NUNGARAY11111111
o-7
CITY OF LA QUINTA
�1S—
HOME OCCUPATION PERMIT
APPLICATION
78-106 Calle Estado
P.O. Box 1504
La Quinta. CA 92253
(619)564-2246
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.
(TYPE OR PRINT IN INK) �(.I wt
k
APPLICANT'S NAME i PHONE I-Zle y `9 70
PROPERTY OWNER �A 7 ��Z�'�`^'' /^7 PHONE
PROPERTY ADDRESS 53 -- Fi
TYPE OF RESIDENCE (single, multi l /
e, mobile home, etc.) ,
TYPE OF BUSINESS ' ( 16
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE L}9 V
d�El
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
1 4 SFi 4-89 10
1 I U I HL 135.00
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) ins Q VALIDATION STAMP
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 SQUARE FEET") 6?4 fl
DESCRIPTION OF MACHINERY, EQUIPeW,l� AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
APPLICANT SIGNATU 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 6 DEVELOPMENT � Q \
APPROVED BY DATE `�� CONDITIONS ATTACHED
DENIED BY DATE
------------
------------------------------------------------------
CODE ENFORCEMENT
•APPROVED BY ( DATE CONDITIONS ATTACHED
DENIED BY DATE
MR/FORMJH.004
REVISED 08/89
FOR OFFICIAL COMMENTS
USE ONLY
- 1
•