KRAKER•
'CITY OF LA OUINTA
U -M tell* toted*
P.O. Box I504
Le OulateAA. qzm
S:019) 664-1146
P P-
664-2246 PLANNING DIVISION 6/87
ead each condition listed on the reverside side of this torm to see if
the proposed activity can comply with the City's Nome Occupation
Regulations. $35.00 fee
S.vN Sr P Vr/T )� o S % F.k M
TYPE OR PRINT IN INK
APPLICANTS NAME n/S K,e A 1,ee a PHONE
PROPERTY OWNER -R-7 7(PHONE
\ PROPERTY ADDRESS .5-3 - 700 .40/ r e/i't 1-4
(Street)
(City) (State) (Sip)
Type of residence (Single, Multiple, mobile home, etc.) alI'r'it/4L
Type of business .-�Sr;4Gl;' of C�l�.�rerv��iC/��/t�irJ FyUI�
Brief description of how the business will operate A„f p,e d2/ 1
'Ll CK Ajw, - 4 .C/ffSc7i' -
Number of persons involved in business %
List names of persons employed S c•,e/=
Square footage of usable floor area in
house (exclude garage) min Z /=T
Location and square footage of area of
business activity in home (example:
bedrooms; 125 square feet)
Validation Stamp
005182 10 9829 04-20-88 i3
10 CASH i TOTAL i 35.00
Description of machinery, equipment, and supplies being used in the
business operation F -SS it�tR-C - S4gAWFP
-
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
okv
-
APPLICANT SIGNATURE DAT
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.
3 t • } t t t t } } f t t }
APPROVED Initials Date
CONDITIONS ATTACHED
DENIED Initials Date
LQHOMOCC.PRT