Wilson78-105 Calle Estado
�r P.O. Box 1504
La Quinta, CA 92253
CITY �F�LA QUINTA (619)___564-224_6
I IIIIII VIII IIII IIII `
HOME OCCUPATION APPLICATION 01
•_
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.
APPLICANT'S NAME ie/ SES F IJ tsor• PHONE
PROPERTY OWNER .57,,Q a PHONE ,- /0 $ e)
PROPERTY ADDRESS /%J
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)�/� L
TYPE OF BUSINESS
B IEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE �c
S
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED - ,Y®
PAID $35.00.
SQUARE FOOTAGE OF USABLE FLOOR AREA IN CRYOFLAQUkA
HOUSE (EXCLUDE GARAGE) /200 VALIDATIO STAMP I
A G 281992
• LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE, BUI D D ETY DEPT.
"BEDROOM - 125 S . F . ")�.c Ir® Y
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEI G USED IN THE
BUSINESS OPERATION�.��/.o�.� /%��cuu �ir/� < /�ir��"e �u,�G�=�i�ST toe,'1c-jar
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
APPLICANT SIGNATURE DATE
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.
• Building and Safety De tment
APPROVED BY DATE Z' CONDITIONS ATTACHED
DENIED BY DATE'