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0 FEE $35.00
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CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
HOME OCCUPATION PERMIT
Read each condition listed on the attachment to this form to see if
the proposed activity can comply with the City's Home Occupation
Regulations.
BUSINESS NAME Aq,/F
< Nu o 6&1 ar>1nOrlfSe 0,2dSl7JN PHONE
&lg - 77/- 1&7,P
PROPERTY OWNER DAA
t Tavy� Si�e,a4gwo PHONE
6/q- 77i- 166?
PROPERTY ADDRESS
-S% 970 1-4 $g,,j74
MAILING ADDRESS
S/ 4ja !f✓ecr/AA 4j,17-
if/ZTYPE
TYPEOF RESIDENCE
(single, multiple, mobil home,
etc.) s',yjil
TYPE OF BUSINESS
ea/nPuiz-1- COVS4,422 4
BRIEF DESCRIPTION
OF HOW THE BUSINESS WILL OPERATE
13ZA51nlE5.5 S 14440
NUMBER OF PERSONS
INVOLVED IN BUSINESS Z
LIST NAME OF PERSONS EMPLOYED TONyA �,�st cANn
Co-QL✓arFic
SQUARE FOOTAGE OF
USABLE FLOOR AREA
IN HOUSE (EXCLUDE
GARAGE) 1,76-o
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME S F ,
( EXAMPLE , "BEDROOM -125 S.F.") 9-0 P-06*"
DESCRIPTION
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION PC &r< /ujQ Fi65-
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME_OCCUPAZAYON-SS_ALLOWED (CONDITIONS ATTACHED).
APPLIC-ANT SIGNATURE DATE
IF APPLICANT IS OTHER THAN*. PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS REQUIRED.
OWNER/AGENT SIUNATURE DATE
.t
IMPORTANT: FALSE OR MISLEADING INFORMATION -SHALL BE GROUNDS FOR
DENYING YOZJR HOME OCCCTION; FAILURE TO COMPLY WITH CONDITIONS
LISTED ONS THE ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF
PERMIT.
ldin anc�58.�.e't De a=tment
'�/ .. APP OVED - DENIED
CONDITIONS ATTACHEDJV�