PUGLIESEFee 35.00
I IIIIII VIII IIII IIII
26 FID
-4�t/ �%Gii(/ APR 18 1997
78-495 CALLE- TAMPICO - LA QUINTA, CALIFORNIA 9225giT-Y IDKA7Q1jTA
FAX (619) 777-7011
APPLICATION FOR
HOME OCCUPATION OF A BUSINESS
Read each condition listed on the attachment to this form to see if the proposed activity
complies with the City's Home Occupation Regulations.
APPLICANT N.AMES (List, all owners, partners and/or corporation officers)
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PROPERTY ADDRESS PHONE
BUSINESS NAME V6 11q
PROPERTY OWNER
AC—A/I ' per6elE.CE
• MAILING ADDRESS (if different from business address) A0 ' qF,? Z- 0 •
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
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TYPE OF BUSINESS <r4A/.7t),0.At LE4yi.J6 �- ��/���✓ /� D� 0� ��/
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BRIEF DESCRIPTION,OF HOW THE BUSINESS WILL OPERATE 0AekATIAJ.9 .
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (exclude garage) o�®Q
LOCATION AND SQUARE FOOTAGE OF AREA OF.BUSINESS ACTIVITY IN' HOME (example,
"bedroom 125 sq. Ft.)
• DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION C,647�✓ V - %o0/s 60-0 Ji ��D,aIK7r-.
MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253
I HAVE READ, UNDERSTAND, AND 'AGREE WITH THE CONDITIONS BY WHICH A HOME
0 UPATIO S ALLOWED. (conditions attached).
Date
pplicant's Signature
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION .OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED.
Owner/Agent Signature
Agent Company Name
Date
Date
Agent/Owner Contact Phone #
IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR .HOME OCCUPATION; FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT.
JAPPR VED' DENIED SPECIAL CO ITI0 S ATTACHED
BY- I . D. # 2 ---DATE
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