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i <br /> I <br /> Fingerprint Appointment: Bus. L10 CURRENT YEAR <br /> I <br /> CITY OF STOCKTON <br /> HOTEL, MOTEL AND/OR RESIDENTIAL HOTEL/MOTEL <br /> PERMIT TO OPERATE APPLICATION <br /> ❑ Residential Hotel/Motel V Hotel/Motel ❑ New ,® Renewal <br /> Name of Hotel/Motel: PCIC.I�1 G �5j)G2►?9S Lhn <br /> Location Address:_11J• W806 YJ� ifD� . GA' '95211SMailing Address: o2��S , rr2ai�r hku (�!� C "k 9522 <br /> Phone # Fax# <br /> Business License Holder: &0A. Wd Phone <br /> Mailing Address: 1M&I '/ &drVSC C-f C1700 /701 o Goo- Q17Vq <br /> Property Owner: AnI 1 -I' PAryal;Wn 19A4WPhone # 001J —12W"Q2(� <br /> Mailing Address: 0 435 lr21'YLaicA We!aj Wk- m, CM %V-2, <br /> Lease Holder: Phone# a �� <br /> Mailing Address: <br /> Please list all Managers employed at this facility (attach additional paper if necessary): <br /> Manager:_ Phone# -qO <br /> Mailing Address: JJ, MI W�+a <br /> 'Sh;�(/Pvn ,C)q � <br /> Manager: Phone# <br /> Mailing Address: <br /> Manager: Phone# <br /> Mailing Address: <br /> Manager: Phone# <br /> Mailing Address: <br /> Pagel <br /> **Fees are effective frorn 07101/2023--06130/2024 <br />