HJELTE06
CITY OF LA OUINTA
�\AHOME OCCUPATION PERMIT
APPLICATION
78-105 Calle Estado
P.O. Box 1504
La Oulnta. CA 02253
(810)584-2218 w
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.
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(TYPE OR PRINT IN INK) rp
APPLICANT'S NAME PHONE-r�S`7
PROPERTY OWNER r611, Ij-e PHO�N+E® S6�- 55 9
PROPERTY ADDRESS J Z� 1/le- u kt Q (X
d . LtC I h 97Jt Com/ I
TYPE OF RESIDENCE ( singlet, �m*ultipllee, mobile home, etc.) Si ni )e
TYPE OF BUSINESS /�Q/_ ��ADQ /tf��4l Ir'd` /UII�� bI �NG�YICC-
BRIEF,,DESCRIJ?TI,ON OF HOW, fTHE BUSINESS WILL OPFRATE Ke -CC -We 'M?,k10;1&
NUMBER OF PERSONS INVOLVED IN BUSINESS P
LIST NAMES OF PERSONS EMPLOYED Note
SQUARE FOOTAGE OF USABLE FLOOR AREA INw .VU
HOUSE ( EXCLUDE GARAGE) C1fQWQM ►AWP
LOCATION AND SQUARE FOOTAGE OF AREA OF MAY 0 6 1991
BUSINESS ACTIVITY IN HOME 1 �A�M�P ''E,
•
B ROOM - 125 SQUARE FEET"
"BEDROOM
�S41AAVL *1 't
DESCRIPTION F CHIN€RY, QUipMENT, D S�LIE BEIN I E USINESS
OPERATION a Gcr r C-e4xP% -h O/S
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (C DITIONS ATTACHED).
APPLIC SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED.,
OWNER/AGENT SIGNATURE DATE
I
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.
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BUILDYNG i SAFETY DEPAR
4
APPROVED BY DATE " / / CONDITIONS ATTACHED
DENIED BY DATE
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