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APPENDIX C. PERMITS AND LICENSES

Republic of the Philippines

Province of Negros Occidental
CITY OF KABANKALAN

CITY HEALTH OFFICE

____________________________________________
SANITARY PERMIT TO OPERATE

Issued to ___________KCC H2O Water Station_________________________

(Registered Name)

Water Refilling Station

(Type of Establishment)

Address ________________Adela St. Brgy 1, Kabankalan City_____________

Sanitary Permit No. _____ 003________ Date Issued: ____________________

Date of Expiration: December 31,2018

This permit is not transferable and will be revoked for violation of the Sanitary
Rules, Laws or Regulation of P.D. 522 & P.D. 856 and Pertinent Local
Ordinances.

Recommending Approval:

ROSE MARIE H. COMPLETO

Sanitation Inspector

Approved:

FERNANDO A. FERNANDEZ,MD
City Health Officer
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Republic of the Philippines

CITY GOVERNMENT OF KABANKALAN
(www.kabankalancity.gov.ph; Tel./Fax 4712-291)
6111 Negros Occidental

OFFICE OF THE MAYOR

MAYOR’S PERMIT
Permit No. :2017 – 001 ( √ ) New
Date Issued: January 20, 2017______________ ( ) Renewal

Name of Permittee: KABANKALAN CATHOLIC COLLEGE_______

Business / Firm Name: KCC H2O Water Station______________________

Place of Business: ADELA ST. BRGY.1, KABANKALAN CITY____

Kind of Business: Water Station Business________________________

TO WHOM IT MAY CONCERN:

This permit is hereby granted to the above-named person to hold, conduct or operate, use o
business pursuant to the provision of Section 4A.01 of Article A, Chapter IV of City Ordinance No.
otherwise known as City of Kabankalan Revenue Code of 2009. The necessary License and P
prescribed by existing laws and ordinances, having been paid under the official receipts indicated
subject to the compliance of the conditions stipulated in accompanying permit application.

Recommending Approval:

NELLY S. ISLAO
Licensing Officer
Permit and License Division

APPROVED:

ISIDRO P. ZAYCO
City Mayor

This Business Permit is NON-TRANSFERABLE and valid only up to December 31, 2017
revoked for cause as provided by law, ordnance or regulation. Official Receipt evidencing payme
attached as part of this Permit.

Paid under O.R. No.: 1234567 Amount: P 10,000.00 Date: January 18, 2017
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