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o�a�'I"�•o APPLICATION — BUSINESS LICENSE <br /> v <br /> z' - -< ' SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. <br /> <<koai; <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: / /� <br /> Business Address: qC"!/j e d Cross St CV/' oy/7/X <br /> Mailing Address: ,07" City: ��(( � State: (f:4, ZIP: 2OG <br /> Phone#: r,2 O f d Ct Assessor Parcel Number(s): 02 <br /> Other Businesses at this Address: <br /> Previous Business at Address DO ,per' $A' (r /� <br /> Type of Business: ,- <br /> � � 'i 'SERVICES <br /> Type of,Organization: X, Single Owner ❑ Partnership ❑ Corporation ❑ Other: <br /> Estimated Number of Full Time Employees:3 f jwt- &jr 1 Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: .7y/ f Applicant First Name: <br /> Applicant Address: /03 P/ L'&_W jroqA- <br /> City S 0,v State CA ZIP 952 .' Applicant Phone N<,20 f) 9,7/ .3`i ::r2 <br /> Water Supply: XPublic ❑ On-site Well Sewage Disposal: X Public ❑ Septic System <br /> Will there be any sale of firearms? ❑ Yes No <br /> NOTE: ANY CHANGE OF OCCUPAN A EQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> Applicant's Signature: r Date: <br /> STAFF USE ONLY 1 1 <br /> G/P Designation: C 16 Zoning: C— = Use Type: ea;` �s 1>�lo W�L�ty� I tJlv�/��wL�tn CQ_ <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden <br /> Public Works <br /> Solid Waste ` <br /> Enforcement 011icer <br /> License Approv�d For:, tL �' �.�� S' • ^. r, r fir; <br /> Remarks: , � (U� I <br /> Accepted as Complete: Date: <br /> g:.mn Cvr1Planninn Annlicatinn Forms\Business License(Revised 12-31-021 Pace 3 of 8 <br />