DETMITH•
70
HOME OCCUPATION PERMIT
APPLICATION
"CITY OF LA QUINTA
78-105 Cello Eetodo
P.O. Box I504
Lo OulntoAA. 92253
(6I/) $t4-2246
664-2246 PLANNING DIVISION �� 6/87
Read each condition listed on the reverside side of this form to see rf
the proposed activity can comply with the City's Home Occupation
Regulations.
RECEIV,EU
TYPE OR PRINT IN INK '
JUL 16 1969 APPLICANT'S NAME la_ ��'''� %%A PHONE - y
PROPERTY OWNER PHONE 4-1 14 2
CITY OF LA OUINTAtoPERTY ADDRESS�Sireet! • 12
�n
PLANNING &DEVELOPMENT DEPT. ;-A n p i n 0 � 2Zs-3
Type of residence (Single, Multiple, mobile home, etc.)
Type of business fDi (� �63�? /}til? /• m/'1-�.l l�19ti1'Z!%?��
Brief descrXption of how the business will operate %)tr1N�i12, S
Number of persons involved in business
List names of persons employed A1.0 A"9
• Square footage of usable fl area in
house (exclude garage) sqOtCUBBi ti n7 W 177P
10 CASH i TOT L i 35.00
iO
Location and square footage of area of
business activity in home (example: -
bedrooms; 125 square feet)
oe i
s �ip on of m� arequ ent, and supplies being us in the
business gperation ✓��✓
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, authorisation 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 /t • R f . f R ✓ APPROVED Initials
CONDITIONS ATT HED
DENIED Initials
LQHOMOCC.PRT
t t R f f
�a Date
Date