NEUBURGER•
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HOME OCCUPATION PERMIT
APPLICATION
CITY OF LA QUINTA
78-105 Celle Eetede
P.O. SOX 1504
a Ou)nto,CA. •2253
k" (619) Seo- 2246
664-2246 PLANNING DIVISION -7+ 6/87
Read each condition listed on the reverside side of this form to see if
the proposed activity can comply with the City's Home Occupation
Regulations.
TYPE OR PRINT IN INK
APPLICANT'S NAME�i a N, r t�E� ��c� 2[�. �� PHONE 4G, CFN
PROPERTY OWNER S PHONE
PROPERTY ADDRESS -::7c_.l -4'b7o Plqne - _71
ra AM
(City) Mate) (Zip)
Type of residen (Single, Multiple, mo�blile home, etc.)
.6 r,- of business _,E.,�I C ''-"
Brief description of how the business till operate
Number of persons involved in business
List names of persons employed 4 :4
Square footage of usable floor area in
house (exclude garage) Validation Stamp
Location and square footage of area of 10 51 CASH i TOTAL 10-89 35.00i0
business activity in home (example:
bedrooms; 125 square feet)
Description of machinery, equipment, and supplies being used in the
business operation
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
APPLICANT SIGNATURE DATE
If Applicant is other than property owner, authorization 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.
• • f • • f f f f f • • f
APPROVED G.:S Initials
CONDITIONS ATTACHED
DENIED initials
LQHOMOCC.PRT
�j Date
Date