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APPLICATION — BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> ���� BUSINESS LICENSE NO. b -- 0 S CD Gj� <br /> tlFo� <br /> JUL 21 PH 3: 24 <br /> V T 4'% a7 }5�:,1 •'¢5 <br /> '•' ..,4L ,t... �� .u•-.til�', s` �,H:n ,o-r.,.�.,w, a. � 's..-J' ,:.x • -�•:a.> 5 � K�'�e�l�«s,�.F:.. .,6-x�....�i� «���,�.. <br /> Business Name: <br /> Business Address: en ekCross;St GJ`i I�I Cfaks <br /> DBA MailingAddress:�225_'L q4 k"[)`2: <br /> .City: V1,C0y\ State: :C ZIP: <br /> Phone#: )_09 Gj 7 Assessor Parcel Nurriber(s): 1 ( J)D <br /> Other Businesses at this Address: <br /> Previous Business at Address: h V1 <br /> Type of Business: an 1A <br /> ,P <br /> Type of Organization: Pt Single 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: 4Yl <br /> Applicant Mailing Address:Jr 2 f �. W G I nr <br /> City &16C4610N I State �I ZIP 1S' Applicant Phone No: (_? o4) <br /> Water Supply: ublic ❑ On-site Well Sewage Disposal: Pq Public ❑ Septic System <br /> Will there be any sale of firearms? ❑ Yes P No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> 1, affirm,all the above information is true and correct Date: <br /> Applicant's Signature: 7--6 —Q <br /> STAFF USE ONLY <br /> G/P Designation: (� Zoning: —(4 Use Type:AU'Qk6QVe ,54t,0 51&VIC& I-144ift— <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: ,(,(J1... 7 --6 J <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden ocCJ v <br /> Public Works <br /> Solid Waste <br /> Enforcement Officer <br /> M.H.C.S.D. <br /> License Approved For: I t �� C k Sa• (C S <br /> 00 6-4-5 1M& d2 0, �� tis h szQ.Q r T�tcC— <br /> Remarks: <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:\DevSvc\Planning Application Forms\Business License(Revised 07-28-04) Page 3 of 8 <br />