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CITY OF LA OUINTA 4/7-/
HOME OCCUPATION PERMIT
APPLICATION
78-105 Call* Estado
P.O. Box 1504
La Oulnta, CA 82253
(818)584-2248
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 _b / L 1 . &N es PHONE 5(P4 -D9 -3(p
PROPERTY OWNER SA�1P� c;l,—sninye PHONE
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PROPERTY ADDRESS Va.Ile,
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS TC,�e.1MCJL`C �CC'� ��. N S �C�fXJ1i ftk,) Ybo
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
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"OF PE*R4tO S NVOL ESD -IH-$U6SlNESS v
LIST NAMES OF PERSONS EMPLOYED / £ 1
SQUARE FOOTAGE OF USABLE FLOOR AREA IN .w— WWAW
HOUSE ( EXCLUDE GARAGE) 1ln Z� cmOrT O AMP
LOCATION AND SQUARE FOOTAGE OF AREA OF APR 1 8 1991
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 SQUARE FEET")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND ST-T� ,BEING USED IN THE BUSINESS
OPERATION F 1 -
C,Oy�o�rle r esr UA tx
I HAVE READ, UNDERSTAND, AND AGREE WITH THE 90NDITIONS BY WHICH A HOME
OCCUPAXION IS ALLOW CONDITIONS ATTAC ).
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APPLICANT A UDATE
IF APPLICANT IS OTHER THAN PROP TY �ER,'
THORIZATION 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.
BUILDI! i SAFETY DEPARTMENT
APPROVED BY Y--1 ML A CONDITIONS ATTACHED .
DENIED BY DATE
I IIID' VIII IIII IIII
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