BANGERTER664-2246
56
HOME OCCUPATION PERMIT
APPLICATION
PLANNING DIVISION
'CITY OF LA QUINTI
10-105 tells tstef•
P.O. sox 1504
L. QYlnt**CA. 92203
�tdtsi 9s.-1246
6107
Read each condition listed on L e reverside s lona to see it
the proposed activity can comply with the City's Nome Occupation
Itegulations. $35.-0(l fee
RECEIVED TYPE OR PRINT IN INK
APPLICANT'S NAME al&-tl PHONE
3 M PROPERTY OWNER , PHONE G�
PROPERTY ADDRESS
CITY OF LA QOINTA (Street)
PLANNING & DEVELOPMENT DEQ Z -a (OU -117&.1 4L
i.•a —I /state) (tiD)
Type of residence (Single, Multiple, mobile home, etc.) E -
Type of business fiecau it h'Iar�a9err�er�f -
Srief_descr,iption of how the businecs�wil4 operate
Number of persons involved in business J
(•
_ List names of persons employed A«7%)P,
Square footage of usable floor area fn -
house (exclude garage) GLS validation Stamp
Location and square footage of area of
business activity in home (example:
bedrooms; 125 square feet) 005182 0 4232 01-1 9 i3
_ /do �..��� SO GA�H i TOTAL i 35.00
Description of machiijery, equipment, and supplies being used in the
business operation nic7-e-r
I have read and understand and agree with the conditions by which a
home occupation is allowed !Conditions on reverse side).
11PPLICANT SIGNATURE ATE
If Applicant Is other than property owner, authorisation of owner or agent
required.
OWNER OR AGENZ SIG ATURE � TE
IMPORTANT: False or misleading information shall be grounds for Qenying
your Home Occupation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
6" APPROVED f'A/ Initials (-23X69 Date
CONDITIONS ATTACHED
DENIED .:-Initials Date
LQHOMOCC.PRT ,