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PLEASE RESPOND WITHI"' TWO WEEKS.
<br /> (LICENSE SUBJECT TO . 'ROVAL IF NO REBRONSE BY S TIME).
<br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT
<br /> ATTN: OWEN (468-3230)
<br /> 1810 EAST HAZELTON AVENUE
<br /> STOCKTON, CA 95205 7
<br /> B.L. NO. QS'338
<br /> RECEIPT NO.
<br /> ANNUAL FEE: u-'
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<br /> Business Name: 6-��A4,- DBA(lf different):
<br /> Business Address: 104 1- - A-_,91nQD
<br /> Other Businesses at this Address:
<br /> Phone: 7- 7 Assessor Parcel Number(s):
<br /> Melling Address: A
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<br /> Type of Business: e�
<br /> (Q o-�
<br /> Type of Organization: ETlingle Owner ❑ Partnership ❑ Corporation ❑ Other:
<br /> Estimated Number of Full Time Employees: / — Z Estimated Number of Part Time or Seasonal Employees:
<br /> Business Owner(s) Name:
<br /> Business Owner(s)Address:
<br /> Manager's Name: I
<br /> Previous Business at Business Ad,,oss:
<br /> Other Local Business Locations (Address):
<br /> Water Supply: u Ilc ❑ On-site Well Sewage Disposal: ❑ Public P-9'eptic System
<br /> Will there be any retail sales of pistols, revolvers or other concealable firearms? ❑ Yea 0-M
<br /> NOTE: ANY CHANGE OF OCCUPANCY WILL REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS.
<br /> Applicant's Signature: / Date:
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<br /> General Plan Designation: Cts Zoning: G/LS
<br /> DEPARTMENT APPROVED DENIED B DATE
<br /> Development Services 4,v�
<br /> Building Inspection
<br /> Environmental Health Div << • "`-�� I\` y� 6
<br /> 1
<br /> Air Pollution Control Dist
<br /> Sheriff (firearm sales only)
<br /> Fire District
<br /> License Approved For: ezf}o41
<br /> ot-
<br /> Remarks: I p(,✓I.Fltj Pyr rC ' r �F ZL - ���45�GT%�
<br /> Accepted as Complete: Date:
<br /> Copies:WHITE-Development,GREEN-Bullding,CANARY-Fire District, PINK-Environmental Health, GOLDENROD-APCD
<br /> PA_BLLG Rev.
<br />
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