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il <br /> SPC`".. PLICATION - BUSINESS LICENSE <br /> ,.. .�o <br /> N JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> Ur <br /> 1S LICENSE NO. o1er-�C, <br /> optjFORa`P JAN. .0 7 2009 `' <br /> TO BEC :APPLICANT PRIOR TO FILING THE APPLICATION <br /> "`Busrnes� tnform'atic�n` , . <br /> Business Name: N CNH WALA ( S MAN'F LjF0A <br /> Business Address: w Vp$ MtV Cross St <br /> DBA Mailing Address: 64(NE City: L/��(Zpyl State: C.,+ ZIP: <br /> Phone#: Q 0 C-5t- Lya 14Assessor Parcel Number(s): <br /> Email: bmol hwj6, iao @, <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Type of Business: /,IIA (� s Nl L• f .•._� <br /> Type of Organization: 2"Single Owner ❑ Partnership ❑ Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: Al <br /> Applicant Last Name: <br /> PP L OQ I11 jE4 Applicant First Name: <br /> Applicant Mailing Address: *3-1-S*-) W y DSicm(ef- <br /> City L-4"WP State et4' ZIP�j�� Applicant Phone No: g T$—a�t(0 <br /> Water Supply: ❑Public ©On-site Well Sewage Disposal: ❑ Public [PYSeptic 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 /> I,affirm,all the above information is true and correct Date: <br /> Applicant's Signature: C. dy0fir, &A,,10 <br /> STAFF USE ONLY <br /> G/P Designation: G�� Zoning: C--- -(., Use Type: <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden l <br /> Public Works <br /> M.H.C.S.D. <br /> License Approved Fol r: <br /> �'3rd IitJ1{ LYS to <br /> Remarks: CJ. <br /> Occ.Grp. <br /> Accepted as Complet : Date: <br /> F:\DevSvc\Planning Application Forms\Business License(Revised 08-21-07) Page 2 of 7 <br /> moi. <br />