AMERI
1 CITY OF LA OUINTA
78-105 Calle Estado
P.O. Box 1504
HOME OCCUPATION PERMIT La Oulnta, CA 92253
APPLICATION ��� 819)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.
_____-- -
(TYPE OR PRINT IN INK) _
011111.
64
APPLICANT'S NAME I 1H^�/�.�i( LV �I - T PHONES GD �o
PROPERTY OWNER q�/i'O�oGi¢ �( n_ PHONE -? 7 3 - yar 9
PROPERTY ADDRESS i S / - SS.S. Cl.v �e
TYPE OF RESIDENCE (single, multiple, mobile home, -etc.) /1i�irs�
/ y
BRIEF
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED w
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) 1.3 G ,Z
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 SQUARE FEET")
• /��
DESCRIPTION OF MACHINERY— UIP T,
OPERATION R.._I
VALIDATIppON STAMP
pp ii gggg po p
- S05i8) 1lyoTRC i6-40 S.00io
AND SUPPLIES BEING LL� T E BUSINFaS-
-
I HAVE -READ, UNDERSTAND, AND AGREE WITH --THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
id, C� - - - _ _ .. . -- - -
IF APPLICANT IS OTHER
REQUIRED.
THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
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
APPROVED
BY ��� Z-6-90
DATE
CONDITIONS ATTACHED
DENIED
BY DATE --
-
CODE NFORCEMENT�j
-----------------------------------------------------------
• APPROVED
B S l DATE�8
CONDITIONS ATTACHED
DENIED
BY DATE
_
/IS
DJ
REV08/89
rneAMltN�r
FOR OFFICIAL COMMENTS
USE ONLY