RELDINE•
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14� RECEIVE
• ��,�• OCT 2 2 B97
INANCE DEPT
78-495 CALLE TAMPICO — LA OUINTA, CALIFORNIA 92253 - (619) 777-7050.
FAX (619) 777-7011
APPLICATION FOR lepO
Fee $35.00. HOME OCCUPATION OF A BUSINESS Q�1 `Z 2, 1997
Read each condition listed on the attachment to this form to see W proposed activity
complies with the City's Home Occupation Regulations.
APPLICANT :••TAMES (List all owners, partners.and/or corporation officers)�Ci, Reck-/re,
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PROPERTY ADDRESS..J�" -&0 4V-6n1'da- 9A PHONE
BUSINESS NAME
PROPERTY OWNER l U )*,d 1n2, 4' &0fivry- R-LL��
MAILING ADDRESS (if different from business address) .3/a-1'1jE'
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS Mlglft OK00 i
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE NN/g�( CAAq1M,61 Vw L
IA)ill ReCel ✓e oy?.er5 b, inlq�te c�i /l Fix e rrd erg 4o sm
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (exclude garage) /900
LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (example,
"bedroom - 125'sq. Ft.)4 s
• DESCRIPTION OFF MACHINERY, EQUIPMENT, AND UPPLIES BEING USED IN THE BUSINESS
OPERATION W pu EQUIPMENT,
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MAILING ADDRESS - P.O. BOX 1504 - LA QUINTA, CALIFORNIA 92253 ��( J
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I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OC UPATION IS ALLOWED (conditions attached).
40(/Y`a ` 1� Date /D .
Applicant's Signature
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED.
Date
Owner/Agent Signature
Date
Agent Company Name 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.
BUILDING & SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION
•�,' A PROVED DENIED SPECIAL CONDITIONS ATTACHED
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BY: I.D.# DATE
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