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l f 4 <br /> APPLICATION �?BUSOIESS LICENSE <br /> a .y 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: �'/�i2A.9 U�'!� r1©N dSIA int C1 E tJ Q�IIS� TGYh <br /> f 111 IY • OYr3b r f' <br /> Business Address: Cross St <br /> DBA Mailing Address: // t 'N1 p� �, city: I Slate:CA ZIP:G]J"'j'�q <br /> Phone#: oR <br /> 7� Assessor Parcel Number(s): (��� i 'i 00 i',1 <br /> Email: <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Type of Business: S4G <br /> i <br /> E <br /> i <br /> Type of Organization: ❑ Single Owner ❑ Partnership ❑ Corporation they. <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: V <br /> Applicant Last Name#. ,,2,.A Applicant First Name: -SQ" IRC) N <br /> Applicant Mailing Address: //a S3 �. 7-1wY - � <br /> City State ZIP Applicant Phone No: <br /> Water Supply: ❑Public 09-6n-site Well Sewage Disposal: ❑ Public 93Septic System <br /> Will there be any sale of firearms? ❑ Yes o <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> I, affirm,all the above information is true and correct Date: <br /> Applicant's Signaturet <br /> STAFF USE ONLY <br /> G/P Designation: Zoning: f` Use Type: -acs L <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services <br /> EPanner Name: —�` gJ <br /> Building Inspection <br /> Environmental Health Div ✓" !1 <br /> Fire Warden <br /> Public Works <br /> s <br /> M.H.C.S.D. <br /> Sheriff(Junk Dealers Only) f <br /> License Approved For: �.�,�. 1 � � t7 i� �- � ���� � <br /> 50000 1 <br /> Remarks: <br /> Accepted as Complete: Date: <br /> FADevSvc\Planning Application FormslBusiness License(Revised 05-01-08) Page 2 of 7 <br />