1. OWNER INFORMATION
- First and Lastname: Autumn Hurst
Phone Number (Optional): 2443332
Email (Optional): N/A
2. BUSINESS INFORMATION
- Name of Business: Melon Grove Café
Link to Registration:viewtopic.php?t=223696
Business Address: 29 Hawick Ave
Subsidiary Names (if applicable): N/A
Business Registration Type:
Mark an X in the appropriate checkbox.
[x] Stand-Alone
[ ] Subsidiary [Parent Company Name]
[ ] Parent
3. LICENSES APPLIED FOR
- Please note as a Parent Company, one license can be used for up to 2 Subsidiaries, but you can subscribe to multiple of the same type of license. If this applies to you, please mention how many subsidiaries need the license.
Please list all licenses you wish to apply for from the list HERE:
((DUPLICATE AS NEEDED))
- LICENSE #1
License Name: GRBL:03
Subsidiary Names (if applicable): N/A
- LICENSE #2
License Name: GRBL:09
Subsidiary Names (if applicable): N/A
- LICENSE #3
License Name: GRBL:11
Subsidiary Names (if applicable): N/A
- LICENSE #4
License Name: EEBL:02
Subsidiary Names (if applicable): N/A
- LICENSE #5
License Name:EEBL:04
Subsidiary Names (if applicable): N/A
- LICENSE #1
Vending Machine License (If applicable)
- Address of Vending Machine: N/A
Photo of Vending Machine: *ATTACHMENT*
4. AGREEMENT
- By submitting this request, you hereby agree that all information provided is truthful. You agree that you have read & understood all requirements, regulations and penalties related to the license(s) you are applying for. If your request is approved, you agree to a continuous effort to adhere to laws and regulations laid out by the San Andreas State Government. You also agree to submit any future changes to your business to the Business Licensing Bureau. You also agree to a full legal background check of your person.
Owner's Signature: Autumn Hurst.
Date: 07/03/2026
Police Detective II