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✓ aPq .c� APPLICATIO — BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. <br /> 2005 OCT 14 Phi 4: 00 <br /> Business Name: Ve C r <br /> Business Address: ` 2 VN r \ Cross St <br /> DBA Mailing Address: SLI'Mcf, ) City. State:(_ ZIP: J� <br /> Phone# jo C( 5 6 7 Assessor Parcel Number(s): IS1 ` . <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Type of Business: <br /> Type of Organization: pqSingle Owner ❑ Partnership ❑ Corporation ❑ Other. <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: Applicant First Name: <br /> Applicant Mailing Address: G <br /> City StateL ZI (0 Applicant Phone No: <br /> Water Supply: ❑Public ❑ On-site Well Sewage Disposal: ❑ Public ❑ Septic System <br /> Will there be any sale of firearms? ❑ Yes No <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 Signature: Q" C r}0 p�r S I D D S <br /> STA F USE ONLY <br /> G/P Designation: Zoning: C Use Type: p S 'l � <br /> DEPARTMENT APPROVED DENIED DTE <br /> Development Services Planner Name: 0 a <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden V <br /> Public Works <br /> Solid Waste <br /> Enforcement Officer <br /> M.H.C.S.D. <br /> License Approved For: <br /> Remarks: BL 00006 ` C <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:1DevSvc\Planning Application Forms\Business License(Revised OM1-05) Page 3 of 8 <br />