Montgomeryt
CITY OF LA QUINTA
76-105 Calls Esteeo
P.O. BOX 1504
Le OulntesCA.92253
Kim) 564-::46
664-2246
PLANNING DIVISION
(o0
6/87
Read each condition
to see f
listed on the reverside side
of this form
the proposed activity can comply with the City's
Home Occupation
Regulations.
MQ
O P Lor S oc-
iQ-Ie S
TYPE OR PRINT IN IjW
APPLICANT'S NAME C GlG� e 6l/ PlHONE
PROPERTY OWNER UPHONE
PROPERTY ADDRESS" t
y- (Street)
at f�c r i A, �'� 92
Type of residence (Single, Multiple, mobile home,
etc.) 151�
Type of business Lc),t e ( u r - 115W /i o A./
-Brief 4escription of how the bus iness w'll operate x7,,f14 'gl e 4 i�
or �r — c' �- r-101 5,
Number of persons involved in business
• List names of persons employed
Square footage of usable floor area in
house (exclude garage) /'% a2S— Validation Stamp
085182 10 4974 02-'23-89 i0
Location and square footage of area of i0 CASH i TOTAL 1 35.00
business activity in home (example:
bedrooms; 125 square feet)
Description of machinery, equipment and supplies being used in the
business operation a x
I have read and understand and agree with the conditions by which a
hom occupation is allowed (Conditions on reverse side).
PLIC
T SIGNATURE DATE
If Applicant is other than pro rty owner, aut orization 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.
•4400 J►PPROVED initials 2 B Date
CONDITIONS A
zi L;�E
DENIED initials Date
LQHOMOCC.PRT