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SAN JOAQUJN COUNTY Control No. <br /> Date License Issued <br /> BUSINESS LICENSE APPLICATION B L. No. r { � <br /> Receipt No. ? <br /> Business Name; N 1�`y ��� r'r31 Phone: t:,. <br /> Business Address: L, L L; h' <br /> Other Businesses at Address: <br /> Assessor Parcel Number(s): L17F 7— j 4 a <br /> i <br /> Mailing Address: (ACIC its. 99 5 95-217-- <br /> Type of Business: [:rr "- *11 IATA; lt-L.rLA <br /> Will there be any retail sales of pistols, revolvers or other concealable firearms? ❑ Yes (Z No (If yes, Sheriff's <br /> Office review is required.) <br /> Type of Organization: g Single Owner, ❑ Partnership, ❑ Corporation <br /> Estimated Number of Employees: _ Full time, .Part tim <br /> Owner(s) Name: At ., c 101M aigg <br /> Owner(s) Address: <br /> Manager's Name: <br /> 7 <br /> Previous Business at Ad ress: . ENVIROMENTAL HEAaH <br /> ether Local Business Address(es): RMIT/SERVICES <br /> STAFF USE ONLY <br /> ' I <br /> Zoning: Section No: I ' +I General Plan: I't/ 1.) <br /> Department Approved Denied By Date <br /> Planning Division ❑ �,/❑ '' ` �' "" <br /> Building Division ❑ ❑ <br /> Fire Warden ❑ ❑ <br /> Public Works 21 ❑ ` <br /> Local Health District 021 ❑ <br /> Sheriff (firearm sales only) ❑ ❑ <br /> Remarks: <br /> Accepted as complete on: By: <br /> Copies: WHITE-Planning, BLUE-Building, GREEN-Fire Warden, GOLDENROD-Public Works, PINK-Local Health District, CANARY-Applicant <br /> 41 PLANNING-21 (2/66) <br />