Laserfiche WebLink
0 / ,) -6i-io <br /> APPLICATION - BUSINESS LICENSE <br /> ••.rr� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name _, 13 Tf Qno1-4 =y�( . <br /> Business Address Z 12 Io L pprrl I S Roct til Cross St <br /> DBA Mailing Addres $ Z Citv, State:\\C A zI G <br /> Phone# 14-1 q LI I q a 1 E,--1 Assessor Parcel Numbers) - <br /> Email <br /> Other Businesses at this Addressi <br /> Previous Business at Address <br /> Description of Business Operation <br /> Type of Organization ❑ Single Owner ❑ Partnersh p ISI Corporation ❑ Other: <br /> Estimated Number of Full Time Employees. Estimated Number of Part Time or Seasonal Employees. <br /> Applicant Last Name e-I),c Cc CA Applicant First Name. nJ C(I F <br /> Applicant Mailing Address P D <br /> city L.G,C E 1 i State Ali? I ZIP-12--l-461 Applicant Prione No —L4 I CJ— 15-7 <br /> Water Supply ❑Public On-site Well Sewage Disposal. Public ❑ Septic System <br /> Will there be any sale of firearms? ❑ Yes (3 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 /> I,the Owner/Agent agree, to defend, indemnify, and hold I the County and its <br /> agents, officers and emplo ees fro.�any claim. action or ee qg against the County <br /> arising from the Ow <br /> Applicant's Signature.oe <br /> STAFF USE ONLY <br /> CP Desrgnal+on L Zoning 'L Use Type I r t �, r"S �• t', �� <br /> DEPARTMENT — APPR VED DENIED D <br /> Development Services Planner Name Z <br /> BuikWq Inspection ---—— JA <br /> — <br /> Environmental Health Div <br /> Fire Warden d- 7)k -- — <br /> Public Works 11 <br /> License Approved For: ( tr <br /> Remarks <br /> �Occ Grp i <br /> Accepted as Complete Date <br /> F,DevSvcTlanrnng Application Forms�Buwess L,--ease;RE,-,+sed of 25 K, Faye of ' <br />