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• QP4144.N, � <br /> APPLICATION - BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FB 191992 B.L. NO. - qoZ- gyp/ <br /> COtoiMUlVIIYUcbL11)Fc: v; .;'.; �, RECEIPTNO. <br /> P1.AfdPa1PlG Ui9litii'4 FEE: `� 1 YR. 3 YR. <br /> ff.T �� pBECpNAV(EFEp9Y7HEApCt1ICAfJYpR1pFTAILINQTMEfAtspF1CATIpCV <br /> NMI )f�\:c 4 f3=f S L}r,(,k:. <br /> '�s;"oc: f s . s'c x L .?�. �UAIII@9tE ltifottnatlon •;< ,; f ';.; ti. . ,? :fx ,�<.�la�`L�g�( <br /> Business Name: -I�1 i- 5 DBA(If differenQ: <br /> Business Address: + 9 7- Glknrskv S+1 0_4 <br /> Other Businesses at Address: P_Y190 , <br /> Phone: Assessor Parcel Number(s): 117rj — <br /> Mailing Address: yyt <br /> Type of Business: wx! .4- <br /> � l <br /> Type of Organization: X Single Owner ❑ Partnership ❑ Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: <br /> Owner(s) Name: pO <br /> Owner(s)Address: r <br /> 911, 17 57 4 <br /> Manager's Name: <br /> Previous Business at Address: ' -_5 In el 1cm 96-loco <br /> Other Local Business Locations(Address): <br /> Water Supply: j8'Public ❑ On-site Well Sewage Disposal: )(Public D Septic System <br /> Will there be any retail sal 2Q, <br /> istols, revolvers o other co ceelable fir arms? ❑ Yes W No <br /> Applicant's Signature: Date: a _ <br /> ' .S7AF. USE YN�1 <br /> General Plan Designation: Zoning: / Code Section Number: <br /> DEPARTMENT APPROVED DENIED BY DATE <br /> Development Services C z—1a-9L <br /> Building Inspection <br /> Public Works <br /> Environmental Health Div <br /> Air Pollution Control Dist <br /> Sheriff(firearm sales only) <br /> Fire District <br /> License Approved For: <br /> Remarks: <br /> Accepted as Complete: Date: <br /> -\ Copies:WHITE-Development, BLUE-Building,GREEN-Fire District, CANARY-Public Works,PINK-Environmental HealthtGOLDENROD-APCD <br />