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SAN JOAQUIN COUNTY control No. <br /> Date License Issued <br /> BUSINESS LICENSE APPLICATION B. L. No. <br /> Receipt No. <br /> -4 ! Fee 1 Yr. 3 Yr.,O. <br /> ENVPIERMIT SERVICESLTH <br /> Business Name: Phone: ��'°'-�S='—i 155 <br /> Business Address: 29 i, lid f;Loc li toyi, Cir 95205 <br /> Other Business at Address: At6hiz'tis 'I i ansnc:rtat: i c.,n ',-v ;.:Fm <br /> Assessor Parcel Number(s): <br /> Mailing Address: ?2 r,F) 1 or>ori 4 c^ r. <br /> Type of Business: t: 1t sc-1 'Rk Aa i <br /> Will there be any retail sales of pistols, revolvers or other concealable firearms? ❑Yes ID No (If yes, Sheriff's Office <br /> review is required.) <br /> Type of Organization: ❑ Single Owner, ❑ Partnership, ® Corporation <br /> Estimated Number of Employees: 2 Full time, 2 Part time or Seasonal <br /> Owner(s) Name: DFi v i d J. <br /> Owner(s) Address: P•U, BOX 1071 San 3060` C'A 95108 UTILITIES <br /> Manager's Name: ME, E[1zfot TA. Vattilta WATER: Public ❑ Well E2 <br /> Previous Business at Address: Sanitary: Public ❑ Septic M <br /> Other Local Business Address(es): <br /> Applicant's Signature: / �.�,!/ Date: <br /> STAFF USE ONLY <br /> - Zoning: Section No.: V General Plan: `"t'� y % 1 ! f,-• <br /> Department Approved DenieO By, `I, r Date <br /> Planning Division Lxl ❑ f <br /> Building Division ❑ ❑ <br /> Fire District ❑ ❑ <br /> Public Works ❑ ❑ <br /> Environmental Health Div. <br /> rd D .� <br /> Air Pollution Control Dist. ❑ ❑ <br /> Sheriff (firearm sales only) ❑. ❑ <br /> License Approved For: <br /> Remarks: <br /> Accepted as complete on: By: <br /> Copies: WHITE-Planning, BLUE-Building, GREEN-Fire District, GOLDENROD-Public Works, PINK-Enviromental Health Div., CANARY-APCD PLANNING 21 191901 <br />