WOODSCITY OF LA QUINTA
HOME OCCUPATION PERMIT
APPLICATION
01
78-105 Calle Estado
P.O. Box 1504
La Qulnta. CA 92253
(819)684-2248
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
APPLICANT'S NAME PHONE
PROPERTY OWNER
PROPERTY ADDRESS -(37/
PHONE le- !11
TYPE OF RESIDENCE (single, multiple,, mobile home,, netc.) J> 416— lip,
.
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUS NESS WILL OPERATE
,moo mnz� &�, zld
NUMBER OF PERSONS INVOLVED IN BUSI�NE'SS �I
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) 4Wd
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 SQUARE FEET") p6-r
,
VALIDATION STAIP
05i8H poiO
')i-89ppCAL 35.00
i0
DESCRIPTION QF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION 4L6"6 .
r
I HAVE READ, UNDERSTAND, AND AGREE WITH THE
CONDITIONS BY WHICH A HOME
PA ON IS ALLOWED (CONDITIONS ATTACHED).
APFLrCANT
SIGNATURE
DATE
I APPLICANT IS
OTHER THAN PROPERTY OWNER,
AUTHORIZATION OF OWNER OR AGENT
R UIRED.
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.
---------------------------------------------__________________
PLANNING & DEVELOPMENT
APPROVED
�,�y�j � I
BY DATE / ��
CONDITIONS ATTACHED
DENIED
BY DATE
CODE ENFORCEMENT
`- APPROVED
BY DATE /'�G-
CONDITIONS ATTACHED
DENIED
BY DATE
MR/FORMJH.004
REVISED 08/89
FOR OFFICIAL COMMENTS
USE ONLY