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- APPLICATION - BUSINESS LICENSE <br />-- 'NI <br />IL AN JOAQUIN COUNTY CjWMUNITY DEVELOPMENT DEPARTMENT <br />ILI, 1' � - , <br />'Ci0q C BUSINESS LICENSE NO. <br />L , , <br />TO BE C 0 M 0 L& E I Yt V' 4 fi EAPPLIPANTP.RIOR YdPIONG" HE APPLICATION-, <br />: <br />-l!"'"'. <br />Businessnformati 06 <br />Business Name: <br />Business Address: <br />cross St <br />DBA Mailing Address: -PhIle-y- 5T-. <br />CRY: � �_'o t <br />State: CA - <br />zIP:45-903_* <br />Phone#:(Poq) <br />Assessor Parcel Number(s): loo - 0 3 <br />Email: 50Wf4A ',(Ako. 6o&t <br />Other Businesses at this Address: <br />Previous Business at Address: <br />Type ol'Business: <br />Type of Organization: WSingle Owner El Partnership <br />El Corporation El Other. <br />Estimated Number of Full Time Employees: p2 <br />Estimated Number of Part Time or Seasonal Employees: -(!D— <br />Applicant Last Name: Cle'414FIlL_ <br />Applicant First Name: (2 HW_! Taj <br />Applicant Mailing Address: -7,;? 1 0 - 5-F. <br />- <br />C i ty6—ro 0-y— +-& 4 <br />1 State jq . <br />I ZlPqo 3 <br />Applicant Phone No: ,7m 401 <br />Water Supply: E]Public El On-site Well <br />Sewage Disposal: El Public 53"Septic System <br />Will there be any sale of firearms? El Yes Na*Ro <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 <br />Applicant's Signature: <br />Y'd <br />Date: <br />6 1 <br />STA 4 USE ONLY <br />G/P Designation: j/L— <br />Zoning: I — L <br />Use Typeb�V <br />DEPARTMENT <br />APPROVED <br />DENIED <br />DATE <br />Development Services <br />Planner Name: <br />Building Inspection <br />Environmental Health Div <br />Fire Warden <br />Public Works <br />M.H.C.S.D. <br />Sheriff (Junk Dealers Only) <br />License Approved For: <br />Remarks: <br />Occ. Grp. <br />Accepted as Complete: <br />Date: <br />F \DevSvc\Planfiing Application Forms\Business License (Revised 01-16-08) Page 2 of 8 <br />