ANDERSON1111111 IIIII IIII IIII � - / �_ _ �
56
4 -e,� Quin&
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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 I" Ir- Q �- U420�
PROPERTY OWNER Mnr(
PROPERTY ADDRESS y� !a :Tb
MAILING ADDRESS mac.-rnp a.
TYPE OF RESIDENCE (single, m
TYPE OF BUSINESS h &)zl _yer
BRIEF DESCRIPTION ,OF. HOW THE
PHONE j-6
PHONE
tiple, mobil home, etc.) ��
INESS WILL OPERATE
Y2S�Lr 4�,rui.�sl otter , and 1-kan mc -L /1 -
NUMBER OF PERSONS INVOLVED IN BUSINESS /
LIST NAME OF PERSONS EMPLOYED 0-(
• SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) /SOU
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME 20
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND S�PPLIES BEING USED IN THE
BUSINESS OPERATION (°,�om�tu�� .er Scr�onnl/�S
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OC UPAT N IS ALLOWED (CONDITIONS ATTACHED).
APPLICANT SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS REQUIRED.
-T 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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BuilcL:i,;?"--.'=.,,=,=;=a=fety Department
APPROVED DENIED CONDITIONS ATTACHED