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SAN JOAQUIN COUNTY Control No. <br /> Date License Issued <br /> BUSINESS LICENSE APPLICATION B. L. No. X26 <br /> �»..�� <br /> FeeAo--�.+-�-1 Yr.Q 3 Yr. <br /> r. <br /> c 1� <br /> b: < <br /> •.O `P <br /> ��rFOA� <br /> Business Name: ' c.�' "ti Phone: <br /> Business Address: ` /y /f✓ k2, kr 4. f -�. o . rK <br /> Other Business at Address: �.- ",� "' %�_, F... y` �r%�rd` ? `T. _rT'"� r✓ '! � t- t'.. <br /> Assessor Parcel Number(s): Z ' h <br /> Mailing Address: 3 a y /t' 1;tr/ �r n,u ,cJ':r�. `rTGS c �r .�✓ <br /> s <br /> Type of Business: <br /> Will there be any retail sales of pistols, revolvers or other concealable firearms? ❑Yes ❑ No (If yes, Sheriff's Office <br /> review is required.) <br /> Type of Organization: ❑ Single Owner, fit Partnership, ❑ Corporation <br /> Estimated Number of Employees: _T_ Full time, Part time or Seasonal <br /> _,7 <br /> Owner(s) Name: ) ,r� � r_-rte, <br /> Owner(s) Address: y 2 Va (��2 e� �� r`t' UTILITIES <br /> Manager's Name: -- WATER: Public ❑ Well ❑ <br /> Previous Business at Address: L" c.' Sanitary: Public ❑ Septic Q <br /> Other Local Business Address(es): 2 -"" 3 V �V <br /> Applicant's Signature: <br /> Date: > <br /> STAFF USE ONLY <br /> Zoning: " " f)4 Section No.: ^r"4 (2/deneral Plan: <br /> Department Approved Denied By __ . - Date <br /> Planning Division E ❑ 2r r r I�e x• ; ',; J! <br /> I <br /> Building Division ❑ ❑ <br /> Fire District ❑ ❑ <br /> Public Works a ❑ �' -•- ) <br /> Environmental Health � � % • . � cr <br /> Air Pollution Control Dist. ❑ ❑ <br /> I <br /> Sheriff (firearm sales only) ❑ ❑ <br /> 1 <br /> License Approved For. <br /> f Remarks: 5[ as h esS du%ll !?ePLm A So.� 1!�V GtJ&she_ �,-j7ri�u�� <br /> Accepted as complete on: �J By: <br /> Copies: WHrrE-Planning, BLUE-Building, GREEN-Fire District, GOLDENROD-Public Works, PINK-Erniromental Health, CANARY-APCD PLANNING 21 (12188) <br />