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PLEAS= RESPOND WI[HIN 1WU WttKS. <br />(LIC' N. E SUBJECT-' 'PPROVAL IF NO RESPONSE F 'TIS TIME). <br />SAN 110,91QUIN COUN, .;OMMUNITY DEVELOPMENT <br />ATTN WEN (468-3230) <br />1810 EkAPT HAZELTON AVENUE <br />STOCKTON, CA,�52pf511;`1 <br />__1 rmpor <br />Copies: WHITE-Developmerrt, GREEN -Building, CANARY -Fro District, PINK-Emlronmental Health, OOLDENROO-APCO <br />PA_BLLG Rev. <br />Business Name: r <br />• ...:::,.. '. Y�`Yh k�'i . �,...� f R�'. �tY r i � "'S£ % 7EiY pS'l. R <�,: <br />DBA('rl differentl: <br />Business Address8932 E. Hwy. 12 <br />Victor, Ca. 95253 <br />Other Businesses at this Address: <br />Phone: 209-368-9864 <br />Assessor Parcel Number(s): 051-060-30 <br />Mailing Address: P.O. BOX 726 <br />or C 2 <br />Type of Business: <br />Type of Organization: $I Single Owner <br />❑ Partnership ❑ Corporation ❑ Other: <br />Estimated Number of Full Time Employees: <br />Estimated Number of Part Time or Seasonal Employees: <br />Business Owners) Name: GOOr 2 W <br />Braun <br />Business Owner(s) Address: P.O. BOX <br />611 Victor, Ca. 95253 <br />Manager's Name: <br />Previous Business at Business Address: <br />Other Local Business Locations (Address): <br />Water Supply: )7 Public ❑ On-site Well <br />Sewage Disposal; ❑Public tic <br />Se <br />� p System <br />Will there be any retail sales of pistols, revolvers or other concealable firearms? ❑ Yes 1P No <br />NOTE: ANY CHANGE OF OCC CY WILL REQUIRE IMPROVEMENTS AND NECESSARY BUILDING PERMITS, <br />Applicant's Signature: <br />Date: <br />MF'�L�.�: xN'\i SA ���r� \\t�2d<_4. 4�2 �� `� -"`lfc ft,Y."a': P A 3':•. F <br />�� i :,enc-�•s,�i:��'����;a.��>a .Sc'T'(:tS'�ki.S^ �h� �aor�\�rx '�.r �' <� q' <br />General Plan Designation: j2S Zoning: C YZS <br />DEPARTMENT <br />APPROVED <br />DENIED Y <br />DATE <br />Development Services <br />Building Inspection <br />3d l gf <br />Environmental Health Div`/v/�, <br />Air Pollution Control Dist <br />Sheriff (firearm salsa only) <br />Fire District 0 <br />License Approved For: <br />Remarks: <br />�{ <br />C/,.�- mss• <br />'�,yvs�co.•.P(�rw r�7Ti�SAf-i CoOE 7�7zf'ZL .eE&r /qr a�.�l <br />Accepted as Complete: <br />Date: <br />Copies: WHITE-Developmerrt, GREEN -Building, CANARY -Fro District, PINK-Emlronmental Health, OOLDENROO-APCO <br />PA_BLLG Rev. <br />