STONE61 O F L
HOME OCCUPATION PERMIT
APPLICATION
CITY A WWI"
18-05 Celle 981919
P.O. sox 1504
Le Gulnro,CA. 92251
(M) $64-1146
664-2246 PLANNING DIVISION 6/87
We -ad each condit on sted on the reverside side of this form to see if
the proposed activity can comply with the City's Home Occupation
Regulations. $35.00 fee
TYPE OR PRINT IN INK / p�
APPLICANT' S NAME '-o%rkx Al r PHONE!
PROPERTY OWNER PHONE
PROPERTY ADDRESS - t • L fs�1
Street)
(City) (State) (Zip)
Type of residence ingle, !Multiple, mobile home, etc.)
Type of business 001 es w �I
Brief description of how the business will operate M .4 s n�--.�
Number of persons involved in business
• List names of persons employed
Square footage of usable #loon �{ea in
house (exclude garage) / (p ) validation Stamp
Location and square footage of area of
business activity in home (example:
bedrooms; 125 square fee )
I t*) .S: 6a 0 -.
• Description of machinery, equipment, ,and supplies being used in the
-buryiness operation - 1"" `' 4
v
I have read and understand and agree with the conditions by which a
home occupation is allowe (Conditions on reverse side).
005i82 10 1826.09--07-88
i�,C A� H i T,01. iA� H i T,01. i
AP IC SIGNATURE DATE __�/ ��
35.0013
If Applicant is other than property owner, authorization of owner or agent
required.
OWNER OR AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for denying
your Home Occupation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
0
APPROVED / Initials Date
CONDITIONS ATT HED
DENIED Initials Date
LQHOMOCC.PRT '