /> Applicant's Signature: - orre I I 17-0107 <br /> STAFF USE ONLY <br /> G/P Designation: Zoning: - Use Type: <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: V <br /> Building Inspection <br /> Environmental Health 0, <br /> Fire Warden '7 <br /> Public Works <br /> M.H.C.S.D. <br /> License Approved For: <br /> Remarks: C <br /> I Sl U Q� <br /> Occ.Grp. <br /> Accepted as Complete n IDate: <br /> F:TevSv6PIanoIng Application FormslBosiness License(Revised 09-12-07) Page 2 of 7 <br />