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S JOAQUIN COUNTY t control No. <br />DateLicense Issued <br />U 1 I E LI ATI L. No: �-7-174 <br />Receipt No. <br />$ R Fe°O 1 Yr. D 3 Yr.�. <br />J <br />Business Name: //9/Vg' Phone: ''ylcsln-`�9�- <br />Business Address: <br />Other Businesses at Address: <br />Assessor Parcel Number(s): <br />Mailing Address: f Agr,& 0;::7,4e <br />Type of Business: <br />Will there be any retail sales of pistols, revolvers or other concealable firearms? F-� Yes XlNo (If yes, Sheriff's <br />Office review is required.) <br />Type of Organization: VSingle Owner, ® Partnership, ® Corporation <br />Estimated Number of Employees:—— Full time, —— Part time or Seasonal <br />Owner(s) Name: <br />Owner(s) Address: �JQd .6�G,F ��� ozTk—(Z rE'Tlvd 152- <br />Manager's Name: <br />/YJ <br />soh <br />Previous Business at Address:L�!/�.✓�%Lii- <br />Other Local Business Address(es): y7✓C <br />m/3/� <br />S7�- <br />Zoning: <br />Section No:q �2G I Ineral Plan: ULO <br />St %-,A <br />Department <br />Approved <br />Denied <br />By <br />Date <br />Planning Division <br />S5 os <br />31.31eyi <br />Building Division <br />® <br />(;�'D <br />is -[6187 <br />Fire Warden <br />® <br />Public Works <br />3 3 1,17 <br />(� Local Health District <br />Pic� <br />a <br />Sheriff (firearm sales only) <br />Remarks: Ii1N�, .Q <br />n� O W <br />tJ P� S <br />Q -1-L 1- <br />Accepted as complete on: By: <br />Copies: WHITE -Planning, BLUE -Building, GREEN -Fire Warden, GOLDENROD -Public Works, PINK -Local Health District, CANARY -Applicant <br />® PLANNING -21 (2/88) <br />