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Il5 0 1111111111111 78-105 Calle Estado
l 1111111 P.O. Box 1504
78
J La Quinta, CA 92253
CITY OF LA QUINTA (619) 564-2246
HOME OCCUPATION APPLICATION
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 PHONE
PROPERTY OWNER PHONE
PROPERTY ADDRESS 54v go Me. A&,L?rM
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE] Q 0+( A -L L -
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
5.00
SQUARE FOOTAGE OF USABLE FLOOR AREA IN CITY OF PAID A Oui
NTA
• HOUSE (EXCLUDE GARAGE) VALIDATION -STAMP.
LOCATION AND SQUARE FOOTAGE OF AREA OF JAN 6199
BUSINESS ACTIVITY IN HOME (EXAMPLE, BUILDING AND SAFE
"BEDROOM - 125 S.F.") IIS �.�_
BY
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUP LIES BEIN USED.IN E
BUSINESS OPERATION _ M, f�Sa-6_Q.-f-{�j, _ 6,-( 1 L(q IT✓�_
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OC PATI IS ALLOWED (CONDITIONS ATTACHED).
APPLICANT SIGNA
(P*
DA
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.
Bui/dinq and Safety rtment
APPROVED BY DATE �3 , qv CONDITIONS ATTACHED
DENIED BY DATE