LEIGHTON•
59 riITY OF IA 0i in
HOME OCCUPATION PERMIT
APPLICATION
To -405 calft t•led
P.O. Box 1504
tOulateoC►.Ott-
(619) $04-s:4•
564-2246 PLANNING DIVISION 5187
Read each condition listed on the reverside side of this lorm to see IT
the proposed activity can comply with the City's Nome Occupation
Regulations. $35.00 fee
AQP ��.9s, «�P� �N� v��o �sv'E•eY ���NitiG
TYPE OR PRINT IN INK
APPLICANT'S NAME TZ,Tec %-i-. KT6,Q Sit
PROPERTY OWNER YZ1_r ff , e . a k-toN R .
PHONE S_G Y �o go $
PHONE o
PROPERTY ADDRESS s FSs 15Ve v;d fferrer-��,
(Street)
�9 Qu1N7a C4. 9,2ZS'3
(City) ' (State) (tip)
Type of residence (Single. Multiple, mobile home, etc.)
Type of business Car e?^clea.v;
Brief description of how the business will operate 40(1060. -le- ;,v �
fay Gyoo-9 _ fiche 76 �c� vje�ac�oO�G--Ice Fn` ,oaoerwo� �r.., eve ca!!s
Number of persons involved in business
List names of persons employed /3-2=a- Ne //j Lest G'To.v
Square footage of usable fl area in
house (exclude garage) 4/?S lValidation Stamp
Location and square footage of area of
business activity in home (example:
bedrooms; 125 square feet)
Description of urachi ery, equipment, and supplies being used in the n (a's)
business operation C�2r eT lec2^�� /���-^r4 e��^re.�T! /�FAx �c 74 t1q v
/(r0 QQN) Or WO/ DO Oma✓
I have read and understand and agree with the conditions by which a
home cupation is allow tions on reverse side).
F7
APPLICANT SIGN)► DATE
If Applicant Ss 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.
APPROVED Initials
CONDITIONS ATTACHED
DENIED 'Initials
LQHOMOCC.PRT
Date
Date