Laserfiche WebLink
JUL 14 2009 APPLICATION - BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> < EWRONMENTAL ncA-, <br /> PERMITISERVIC' C ® � "°,-PBUSINESS LICENSE NO. <br /> �• `P' <br /> ��FORa <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: <br /> Business Address: Cross St <br /> _(6 c State: <br /> DBA Mailing Address: �• oo �d City: ZIP: Z I S <br /> Phone#: 3 d Assessor Parcel Number(s): <br /> Email: <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Type of Business: & « i MOO <br /> J I' <br /> Type of Organization: ❑ Single Owner ❑ Partnership Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: Z <br /> Applicant Last Name: AL: I Applicant First Name: <br /> Applicant Mailing Address: rz w,( 0,0 <br /> City '� c3 State C ZIP Applicant Phone No: <br /> Water Supply: EfPublic ❑ On-site Well Sewage Disposal: Uf Public ❑ Septic 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 or c Date: <br /> M <br /> h� S I <br /> Applicant's Signature: �r ��}' (� <br /> STAFF USE ONLY <br /> G/P Designation:CIR55 1 Zoning: Use Type: ` <br /> DEPARTMENT APPRVED DENIED DATE <br /> Development Services Planner Name: 3 <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden <br /> Public Works <br /> M.H.C.S.D. <br /> Sheriff(Junk Dealers Only) on <br /> License Approved For: <br /> Remarks: <br /> ` --- I Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:\OevSvc\Planning Application FormsTusiness License(Revised 03-09-09) Page 2 of 7 <br />