Laserfiche WebLink
APPLICATION - BUSINESS LICENSE <br /> F :,`l +. •t ��t g ] 10JOAQUIN COUNTY COMMUNITY DFVELOPMENT DEPARTMENT <br /> ` tSVI�tONMrtiTAWFALTH BUSINESS LICENSE NO. SL— I�l 0eQ <br /> tl4u$ � <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Informatlon <br /> Business Name: Vi)b 3A, Arro k <br /> Business Addfess: U Cross St -W <br /> DBA Mailing Address: I City: l,0(tu Q I state: CA ZIP: q 4>-I <br /> _Phone S: 00q)3G — )qIq_ Assessor Parcel Number(s): 0 5 5 _ Ile 0^5,1 •-U a O <br /> Emag: ..I/sxrCk6a-_ ,,,ter +tiN�iVa&k 'd h,6 k_NJyt-ko0. Con•v �. <br /> Other Businesses ai this Address: <br /> Previous Business at Address: <br /> Description of Business Operation:: 6-&S 5 C- $ rG <br /> Type of Organization: f] Single Owner ❑ Partnership Corporation ❑ Other. <br /> Estimated Number of Full Time Employees: Estimated Number of Part Tints or Seasonat Employees:�} <br /> Applicant Last Name: ��{I\1rL SLP _ Applicant First Name: <br /> Appikanl idailinq Address: A I . <br /> City .Xi,(%'A,%A,/Lip I State CA ZIP q.S?;?_I I Applioanl Phone No: ( q(Ce �j•. D I �'�. <br /> Water Supply: ElPubllo ❑ On-site Well Sewage Disposal: ❑ PubIIC d septic System <br /> Will there be any sale of firestins4 Q Yes No - - - - -- <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> I,affirm,under penalty of perjury that all the above information Is true and correct Date: <br /> 1,the Owner/Agent agree, to defend,indomnify,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: Cut L /y t1yY11_,P 1'0 <br /> STAFF USE ONLY <br /> GIP Designation: �' .S Zoning: �-� �,} Use Type: 6gs0 <br /> DEPARTMENT APPROVED DENIED _ DAT <br /> Development Services <br /> ces Psanner Name <br /> Building Inspection <br /> Environmental Health Div <br /> (U <br /> FireWo w, <br /> Public Works <br /> M.H.C.S.D. <br /> License Approved For. <br /> Remarks: <br /> .Z Oce.Grp. <br /> Accepted as Complete: Data: <br /> F/APPIIcallonsFormsaHandoulslPlanningAppli ationsfBusiness Ucense(Revised 11.14.11) <br /> Page 2 of 6 <br />