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o ern.. <br /> .>�•�.•., APPLICATION — BUSINESS LICENSE <br /> ut SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. <br /> mak!"o <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: Ske qS L L <br /> Business Address: S, S .Cross St 14 <br /> DBA Mailing Atltlress: S r GA S u State: ZIP. <br /> Phone N: - e_�- 0 6 Assessor Parcel Number(s): <br /> Email: r6 +o-ed m <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Description of Business Operation:: Dlarin& �.�. <br /> Type of Organization: C Single Owner ❑ Partnership ❑ Corporation Cher: `,L <br /> Estimated Number of Full Time Employees: 3 Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: C e 1Y)cLn Applicant First Name: T <br /> Applicant Mailing Address: , wh I l.F eA1j;934 <br /> City � State CA I ZIP pplicant Phone No: - (o _MO <br /> Water Supply: ❑Public Von-site Well Sewage Disposal: ❑ Public 03101septic 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 /> 1,affirm,under penalty of perjury that all the above Information is true and correct Date: <br /> I,the Owner/Agent agree,to defend,Indemnify,and hold harmless the County and its <br /> agents,officers and employees from any claim,action or proceeding against the County <br /> arising from the Owner/Agent's project. <br /> Applicant's Signature: - - �O <br /> STAFF.USE ONLY <br /> G/P Designation: Q Zoning: - Use Type: <br /> DEPARTMENT APPROVED DENIED I I PATE_--, <br /> Development Services Planner Name: <br /> Builtling Inspection <br /> Environmental Health Div <br /> Fire Warden <br /> Public Works <br /> M.H.C.S.D. <br /> License Approved For: <br /> Remarks: <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:\DevSv6PlannlngAPP1icadon Forms\Business License(Revised 01-25-10) Page 2 of 7 <br />