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CITY OF LA QUINTA
78-105 Calle Estado
P.O. Box 1504
La Quinta, CA 92253
(619) 564-2246
0 � Mo TM�• HOME OCCUPATION APPLICATION'
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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APPLI CANT' S NAME 4C•10ST "J ��"Z� PHONE 5C<4- 4.133
PROPERTY
OWNER
&-0L A s
PHONE -
PROPERTY
ADDRESS
V601OIN
VC—Lr�,SC-O 0j LLjTy, Cd
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
r
NUMBER OF PERSONS INVOLVED IN BUSINESS 72 --
LIST
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) I Sao
• LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,.
"BEDROOM - 125 S.F.") 1 -,)-o SQ -r-�
DESCRIPTION OF MACHINERY,
BUSINESS OPERATION
13
EQUIPMENT, AND SUPPLIE
VALIZA(D=MSTAMP .
WY OF LA QUINTA
JUL 0 61992
M
I HAVE READ, YNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION OWED CONDITIONS ATTACHED).
AP CANT 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.
Buil ing and Safety D a tment
APPROVED B DATE CONDITIONS ATTACHED
DENIED BY DATE