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�p0.U'" APPLICATION - BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO._ <br /> 0 <br /> G G rL s b3 s k"+ wM'r -^ter 1 f a7•- <br /> LCOMPLETED BY THE APPL`f��►1t 'PFIpITy � ,g� 0 �ifPLIGi4 `4fiF `�. <br /> B,usr>gess-1n�Qr �tFo.�,�� ���i���c� st�'.�.l�,;xf,��� <br /> Business Name: p TIPt <br /> Business Address: �'• MEKLOO Cross St ,� r ,, <br /> DBA Mailing Address: p City: ---roc State: CA ZIP:q 5-20 <br /> Phone#44 a Assessor Parcel Number(s): ( 2� <br /> Email: <br /> Other Businesses at this Address: — <br /> Previous Business at Address: <br /> Type of Business: <br /> Type of Organization: Eq Single Owner ❑ Partnership ❑ Corporation ❑ Other. <br /> Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: -25�- <br /> Applicant Last Name: Applicant First Name: (Y` <br /> Applicant Mailing Address: S26tj-5 <br /> City 5 C. State CA ZIPqS-S2g Applicant Phone No: 9 16 S L-1 <br /> Water Supply: ❑Public ❑ On-site Well Sewage Disposal: ❑ 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 /> 1, affirm,all the above information is true and correct Date: <br /> Applicant's Signature: I vl - 0 <br /> STAFF USE ONLY <br /> G/P Designation: U G, Zoning: G Use Type: L,+yyy <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: <br /> Building Inspection <br /> Environmental Health Div A/1.) ©� <br /> Fire Warden <br /> Public Works <br /> M.H.C.S.D. <br /> Sheriff(Junk Dealers Only) <br /> License Approved For: <br /> Remarks: , <br /> Oa Occ.Grp. <br /> Accepted as Complete: Date: <br /> :\DevSvc\Planning Application Forms\Business License(Revised 01-16-08) Page 2 of 8 ( ( —O Fly <br />