PIEKAARCITY OF LA QUIN'
70-105 Cells Estede
P.O. BOX 1504
Le Oulnte,CA. 922 5
,tsiel tss-ttss
C 664-2246 PLANNING DIVISION 6/87
lead each condition listed on the reverside side of this form to see if
the proposed activity can comply with the City's Home Occupation
Regulations. $35.00 fee
TYPE OR PRINT IN INK
APPLICANT'S NAME
PROPERTY OWNER -Z
PROPERTY ADDRESS
PHONE
PHONE
y� (Street)
LA Qu 1-41-04CA.
g226�3
(City) (State) (Zip)
Type of residence (Single, Multiple, mobile home, etc.) FA/N• OWL -6 -
Type of business ees4SSIF/C0 A tDVER-TlZ /NCi PU8L164 f/d/./
Brief description of how the business will operate U1144. F�✓£ fj�
11JRV 9Y PAJy,A/E Ilf- %•!U. BOX. - ////LL-P&.'A/T L re/,/ Cu�vllJu-� /d
U//4-4- TAW -e- 10416V A114'1_ To bZd A TE2 Ike_ 7UQ! .�.4T%�!- ltJ.rGC D�S%�a [ATE Tff�Gt
L �IQL T �S
Number of persons involved in business rwo
• List names of persons employed 1Zo/i1 � Y i1,0A1A.1, PAEX'AAPL
Square footage of usable floor area in
house (exclude garage) /400 Validation Stamp
Location and square footage of area of
business activity in home (example: 005H? I.0 620$. 04-11-89 i0
bedrooms; 125 square feet) 1.0 DiSH I. TOTAL I. 35A0
3E ?r2.W/✓I //O SQ. r -
Description of machinery, equipment, and supplies being used in the
business operation WAC r SH h -LIS C,0747-1LciE2 f die/tir7ER—
I have read and understand and agree with the conditions by which a
home
/Joccupation
/� is allowed (Conditions on reverse side).
APPLICANT SIGNATURE DATE
If Applicant is other than property owner, authorisation of owner or agent
required.
OWNER 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.
"PROVED Initials
CONDITIONS ATTACHED
DENIED Initials
LQHOMOCC.PRT
O ` �3 / Date
Date