CARNAHAN•
CITY OF LA OUW.
HOME OCCUPATION PERMIT
APPLICATION
/Q -2/F AF/
78-105 Call* Est
P.O. Sox 1504
La Ou(n(B. CA •
(619)664-2246
Pead each conditlon listed on tte attachment to this form to see if the
proposed activity can comply with the City's Home Occupation Regulations -
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egulations.-S==S---LL--S-LSL Sac SLL SLSLSSLSLSlSLIILiSfII!!!!ltIISLIICLLL6lLLLL L -C -L -SS
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(TYPE OR PRINT IN INK)
APPLICANT'S NAME 6A UTAM 4. 441/44 0-4PA)APHONE S&4-3514
PROPERTY OWNER �lft-4 T/1/I%��/ PHONE 3 n-Sfl
PROPERTY ADDRESS ��$g� Lh/G- /Y/igiZT�✓crZ
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) _ < 1,J&7 LG
TYPE OF BUSINESS �^��n�✓YI
BRIEF DESCRIPTION OF NOW THE BUSINESS MILL OPERATE P e6Z; !A) COr✓1Jnl-
I
HUM.EER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE Fj,0OR AREA IN
HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE TOOTAGE..OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE.
"BED ooM • 125 SQUARE FEET") M4"/y1
D cif. r , • _
DESCRIPTION OF MACHINERY, EQUIPMEI--T,
OPERATION <MA -LL- f5CC-6�1-, An_✓._ -9 10AS
VALIDATION STAMP
I 511AA (Sf ltit
AND SUPPLIES 'BEING USED IN THE BUSINESS
I HAVE REAP, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A NOME
OCCUP*TIOtF I$ ALMWED (CONDITIONS ATTACHED). „ ^. n
l9
If APPLICANT THAN tROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED.
IMPORTANT: FMse or misleading information shall be grounds for denying your
Nome Occupation; failure to comply with conditions listed on the attached page
shall be grounds for revocation of permit.
BUILDING i S Tr DEPAR71aNNT
APPROVED BY 6.6-1 DATE /&-J/'?/ CONDITIONS ATTACHED
T
DEN:ED BY DATE
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BUS. -LIC. NO.
vt.cn� p
.1991 BUSINESS LICENSE APPLICATION FORM
***************************************** ************************
*APPROVED INITIALS DATE ,/�- r77- P
*DENIED INITIALS DATE
A0 -AID PH27 '112391
IS THIS BUSINESS LOCATED AT YOUR HOME:. YES :NO
2.
Business
Name:
�l(� S
.S>(; KK/I C',c
3.
Business
Address:
4.
Mailing Address :
5.
Business Phone:(
6. Owned By:
7.
8.
9.
10.
11.
12.
CORPORATION
PARTNERSHIP
If Corporation or Partnership: Tax I.D.#
If Individual Owner: Social Security #
Name of Owner 1,A) 1 LU AM
Or Officers
Type of Business: 4A -n " -r✓1
INDIVIDUAL
SS �' / -1- 1919-3
Title:
i005 1
CASH i TOTAL i 18.00
SBE Resale Number:
BUSINESS.LOCATED.WITHIN THE CITY OF LAIQUINTA (Does Not Apply To
Building Contractors):
A. Estimated Gross Business.Receipts for New Businesses Only:
$ I64 4-V /S, 000
B. Previous Year Gross ReCeipts For Established Businesses:
$ DODO
********GOOD ONLY FOR JANUARY 1,1991 THRU DECEMBER 31,1991*******
I HEREBY CERTIFY that jy1l the information supplied by me is correct and
any licenses require y the County, State or Federal Government have been
issued to WOW. ar /n full force and effect.
Sign r Title
Submit Form To:
CITY OF LA QUINTA
BUSINESS LICENSE DIVISION
P.O. Box 1504
La Quintal CA 92253
/ / c7 1/
Date
/ I IIIIII VIII Ilii IIII
12