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SAN JOAQUIN COUNTY Control No. <br /> Date License Issued <br /> BUSINESS LICENSE APPLICATION <br /> B. L. No. <br /> Receipt No. <br /> c0.�qV(ANFee _1 Yr,0 3 Yr.�] <br /> r' y <br /> X <br /> Business Name: U•�/� tkx) &4,w _2�_ Phone: 2 7U,)-y <br /> Business Address: -S <br /> Other Business at Address: <br /> Assessor Parcel Number(s): i <br /> Mailing Address: <br /> Type of Business: <br /> r <br /> Will there be any retail sales of pistols, revolvers or other concealable firearms? ❑ Yes ❑ No (If yes, Sheriff's Office <br /> review is required.) <br /> Type of Organization: ❑ Sir gle Owner, ❑ Partnership, ❑ Corporation <br /> Estimated Number Employees: Full time, Part time or Seasonal <br /> Owner(s) Name: "' 5 >-r, <br /> Owner(s) Address: UTILITIES <br /> Manager's Name: `5 VC WATER: Public ❑ Well ❑ <br /> Previous Business at Address: Sanitary: Public ❑ Septic ❑ <br /> Other Local Business Address(es): <br /> Applicant's Signature: Date: <br /> STAFF USE ONLY <br /> Zoning: Section No.: General Plan: <br /> Department Approved Denied By Date <br /> Planning Division ❑ ❑ <br /> Building Division ❑ ❑ <br /> Fire District ❑ ❑ <br /> Public Works ❑ ❑ <br /> Environmental Health [ ❑ <br /> Air Pollution Control Dist. ❑ ❑ <br /> Sheriff (firearm sales only) ❑ ❑ <br /> License Approved For: <br /> Remarks: <br /> Accepted as complete on: By: <br /> Copies: WHITE-Planning, BLUE-Building, GREEN-Fire District, GOLDENROD-Public Works, PINK-Enviromental Health, CANARY-APCD PLANNING 21 (12188) <br />