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01 <br /> a4ul"'� APPLICATION — BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. <br /> a <br /> x <br /> 5 a <br /> .._ y.. IM <br /> Business Name: 3l , LCOA 4 -- <br /> Business Address: 19 71,},r�- /j PC, VJ . Cross St l <br /> DBA Mailing Address: (C , , 1 Q0 ` City: L 0d, State: G- ZIP: `)J` / <br /> qq c.tz - C Assessor Parcel Number(s): < 70 - <br /> Email: --- - -- <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Type of Business: C°lo:-)- ,CT!.!-- E r <br /> CtC C.F�E -;f J AC 1. <br /> Type of Organization: ❑ Single Owner Partnership ❑ Corporation ❑ Other. <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: (j <br /> Applicant Last Name: °� azlcCAApplicant First Name: C Cao d <br /> Applicant Mailing Address: 105 -/J, OCA <br /> City (.k-)6k State ZIP(j6,�) ,? Applicant Phone No: CO L) - Cf <br /> Water Supply: []Public YOn-site Well Sewage Disposal: ❑ Public Septic 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,all the above information is true and correct Date: <br /> Applicant's Signature: <br /> 0,06f <br /> GIP Designation: G Zoning:PC, Use Type: <br /> DEPARTMENT APPROVED DENIED DATE <br /> Devetopment Services Planner iJame: ) rA <br /> Building Inspection <br /> Environmental Health Div L) <br /> Fire Warden` av- <br /> Public Works <br /> M.H.C.S.D. <br /> Sheriff(Junk Dealers Only) <br /> License Approved For: I <br /> Remadcs: <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:0evSvc\Planning Application Forms\Business License(Revised 01-16-08) Page 2 of 8 <br />