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WHEN REVIEWED AND APPROVED, F SE <br /> to IM RETURN TO: <br /> OAQUIN- C—O"TY COMMUNITY <br /> DEVELOPMENT <br /> ATTN: OWEN(4e"120) 4ESS LICENSE <br /> 1810 EAST HAZELTON AVENUE ELOPMENT DEPARTMENT <br /> STOCKTON CA 95205 <br /> B.L NO. gq--s-q <br /> RECEIPT NO. <br /> FEE: Yo <br /> 4 r,'7 <br /> �W o <br /> Busineser Name: *&.dr0BA(If cliff...nV: <br /> Business Address: of o 60 -,6,4, 5-2 <br /> Other Businesses at Address: <br /> Phone: 3 3 ff <br /> Mailing Adore": 57amta <br /> Type of Business: /,?" —/ Yt,ci 4 <br /> Type of Organization: WSIngle Owner 0 Partnership 0 Corporation 0 Other: <br /> F- <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: <br /> Owner(s) Name: <br /> Owner(s) Address: AA'-5q v <br /> Manager's Name: <br /> Previous Busineser at Address: <br /> Other Local Business Locations (Addrese): -S-9. <br /> Water Supply: 0 Public ,Q�On-sheO -she Well Disposal: El Public Septic System <br /> Will there be any retail sales of pistols, revolvers or other concealable firearms? 0 Yes No <br /> NOTE: ANY CHANGE OF PANCY WILL REQE BUILDING INPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> Applicant's Signature: f Date: <br /> ........ <br /> �0 <br />