Laserfiche WebLink
RECEIV f-J-3 -1(.�2 <br /> APPLICATION — BUSINESS LICENSE <br /> AN 1 1 2016 <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> np <br /> ENTALHE&TH. BUSINESS LICENSE NO.. <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: OLIN 0444—or- P Lk4aL 1 (?rZoDI�C�TS <br /> Business Address:2(ol-vt) 5'OLtQ11-6ANTPc tzcA1> Cross St 11 '!14 STTZEbT <br /> DBA Mailing Address: AMC- City:—_)ZAC-y State: 03, ZIP: �"7y@�{• <br /> Phone#: of. $3S"• 5424— Assessor Parcel Number(s):, �, j• lJ� <br /> Email:7-e &Vn Oil CZnm <br /> Other Businesses at this Address: <br /> Previous Business at Address: SFcME <br /> Description of Business Operation:: MAN lA FA CTU r_1 N —W p 15Tkj F3UT10 <br /> Type of Organization: ❑ Single Owner ❑ Partnership Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: ?i / Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: Wn(712 LL(_-( Applicant First Name: 'TVzI l" <br /> Applicant Mailing Address: Z(p T&A NTA (ZO R17 I'-YZAC A <br /> City —TVA-U•{ I State C_k ZIPCt56D.44 Applicant Phone No: 206)• 22( , <br /> Water Supply: ❑Public PC,On-site Well Sewage Disposal: ❑ Public �XSeptic 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,under penalty of perjury that all the above information is true and correct Date: <br /> I,the Owner/Agent agree,to defend,indemnity,and hold harmless the County and its <br /> agents,officers and employees from any claim,action or proceeding against the County <br /> arising from the Owner/Agent's project. <br /> Applicant's Signature: <br /> STAFF USE ONLY tt <br /> G/P Designation: i Zoning: 1-i J ,j t, Use Type: <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: 11n , l I <br /> Building Inspection sv <br /> Environmental Health Div <br /> Fire Warden Y SLC <br /> Public Works <br /> M.H.C.S.D. <br /> License Approved For: <br /> Remarks: L �• L]� I �L c1q � �L -ox /C il� .NF1 ' I W /1, <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F/ApplicationsForm s&Handouts/PlanningApplications/Business License(Revised 02-24-15) <br /> Page 2 of 6 <br />