|
APPLICATION — BUSINESS LICENSE
<br />SAN ,JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT
<br />BUSINESS LICENSE NO 1 „t.' LC(
<br />
<br />TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION
<br />Business Information
<br />Business Name: "IL z- pii,/, .4 4.... C--
<br />Business Address: a iii. tip_4_,..-7 Cross St _17- AT iki-vm., Ly i57(:)_ 1 d mizt12, i 14
<br />DBA Mailing Addressj it"--- la 610//: &IA 7 4-(,,Zeli City: ea( 6R,C)V6 State: 6A- ZIP: 7S" 75?
<br />Phone #: Ike — ag9- 17 21 Assessor Parcel Number(s) 13 i
<br />Email: ir)% Aitaire L. 1... '—---, c_a s5,---
<br />Other Businesses at this Address:
<br />Previous Business at Address:
<br />Type of Busiric e5A jKS 4,19/11b OCA-/ ,,,Q67;2,4,00:2,,c
<br />Type of Organiation: 0 Single OwnE r 0 Partnership Corporation 0 Other:
<br />Estimated Number of Full Time Employees: _: Estimated Number of Part Time or Seasonal Employees:
<br />Applicant Last Name: SO /.11VS Applicant First Name: m ARG lite i-A-
<br />Applicant Mailing Address: c,7 l 6-> l( CAVVe_ CA- 515-73-E ,
<br />City Fax, 6664:, State c.A i
<br />i
<br />ZIP !.1675ye" Applicant Phone No: 9'd —0745:1": 2797
<br />Water Supply: ['Public Iff (--5n-site Well Sewage Disposal: di Public leSeptic System
<br />Will there be any sale of firearms? 0 Yes No
<br />NOTE: ANY CHANGE OF OCCUPANCY QUIRE BUILDING IMP VEMENTS AND NECESSARY BUILDING PERMITS.
<br />, r
<br />I, affirm, all the above informati • Ts • •'.. orrect Date:
<br />7 ? Applicant's Signature. z,././ #,F, „„/IT
<br />TAFF U LY
<br />G/P Designation: LJ Zoning: If ' CO 1 ,....... Use Type A. 31-, e 4,,--.A Q4-1 04- -
<br />DEPARTMENT APPft VED DENIED /. DATE
<br />Development Services Pia e Name: ,
<br />Building InspeGtion '7
<br />, )v y--7--- (r
<br />Environmental Heatth Div Environmental -V .., C1(4-.}1
<br />Fire Warden -V ..,,..----
<br />Public Works -\/7
<br />M.H.C.S.D.
<br />.....,
<br />
<br />Sheriff (Junk Dealers Only)
<br />License Approved For: vv,c, (12- 0 L-.( - ,p 4. 64,vie-
<br />3 Lk S-11)11-)e_, t .3) 0 ,---k" al- Pc, r AP v u 7 (3-
<br />Remarks:I 0, y , , ) ) V5 L (3 •___Li, v_ILL L ll-siV‘zve - t, (/•,-fk•-• Ocet, 1r
<br />. . I.,
<br />L Occ. Grp.
<br />Accepted as Com te:L.,., Li /...4-/-7-7:17:
<br />..e- Date:
<br />F:10evSvc1Plannin) Application Forms113usiness License (Revised 03-09-09) Page 2 of 7
|