HIESTANDI I"I (I VIII I' I I I"I I
20
CITY OF LA 78-105 Calle Estado
P.O. Box 1504
HOME OCCUPATION PERMIT La Oulnta, CA 92253
(819)684-2248
APPLICATION RECEIVED
Read each condition listed on the attachment to this form ee
proposed -activity -can -comply -with -the -City's -Home -Occupation -Regu oons�f19W
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(TYPE OR PRINT IN INK)
C ] I PLANNING E. DEVELOPMENT DEPT.
AAPPLICANT'S NAME1'//t/�/ PHONE 5_6 " - 04q,?
PROPERTY OWNER '56u44 tue,i A, A&Mer , �h C PHONE
j
PROPERTY ADDRESS 51 7 -Is- Aemcwy C -lc lryG�N 2 �i
t�TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS
VBRIEF DESCRJIPTION OF HOW THE BUSINESS WILL OPERATE
�\, C�tn�r4c.7"o.S fa %U51.Sf1-uc� Y'C4icrebcPi o:� -k,��" i��'3�Gr-rc,
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED -R+11t3
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) 11.74 VALIDAT00fl§dkMW 0503 E -14-89 i0
10 CASH i TOTAL 1 35.00
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 SQUARE FEET") ET")
&.4 roo^ - /,24 of
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION - LAc - F)a f"
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
AA PLI ANT SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED
OWNER/AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for denying your
Home Occupation; failure to comply with conditions listed on the attached page
shall be grounds for revocation of permit.
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PLANNING 6 DEVELOPMENT
yNNAPPROVED BY �yH^� DATE y'89 CONDITIONS ATTACHED A"_0
DENIED BY DATE
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CODE�FORCEMENT `�
• ti/ APPROVED BY DATE L1 CONDITIONS ATTACHED 61JE.-
DENIED BY DATE
MR/FORMJH.004
REVISED 08/89
FOR OFFICIAL COMMENTS
USE ONLY
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