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I I"III IIIII'I'I IIII
34
OF LA QUINTA
ATION APPLICATION
78-105 Calle Estado
P.O. Box 1504
La Quinta, CA 92253
(619) 564-2246
Read each ition 1' on the attachment to this form to see if the
proposed activity can comply with the City's Home Occupation Regulations.
-----------------
APPLICANT'. S NAME AA PHONE
PROPERTY OWNER
PROPERTY ADDRESS
TYPE OF RESIDENC (single, multiple, mobile home,
TYPE OF BUSINESS
BRIEF DESCR PTION 0 HOW 4E BUSINESS W LL OPERATE
PHONE
Q�
etc.)
ai
NUMBER OF PERSONS INVOLVED IN BUSI SS
1
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
• HOUSE (.EXCLUDE GARAGE)
-LOCATION AND SQUARE FOOTAGE OF AREA OF
SEP 2 X1992
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 S.F.")
OWN AND r.,Ak= Arm
L -
BE
DESCRIPTION OF MACHINERY, EQUIPMENT, SUPPLIES
G
BUSINESS OPERATION
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPAT ON IS ALLOWED (CONDITIONS ATTACHED).
/1?
APPLICANT SIGNATURE
ATE
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.
uildin and Safety I Qe artfinent A/
APPROVED BY SY DATE CONDITIONS ATTACHED
DENIED BY . DATE