SELTSAMCITY OF LA OUINTA
HOME OCCUPATION PERMIT
APPLICATIOO'3S �!?
63
78-106 Calle Estado
P.O. Box 1504
La Oulnta, 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)
7) S PPLICANT'S NAME 4 �F�TS/� n, P ONE
PROPERTYY
OWNER -E a vJ c N'�n'1 t� USA A
Y-�1�., PHO �' sb -zrg I
PROPERTY ADDRESS tea- 9124) V/-LLe Ta
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) SIN G L6
TYPE OF BUSINESS -P0 t:, L &L-L--Atj11y6 9C-P-uIC.E
BRIEF DESC IPTION OF HOW THE BUSINESS WILL OPERATE I` "J' LC_ t7 o j4)
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED Cr/'9A,--it .5,FL%3al'r►
SQUARE FOOTAGE OF USABLE FLOPR AREA IN
HOUSE (EXCLUDE GARAGE)/6 SD VALIDATION STAMP
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 SQUARE FEET")
8MR-CDM .;I Z��-5a . I+ r
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING $ti 3V � i8-89 SD
OPERATION ?6f-TAALr- UA' go- _ P_µg-h kc-4LS� NET .L S/i a,ctE' / @MN(� 35.00
DOLr� . -
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
APP ti&T SIGNATURE DATE
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.
PLANNING & DEVELOPMENTR
APPROVED BY DATE CONDITIONS ATTACHED
DENIED BY DATE
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7APPROVED
NFORCEMENT p�
. BY
DATE_O CONDITIONS ATTACHED
DENIED BY DATE
MR/FORMJH.004
REVISED 08/89
FOR OFFICIAL COMMENTS
USE ONLY