ALBERT6
CITY OF LA QUINTA
U-105 Cele Eefeae
P.Q. SOX I504
Le Qu)etaAA.12283
Kim) so* -lit-so
664-2246
PLANNING DIVISION
#
6/87
Read each condition listed on the reverside side of this form to see f
the proposed activity can comply with the City's Home Occupation
Regulations.
TYPE OR PRINT IN INK /f' ,(
APPLICANT'S NAME /e L le Zee /siLll P9 / PHONE &4
S�•�no�c3y
PROPERTY OWNER F.TogmA PHONE Sarft4
PROPERTY ADDRESS c-� a. L /0IV/
'(street) AA 9 ^ 3
(city) (State) (Zip)
s Type of residence (Single, Multiple, mobile home, etc.) IL
C •
,g Type of business
�9 Brief description of how the business wil SW rate
... ggdd•
Q�
� Number of persons involved in business A nit
• 0 List names of —~ �-
persons empled
0 9'
Square footage of usable f oor area in
? house (exclude garage) Validation Stamp
�u
V\) Location and square footage of area of
business activity in home (example:
bedrooms; 125 square feet) SaJr
Description of machinery, equi ent, and supplies being used in the
business operation Qdif7D� OdZ4W L CQ9&A —,Gf)f
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side). .
005182 10 7582 06-29-89
�1StjTOTAL i
PLI GNA DATE 7 d 7
If plicant 16 other than property owner, authorization 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 f f R f f f f ! n• Gt f - f f
APPROVED DL4
Initials a 7 ^ / Date
CONDITIONS ATTAMtED
DENIED Initials Date
LQHOMOCC.PRT
12
35.00