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PROPERTY OWNER
53
PHONE "SLL- an q.
CITY OF LA QUINTA
HOME OCCUPATION APPLICATION
78-105 Calle Estado
P.O. Box 1504
La Quinta, CA 92253
(619) 564-2246
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.
APPLICANT'S NAME
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PHONE OS ICI,
PROPERTY OWNER
N((-(XA CCI,
PHONE "SLL- an q.
PROPERTY ADDRESS
= -p7�
R1r- i?4AA(O E CA OU lmn
, CA g2o5E
TYPE OF RESIDENCE
(single,
multiple, mobile home,
etc.)
TYPE OF BUSINESS
BRIEF DESCRIPTIOP
OF HOW THE BUSINESS WILL OPERATE
COM oca M4-
T Pffrn.J
NUMBER OF PERSONS INVOLVED IN BUSINESS cf\JE 1
LIST NAMES OF PERSONS EMPLOYED /�p/1/-�::
•` IQUARE FOOTAGE OF USABLE FLOOR AREA IN C11Y0F1jK� /2
" HOUSE (.EXCLUDE GARAGE )��, VALIDATION AMP
LOCATION AND SQUARE FOOTAGE OF AREA OF
-A) 12 X993 C/_
BUSINESS ACTIVITY IN HQMEiEl�,
to ) 1f)(550Sr BUILDIfV�igNpDE ,
"BEDROOM - 125 S.F.
DESCRIPTION OF MACHINERY, EQUIPMENT,
QSUPPLIES BEING USED IN THE
BUSINESS OPERATION P r % j�� �f
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
i%L/OG(
APPLICANT SIGNATURE ATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED.
OWNER/AGENT SIGNATURE DATE
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.
Buil and Safety D - pa tment
APPROVED BY
y
`JiDATE'- Jl CONDITIONS ATTACHED
Okk DENIED BY DATE