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51
HOME OCCUPATION P
APPLICATIO
'CITY Of LA QUANTA
19-105 Celle Eefeee
P.O. box 1504
Le QuintsCA. 92253
(919) 664-1146
664-2246 PLANNING DIVISION 6/07
ead each con t onste on the severs e side o this form to see f
the proposed activity can comply with the City's Home occupation
Regulations. $35.00 fee a
3'h)jr,7% M, S/3�t3 LOW 8 o>✓GINFftiIT
TYPE OR PRINT IN INK 6pNRN%�J✓T
APPLICANT'S NAME TANET!'- to, SAY9$LOu/ PHONE
PROPERTY OWNER 13ON 7 PHONE 7 / — —.141,54 Z
PROPERTY ADDRESS - S' 90 4-V,4RRQa
(Street)
CALIF laa
_ Gt}�►/iN774 -
(City) (State) (Zip)
Type of residence (Single, Multiple, mobile home, etc.)[
Type of business 14 A 5 S
�
WS f rief descriplt�of ion how the business will operate i,Ji�� 4o vleS
ODYOikwL .SS(o hat
Number of persons involved in business �9hL Shl3a4lAlJ Bd�R�7
List names of persons employed �E L
Square footage of usable floor area in
house (exclude garage) /0 S40fP�� Validation Stamp
r -o% oh,,n.LIraSle, j- 5ag4Sfort, q*SC04t4S;&)
Location and square footage of area of 005182 10 6504 04-28-89 i0
business activity in home (example: 10 CASH i TOTAL 1 35.00
bedrooms; 125 square feet)
Room
Description of machinery, equipment, and supplies being used in the
business operation Masses Tabje, c -G IWC SI�o�
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
PLICANT SIGNATURE DATE
If Applicant is other than property owner, authorisation of owner or agent
required.
OR AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for denying
your Home Occupation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
• V�f • f • • • f f / • f f f
r APPROVED `�Initials �( 2 9 Date
CONDITIONS ATTACHED
DENIED :71nitials Date
LQHOMOCC.PRT ,