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1 <br /> COPY <br /> E:Id e N't Ai. HEAI-1 II <br /> APPLICATION — BUSIN S' 6' SE <br /> SAN JOAQUIN COUNTY COMMUNITY DEVEL TIS <br /> g BUSINESS LICENSE NO. 2L— OZ -3N) <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Business Information <br /> Business Name: 0 ! •C--+� %e o b <br /> Business Address: - �i5%!1 /�! ,�j Cross St rj �- z,. <br /> Mailing Address:.3 Q Z ,S..CK •S Al A-63 01 City: C_1 State: ZIP:93-3 7 <br /> i <br /> Phone#: t, Z Assessor Parcel Number(s): 3 -)yo -o <br /> Other Businesses at this Address: <br /> Previous Business at Address: <br /> Type of Business: A s a <br /> Type of Organization: ❑ Single Owner 9 Partnership ❑ Corporation ❑ Other. <br /> Estimated Number of Full Time Employees: 3 Estimated Number of Part Time or Seasonal Employees: 7_ <br /> Applicant Last Name: S A IN Lk Applicant First Name:.74 0 N • !;AN W4 <br /> Applicant Address: I.;Z V- Applicant Phone No: ')09-=5534-11987 <br /> Water Supply: ❑Public IN On-site well 95377 Sewage Disposal: ❑ Public R Septic System <br /> Will there be any sale of firearms? ❑ Yes JW No <br /> NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br /> Applicant's Signature: Date: $--27 -D 3 <br /> STAFF USE ONLY "A <br /> G/P Designation: Zoning: C.-�.S Use Type: 6 s0�lk S w& <br /> DEPARTMENT APPROVED DENIED DATE <br /> Development Services Planner Name: ? h7 a <br /> Building Inspection <br /> Environmental Health Div <br /> Fire Warden TRAO� <br /> Public Works <br /> Solid Waste <br /> Enforcomont Officer <br /> License Approved For: <br /> Remarks: (, Zj 1^ / r,W <br /> res 3 <br /> Accepted as Complete: Date: <br /> F:\DevSvc\Planning Application FormslBusiness License(Revised 12-31-02) Paqe 3 of 8 <br />