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BUSINESS LICENSE <br /> APPLICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> BUSINESS LICENSE NO. <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> usinesInformation <br /> Business Name: rj Cr'[I tt,3 P&-f g Bs <br /> _o LL- C- <br /> Business Address: 3 j 2 W A T 6-K L 0 Cross St U T 7-6k Z t A 7E4 C 6 6 <br /> DBA Mailing Address: city: -C-r p ck,-r U 0 State: CA I ZIP-9 <br /> Phone#: C) 7 Q Assessor Parcel Number(s): 0 <br /> Email: �-23 P A\3 L 0� GM A I L to - <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Type of Business: 62 A" -T i <br /> Type of Organization: 0 Single Owner 0 Partnership Corporation 0 Other. <br /> Estimated Number of Full Time Employees: 2 Estimated Number of Part Time or Seasonal Employees: 2- <br /> -K— <br /> -j P <br /> � A L <br /> Applicant Last Name: H I L Applicant First Name: <br /> Applicant Mailing Address: -T L I LL <br /> city zip 01,S-(791 Applicant Phone No: 9 Y 6" <br /> Water Supply: ]Public 0 On-site Well Sewage Disposal: E3 Public 0 Septic System <br /> Will there be any sale of firearms? 0 Yes 0 No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> 1,affirm,all the abovl�,n�frmation is true and correct Date: f <br /> Applicant's Signature: <br /> STAFF USE ONLY <br /> C— <br /> G/P Designation:(f— Use Type:I Zoning: ( - <br /> DEPARTMENT APPROVED-- DENIED DATE <br /> 4LAjDevelopment Services PlannerrR <br /> Building Inspection A <br /> Environmental Health Div <br /> Fire Warden <br /> Public Works 7 <br /> M.H.C.S.D. All^ ft— <br /> Sheriff(Junk Dealers Only) Muo I <br /> 8WRONMENTA&HEALTH <br /> License Approved For ri n 4n C- QrN FMI <br /> Remarks: <br /> e)L- qq b2 <br /> Occ.Grp. <br /> Accepted as Complete: Date: <br /> F:\DevSvc\P1anning Application Forms\Business License(Revised 03-09-09) Page 2 of 7 <br />