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APPLICATII A — BUSINESS LICENSE <br /> U Dil SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> P. MAR 2112-08 EC C O PYINESS LICENSE NO. <br /> TO BE THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: <br /> Business Address: Ictcl coo 1/1> Cross St VL/k (c-::- <br /> DBA Mailing Address _qn-i city: <br /> SZd <br /> Phone#: Z-fbc -Z\ Assessor Parcel Number(s): <br /> Email: <br /> Other Businesses at this Address: <br /> Previous Business at Address: ( C])1-1 A-) <br /> Type of Business: e <br /> Type of Organization: XSingle Dwner El Partnership E] Corporation El Other: <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: — <br /> 2— <br /> Applicant Last Name: <br /> Applicant First Name: <br /> Applicant Mailing Address: <br /> CityStateApplicant Phone No <br /> (f ZI <br /> Cjb\_ <br /> Water Supply: 9f ublic El On-site\(Vell Sewage Disposal: f Public El Septic System <br /> Will there be any sale of firearms? El Yes XNo <br /> NOTE: ANY CHANGE OF OCCUP kNCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> 1,affirm, all the above informa lion is true an iNnorrect Date: <br /> 01 <br /> Applicant's Signature: <br /> STAFF USE ONLY <br /> G/P Designation: Zoning: Use Type: <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services 46 Planner Name: <br /> Building Inspection <br /> Environmental Health DivV 7: <br /> Wc <br /> Fire Warden <br /> Public Works <br /> M.H.C.S.D. <br /> Sheriff(Junk Dealers Only) <br /> License Approved For: c,— <br /> Remarks: /4 <br /> V <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:\DevSvckPlanning Application Forms\Busin ss License(Revised 12-07-07) Page 2 of 7 <br />