Laserfiche WebLink
oRa�l" 2C� APPLICATION--- BUSINESS LICENSE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> N• � < i r�I <br /> BUSINESS LICENSE NOM - <br /> � <br /> TO <br /> BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: � � .�r <br /> Business Address: ��G ,S�f� Cross St <br /> DBA Mailing Address: 2/lC City: StateG <br /> : W ZIP: �lA <br /> Phone#:C,Zo f f/,�p -,3 0�jG (t Assessor Parcel Number(s): y . <br /> Email: ��/Sa �►.�roo. C6+rs <br /> Other Businesses at this Address: <br /> Previous Business at Address: Clp p 175 o <br /> Type of Business: <br /> Type of Organization: N Single Owner ❑ Partnership ❑ Corporation ❑ Other: <br /> Estimated Number of Full Time Employees: 1 p y 2 . Estimated Number of Part Time or Seasonal Employees: <br /> Applicant Last Name: /j(q �' Applicant First Name: <br /> Applicant Mailing Address: <br /> City ���/ State ZIP Applicant Phone No' 3v3� <br /> Water Supply: PPublic ❑ On-site Well Sewage Disposal: RI 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 its true and correct Date: y <br /> Applicant's SignatureE4Z 711- 0 <br /> STAFF USE ONLY <br /> G/P Designation:�� Zoning: C - Use Type Ap - w <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name:El TMA <br /> Building Inspection <br /> Environmental Health Div ✓ <br /> Fire Warden <br /> Public Works <br /> M.H.C.S.D. <br /> ENVIRONMENTAL HEALrM <br /> Sheriff(Junk Dealers Only) <br /> License Approved For: Mo C')V)00 <br /> Remarks: <br /> V©wo 2---1 <br /> Occ.Grp. <br /> bAcepted as Complete: Date: <br /> F:\DevSvc\Planning Application Forms\Business License(Revised 03-09-09) Page 2 of 7 <br />