MILLER4 14 c? CITY OF LA OUINTA
HOME :OCCUPATION PERMIT
APPLICATION
78-106 Call* Estado
P.O. Box 1604
La Oulnta. CA 92263
(019)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-TEgp\Z L . i7/ I LEX! _ PHONE SGL 3(-/ 9
PROPERTY OWNER SAME- PHONE
PROPERTY ADDRESS S Z I2 I VLLA& C K\ 1A1W-- 1N
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) SITU F_
TYPE OF BUSINESS Z)W? C( -_S MAl&I2F� �l�% ( 5 6'0 %Z[,��I.1
BRIEF DESCRIPTIOq OF HOW THE BUSINESS WILL OPERATE &Q-C)W(�-T OVrg_J
'K,AV- PAWL t uk E CA)tn'AA-Fi y -Z— � 6 f!L-E CIZA
NUMBER OF PERSONS INVOLVED IN BUSINESS Off_
LIST NAMES OF PERSONS EMPLOYED \ a1(1,A 1✓, rnLl.•e-z—
SQUARE FOOTAGE OVXLiDF USABLE FLOOR AREA IN M��y "^+•w
HOUSE (EXCLUDE GARAGE) I -LIDO AFih�
LOCATION AND SQUARE FOOTAGE OF AREA OF APR 12 7991
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 SQUARE FEET")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPP�.LED IN Tff VUSINESS
OPERATION CCMPW"P�J2�, "t�tP�WrL1'GF1't-� PRDWE. YK
rnA, L. OYt.t7eSAi rti
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
. eAJ121�1 ���
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.
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BUILDIIG i SAFETY DEPAR C qL1_L—j/ APPROVED B DATE CONDITIONS ATTACHED
N-74 f
DENIED BY DATE
I
I II'III II'II II'I I"I
17
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