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APPLICATIOW BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NCe -=7 b OZ �— L) 0 <br /> ogYil'oil�� .• v <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: ULA-G,4Sill oU o-k-1 ikA r L L <br /> Business Address: 3`40 1 IS- a (1 Cross St <br /> DBA Mailing Address: I T C " at Lf, stc 10 City: <br /> State ZIP: SZ <br /> Phone#: _ cA p 2_Cf S$8 Assessor Parcel Number(s): <br /> Email: L_vX C( t' Oro . "M-t <br /> Other Businesses at this ddress: <br /> Previous Business at Address: <br /> Type of Business: /�4 jt u- ,bad 661--a t <br /> Type of Organization: ❑ Single Owner ❑ Partnership ❑ Corporation ROther: LL C <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: ?j <br /> Applicant Last Name: L vK- Applicant First Name: /L�/iL 4J <br /> Applicant Mailing Address: o �•{c 2�LO s4tt p_ h Cf- <br /> CIH�� y rs N State � ZIP Applicant Phone No: 12E, 2C <br /> Water Supply: []Public Er On-site Well Sewage Disposal: ❑ Public 9 Sepfic System <br /> Will there be any sale of firearms? ❑ Yes RlNo <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> I,affirm,all the above informa�true and correct Date: <br /> 13 Applicant's Signature: 7 / <br /> STAFF USE ONLY <br /> G/P Designation: Zoning: Use Type: <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: 3 I1;Z <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden <br /> Public Works <br /> Solid Waste <br /> Enforcement Officer <br /> M.H.C.S.D. <br /> License Approved For: S <br /> Remarks: <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> FADevSvc\Planning Application Forms\Business License(Revised 0830-08) Page 2 of 7 <br />