MANNW
` II'lll"IIIIII'll"I P,78-10
Boxa1504Estado
67 La Quinta, CA 92253
CITY OF LA QUINTA (619) 564-2246
HOME OCCUPATION APPLICATION
Read each ondit'on listed on the attachment to this form to see if the
proposed ac y can comply with the City's Home Occupation Regulations.
APPLICANT'S NAME i���l �t (J� �I � I P M(104 (10 h PHONE ECL12
l
PROPERTY OWNER i M PHONE
PROPERTY ADDRESS - Iii (� ��Q , V I I f Gt
TYPE OF RESIDENCE single, mull��'ple, mobile home, etc.)
TYPE OF BUSINESS i�6�� � C (Q J�_:�,
BRIEF
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED ST ti, 0
SQUARE FOOTAGE OF USABLE_ FLOOR AREA IN 04 PW PAID $35.00
HOUSE (EXCLUDE GARAGE) VALIMIMPAWKNP
• LOCATION AND SQUARE FOOTAGE OF AREA OF MAR:30' 92
BUSINESS ACTIVITY IN HOME (EXAMPLE, "
"BEDROOM - 125 S . F . " ) F 8UILDING AND TY
•DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIS BEING USEi IN THE
BUSINESS OPERATION U,� a�_
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
/L\ jhth
APPLICANT SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR .AGENT
REQUIRED.
Nvtta 0 \,q 4) t� j VA,- �� �J I � 3 30 Z-
OWNER/AGENT SIGNA 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.
Building and'Safety De ar ent
APPROVED BY 6LI DATE CONDITIONS ATTACHED
/X— _Ur__
DENIED BY DATE