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y �i-0I � SAN JOAQUJN COUNTY control No. <br /> JJDale License Issued <br /> s �•r n PU9INESS LICENSE APPLICATION B. L. No. r `— <br /> JCP Z 178 Receipt No. - <br /> E 'Airy•• Fee i Yr. 3 Yr.� <br /> CLAVI '•a HEALTH <br /> Business Name: Phone: <br /> Business Address: <br /> Other Businesses at Address: A)Q �H>` /f <br /> Assessor Parcel Number(s): <br /> Mailing Address: <br /> Type of Business: k02,A i t i Y)'? FY i n P <br /> Will there be any retail sales of pistols, revolvers or other concealable firearms? [-]Yes CKNo (If yes, Sheriff's <br /> Office review is required.) <br /> Type of Organization: ❑ Single Owner, ®�Partnership, ❑ Corporation <br /> Estimated Number of Employees: ea ull Part time or Seasonal <br /> Owner(s) Name: J ir'i ke C'.- � a re <br /> Owner(s) Address: 7( + g rr O_ i,)r— <br /> Manager's Name: <br /> Previous Business at Address: <br /> Other Local Business Address(es): <br /> Zoning: (1 PT_Section No: AAl General Plan: <br /> Department Approve d Denied By / Date <br /> Planning Division ❑ / 7-/ ( , <br /> -�f z <br /> Building Division / ❑ ❑ <br /> Fire Warden ❑ ❑ - <br /> Public Works ❑ ❑ — <br /> Local Health District ❑ W ' �3�� <br /> Sheriff (firearm sales only) ❑ ❑ <br /> Remarks: 4�� .& <br /> Accepted as complete on: By: <br /> Copies: WHITE-Planning, BLUE-Building, GREEN-Fire Warden, GOLDENROD-Public Works, PINK-Local Health District, CANARY-Applicant <br /> ' ® PLANNING-21 (2/961 <br />