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WHEN REVIEWED AND APDRovED. PLF'-E <br /> Ptw IH, v RETURN To: _ <br /> gq�JAKAU1N Ct INTY COMMUNTi Y <br /> DEVELOPMENT <br /> EVELPMON (,88-,,120) :SS LICENSE <br /> lei EAST HAZELTON AVENUE )pMENT DEPARTMENT <br /> ...ri:IitEMa`'. STOCKTON CA 9505 <br /> E <br /> O.PT NO.na is ` NPHI7!)1E1RrfiFC »14(1k <br /> r r= act <br /> F <br /> €�,� , ; .. <br /> 3€y sa 'S�s <•�zga'- <br /> Business Name: . ' r� DBA(N different): <br /> L� ,f <br /> Business Address: �7 <br /> J L <br /> Other Businesses at Address: <br /> Phone: — — S 73 Assessor Parcel Number(s): Q <br /> Melling Address: 7 G 2-2.� <br /> Type of Business: <br /> Type of Organization: Single Owner O Partnership ❑ Corporation ❑ Other: c I� <br /> Estimated Number of Full Time Employees: (J 1e Estimated Number of Pert Time or Seasonal Employees: �' ) <br /> Owner(.) Name: 17dal4l <br /> Owner(s) Address: 9 ' j ✓ \ <br /> Manager's Neme: <br /> Previous Business at Address: <br /> Other Local Business Locations (Address): <br /> Water Supply: ❑Public (X on-ehe Well Sewage Disposal: O Public Septic SyNem <br /> Will there be any retail sales of pistols, revolvers or other concealable firearms? ❑ Yes If No <br /> NOTE: ANY CHANGE OF OCCUP NCY WILL REQUIRE BUILDING INPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> Applicant's Signature: TWO: <br /> < <br /> 1_ <br /> .... 21 . ........... .y..... .. . . .. ..... .. .. .. /p` <br />