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APPLICATION - BUSINESS LICENSE <br />MAR pais <br />s SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />��. <br />BUSINESS LICENSE No.,i <br />''2:_a ''�.'vili)is`tt;iN;Vi�I`J`f"r�.l_. � 1=�>�1I,:i'I•I -- <br />.. .......:.... <br />TO BE gpMPLETEd BY THE AP_PI IOANT PR 0R TO t✓ILING THE AF?PLICATION <br />:Burslness liifocrriatl®ri <br />Business Name: ` rtl P A.,. Ce-.V-'--eb1 fw+ e <br />Business Address: Gross St <br />DBA Mailing Address: Q City State: ZIP. 30 <br />Phone #: ' 0 , Assessor Parcel Number�). <br />Z <br />>=rnaii <br />Other Businesses atthis Address: <br />Previous Business atAddress: <br />Description of Business Operation:: <br />Type of Organization: ❑ Single Owner ❑ Partnership ❑ Corporation E2 Other. b M ;-+ et( („ &y, ) <br />Estimated Number of Full Time Employees: Estimated Number of Part Time or Seasonal Employees: .4e <br />Applicant Last Name: Applicant Fust Name: <br />Applicant Malling Address 13 ` (o " Aga <br />CV L j;iZ 'fin K? State tA I ZtP $ 3 Applicant Phone No: ;_ <br />Water Supply: i]Publ1c On-site Well Sewage Disposal: ❑ Pubiic 19 Septic System <br />Will there be any sale of firearms? ❑ Yes IR No <br />NOTE: ANY CHANGE OF OCCUPANCY MAY REQUIRE BUILDING IMPROVEMENTS AND NECESSARY BUILDING PERMITS. <br />1, affirm, under penalty of penury that all the above information Is true and correct'; Date: <br />1, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its ® j <br />agents, officers and employees from any claim, a'on or proceeding against the County <br />arising from the OwneC/A enYs project. <br />Applicant's Signature: M49LL- - <br />Sr,FF USE 6NLY . <br />GIP Designation: A Zoning: — Use Type: U <br />DEPARTMENT APPRO ED DENIED <br />Development Services Planner Name: <br />Building Inspection <br />Environmental Health Div <br />Fire Warden i? p b j j? <br />Public Works F <br />M.H,C.S.D. <br />License Approved For. <br />Remarks: <br />Occ. Grp. <br />Accepted as Complete: Date: <br />F/Applicat'sonsForms&HandouWPlanningApplicatorts/Business License (Revised 11-14-91) <br />Page 2o€6 <br />