Keeley•
11111111111111111111
57
HOME OCCUPATION PERMIT
APPLICATION
CITY OF LA QUINT
78-105 Celle 991609
P.O. Box 1504
tQulnft,tA.9225!
1619) 964 - 114 6
664-2246 PLANNING DIVISION 6/57
Fad each condition listed on the reverside side of i s orm to see if
the proposed activity can comply with the City's Home Occupation
Regulations. $35_40–fee a
TYPE OR PRINT IN I(N�K
APPLICANT'S NAME P Q PHONE 5 L10440,��
PROPERTY OWNER c Q2 2A PHONE
PROPERTY ADDRESS '�' Q �►
(Street)
(City) (State) - (tip)
Type of residence (Single; Multiple, mobile home, etc.)
Type of business VYWL-A Od"d2'C"
Brie desc iptio o how th business will o rate
u�v ae c-
-` SP�
- \ �ex�S Cmc-2�\Je.ci . _-VOLPIr—
w AN
ssz
o C1 Ow�. % r
Number of persons involved in business
List names of persons employed VSO h
Square footage of usable flarea in -
house (exclude garage) �I3Zd ' Validation Stamp
Location and square footage of area of
business activity in home (example:
bedrooms; 125 square f et) 00.` 9.82 .i.0 6353 04-1.9--89 J.0
,M� l3ols i0 CASH i i OTAL i 35.00
Description of machinery, a i;pment, and supplies be ng used in the
business operation Ca C.u�"r0C
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
ri.-IBJ
VA9
AP-PtICART SIGMA DATE
If Applicant is of than property owner, authorization of owner or agent
required.
OWNER OR AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for Qenying
your Home Occupation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
R 'fes } ! ! R ! ! R f R R f
00 APPROVED Initials Date
CONDITIONS ATTAC
DENIM Initials Date
LQHOMOCC.PRT ,