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<br />SAN JOAQUIN
<br />- - COUNTY
<br />COMMUNITY DEVELOPMENT DEPARTMENT
<br />BUSINESS LICENSE
<br />FILE NUMBER: FOL - 2-1002-C9
<br />
<br />k_31tft11.11.-:3 9107.':, Ili!! e.
<br />FOR STAFF USE ONLY
<br />Response Due Date:
<br />---‘,
<br />Business Information Applicant Information
<br />Business (DBA) Name: ,_ce/•,e.‘.--....,43.4.4 -4.-.-&-J- .z_e..- Name:...../1",./,-,...- „L,..7, . 7--*/
<br />Mailing Address: 97-62 AA ,f-v-/,- 2 izc..,, Mailing Address: 2.20 /r/ _f>,..,e,
<br />-r7-.2 04-7-:-, / , a4 5' -f---e-4.--- •1/4 e) I e."1 - -
<br />Phone:5--1Z0 V
<br />Email:/t.r/ Ve4r- - X7:4 ' .--, • ' a v " "If y,/,,e6.--•4-78.(6-7-. 6-,.,/,i
<br />Phone: 10 p - .57e.- ..s-ic,
<br />Email: /1-7/A-4-.• F-:-/77-1z9 .41-P,P, ,t,.--",-P,it /-ye-.7. . c a ...-1
<br />Property Information
<br />Assessor Parcel Number Property Address City Cross Street
<br />---/-- - 0770 - %fa -ace ;..e,7 .,(/ -C,4trive-/ Z J-7-- -a uk-;----0 ...,../,---
<br />Business Details
<br />Description of Business: A-Tpcyd ,a,,r,„--,,,e-,--,..,-s--<. _ V,0",,,,„,,,,,,....72_ ,,,-- /744,„,,er,,,,,-r.e. ev,,,,,y,,
<br />e:"----c/617-•r.,/ ,e----"A--/-rt_i_r.
<br />----- Type of Organization: • Single Owner M Partnership IS Corporation 111 Other:
<br />Does the business include the sale of firearms? M Yes 11-N-o
<br />Number of Employees Hours of Operation Water Service Sewer Service
<br />Full Time
<br />e99
<br />Part Time
<br />- .„2„,-/ Public
<br />--
<br />Private (on-site)
<br />• Public
<br />0 -' Private (on-site) . •
<br />NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS.
<br />AUTHORIZATION SIGNATURES
<br />I, the Owner/Applicant/Agent, agrees to indemnify, defend (with counsel reasonably approved by County), and hold harmless the County and its officers, officials,
<br />employees, agents, boards and commissions (collectively "County") as follows:
<br />1. INDEMNITY:
<br />A. From and against any and all claims, demands, actions, proceedings, lawsuits, losses, damages, judgments and/or liabilities arising out of, related to, or in
<br />connection with the application and applied for project or to attack, set aside, void, or annul, in whole or in part, an approval of the applied for project by the
<br />County, the adoption of environmental review documents related to the applied for project, and any related development approvals or project conditions for
<br />the applied for project (hereinafter "Claim");
<br />For any and all costs and expenses incurred by the County on account of any Claim, except where such indemnification Is prohibited by law, including but
<br />not limited to damages, costs, expenses, attorney's fees, or expert witness costs that may be asserted by any person or entity, private attomey general fees
<br />claimed by or awarded to any party against the County, and the County's costs incurred in preparing an administrative record which are not paid by the
<br />petitioner.
<br />Except as to the County's sole negligence or willful misconduct.
<br />2. DEFENSE:
<br />The County may participate or direct the defense of any Claim. The County's actions in defense of any claim shall not relieve me of any obligation to
<br />indemnify, defend, and hold harmless the County.
<br />In the event of a disagreement between County and me regarding defense of any Claim, the County shall have the authority to control the litigation and
<br />make litigation decisions, including, but not limited to, the manner in which the defense is conducted.
<br />If I fail to promptly assume the defense of any Claim or to promptly employ counsel reasonably satisfactory to the County, then County may utilize the Office
<br />of the County Counsel or employ separate outside counsel to represent or defend the County, and I shall pay the reasonable attorneys' fees and costs of
<br />such counsel. /
<br />I, the Owner/Applicant/Agent, affirm all the information above is true and correct, uncle; pe alty of perjury. „
<br />Print Name: ,--;1/•-7--,/LL-ei' Signature: • ------- • Date: 294 ./0•{".7--/
<br />FOR STAFF USE ONLY
<br />General Plan Designation:-11 1... Zoning Designation: I" - Use Type: A_,6 (4o Ces 4\ . _ 0 . l I. ... _I — r/ C.-
<br />Department Approved Denied iignature Date
<br />ODD: Planning Division ,
<br />•
<br />0/ 8-2-3-2o21,
<br />ri f‘
<br />c
<br />Building Division
<br />Enforcement Division
<br />Fire District/Warden:
<br />
<br />Environmental Health Department
<br />Department of Public Works
<br />MHCSD (if applicable)
<br />License approved for: AdA e_y:1_4-iy9_ftyyt-CaktfAkinfalheae..- bar—eA---GA.
<br />- , De -Gt -00 (71 History: 15L.:"' 20(20 23/ ' ?)L - l Voo 2-37 1 (3l.- b) - le) 20
<br />Finalized by: i 1 Date
<br /> TS SU0014384 08/30/2021
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