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Moshierp1tuf CITY OF LA QUINTA 1 111111 11111 1111 1111 30 78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253 HOME OCCUPATION PERMIT 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. /NS /Rc L A416 BUSINESS NAME L'95HXZ: e64-c-Ez1e= PHONE (4,191) JS%S'- PROPERTY OWNER ArR1e_1A oSN/ER PHONE (&1y Jy91- ?..;14 a PROPERTY ADDRESS 111__670 ,rTEAcu)0 ,(/9-Aj-' ,(AQP/,A,r,4 L?f� 4 ads3 MAILING ADDRESS Jimr !tS f9.6o V ca TYPE OF RESIDENCE (single, multiple, mobil home, etc.) .flAi&LE TYPE OF BUSINESS .Se^9r-" FOX Sevg044 leJrWIIO A,9AJCy Fok J70DE'N7S BRIEF DESCRIPTIO)1 OF HOW THE BUSINESS WILL OPERATE PJ4fANE d1fd.t3 To f 0".9-M Ce1EN7'.S (,,Sru0ew'rS)-%4-In1/clAjef OF/➢�Oooe/Gdqr1aA) oroxpivs NUMBER OF PERSONS INVOLVED IN BUSINESS LIST NAME OF PERSONS EMPLOYED F6 -(_e SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (EXCLUDE GARAGE) /& 0 LOCATION AND SQUARE FOOTAGE OF AREA OF BUSINESS ACTIVITY IN HOME (EXAMPLE, "BEDROOM -125 S.F. ") 19,01"1 IaS'z� ( 8tdaoor�t) DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS OPERATION do A7/urE.Q_, Cl1-e-Cue,+ro/Q,` I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME (J�UPATION IS ALL WED (CONDITIONS ATTACHED). 6'a7 -9�/ APPLICANT SIGNATURE DATE IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT IS REQUIRED. '� OWNER/AGENT SYGNATURE DATE.• IMPORTANT: FALSE 09. 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 Department )� APPROVED _ DENIED CONDITIONS ATTACHED �J - s�H 1. 4a QU14t& 7-s - P� BUS. LIC. NO. 1994 BUSINESS LICENSE APPLICATION FORM ************************** *APPROVED BY * DATE ************************** ......PROOF OF WORKERS COMPENSATION INSURANCE IS REQUIRED.'....... IS THIS BUSINESS LOCATED AT YOUR HOME: YES X NO 2. Business Name: Cash IV College 3. Business Address: 44-370 Buttercup Latie Mailing Address: same La Ouinta, CA 92253 5. Business Phone:( 61�L—) 345-6652 & 1-800-340-6652 6. Owned By: CORPORATION PARTNERSHIP NDIVIDUAL 7. If Corporation or Partnership: Tax I.D.# 8. If Individual Owner: Social Security #_ 571-60-4128 9. Name of Owner patricia Moshier Title: • Or Officers , SEA�aN 10. Type of 'Business:�e�e.. service for scholarships & grants p (non-federal; for students needing financial aid 11. IF YOU ARE A FOOD VENDOR, DO YOU HAVE A COUNTY HEALTH PERMIT: YES NO X 12. SBE Resale Number: 13. BUSINESS LOCATED WITHIN THE CITY OF LA QUINTA (Does Not Apply To Building Contractors): yes A. Estimated Gross Business Receipts for New Businesses Only: unknnwn B. Previous Year Gross Receipts For Established Businesses: is $ not applicable ********GOOD ONLY FOR JANUARY 1,1994 THRU DECEMBER 31,1994******* I HEREBY CERTIFY that all the information supplied by me is correct and any licenses required by the County, State or Federal Government have been issued to me and are in full force and effect. Date Signature Title Submit Form To: CITY OF LA QUINTA BUSINESS LICENSE DIVISION 78-495 Calle Tampico La Quinta, CA 92253