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Uty Of Santa Ana <br />PROTEST FORM FOR 2013 DOWNTOWN SANTA ANA BUSINESS <br />IMPROVEMENT DISTRICT ASSESSMENT <br />Javier Zamora Business License #: 312321 <br />South Gate Rose Pharmacy Inc Assessment Type: Gross Receipt <br />517 N Main St Unit# 101 Business Type: Drug Stores W Sched 1 <br />Santa Ana, CA 92701 Bid Rate: 1.5 x Business License Tax <br />Business Location: 517 N Main St Unit# 101 <br />NOTE: The person submitting this protest must be the owner of the business referenced above. <br />Please complete and submit this form to the Clerk of the Council during or prior to the public hearing <br />scheduled for July 1, 2013. <br />The Public Hearing will be held at 5:45pm at: <br />City Council Chamber <br />22 Civic Center Plaza <br />Santa Ana, California 92702 <br />This form can be mailed to the Clerk of the Council at: 20 Civic Center Plaza, 8a' Floor, Santa Ana <br />CA 92702; however, it must be received prior to the date of the hearing in order for the protest to be <br />considered. <br />VI am protesting the assessment in its entirety. <br />❑ I am protesting the following specific types of improvement or activities: <br />j4vj��- &-'1/t0PA. <br />Print Name <br />PN <br />t ign <br />n__ <br />Title <br />Date <br />