Yoshimura (1994)I\ • A , I I II IIII II'll IIII II'I
a 43
1994
JAN 1.
CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La Quinta,1jCA 225
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 VDSk�h�u�c� CI UZr'tj°5;► PHONE OD46LS-
PROPERTY OWNER T osk; MUM- PHONE (0 10, - s?,L1 - )yo -7
PROPERTY ADDRESS 53 - p Ave,nj a- agree LA a
MAILING ADDRESS ,)Q a--✓► e__
TYPE OF RESIDENCE (single, multiple mobil home, etc.)„',.�,I�
TYPE OF BUSINESS
BRIEF_ DESCRIPTION OF HOW THE USINE S`, WILL. OPERATE
C.e�r�-'I-x e t5 ee-x,& yytc� �f�'irrx �- k -SL t
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED
Self -SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) &7/0
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
( EXAMPLE , "BEDROOM -125 S.F.") i3e1 rrrr&, — 3
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION persFnkk C" X e e esso ri'eS
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME CUPAT N IS -)ALLOWED, (CONDITIONS ATTACHED).
AIYPLICANT SIQN TURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION'OF OWNER
OR AGENT IS RED.
77
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
PERMI .
• Bui din and Safety Department
APPROVED DENIED CONDITIONS ATTACHED
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