LUSSIER29
HOME OCCUPATION PERMIT
APPLICATION�a-
CITY OF LA OUINTA
10-*$ Celle Esfsd.
P.O. Box 1504
L. OuinhwCA. 92203
�Wo) ss. -1141
564-2246 PLANNING DIVISION 6/07
Read each condition listed on the Rverside 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
r `
PHONE
APPLICANT'S NAME
PROPERTY ObiNER
PHONE
PROPERTY ADDRESS -7fn
(Street)
- / Qui `fy+-- Lam-
4zZS3
(City) (State)
(Zip)
Type of residence (Single. Multiple, mobile home, etc.)`
Type of business �Gcooe
Brie description of how the businessll
g,
o rate �[p{4,4s Cf4-�i1 i r�
z
rM fe-T
Number of persons involved in business
List names of persons employed bkyt L
WG5I Cr . r`sf 2ale
Square footage of usable floo�a�n
house (exclude garage)
Validation Stamp
Location and square footage of area of
p0
105i8AH SOOTAL i9-89 35.00S0
business activity in home (example:
bedr s, 125 square feet)
Description of machine equipment, and supplies being used in the
business operationIQ�I�or��
i'Vl,r'1PL,irn e
I have read and understand and agree with
the conditions by which a
home occupation is allowed (Conditions on
reverse side).
/-- 7�g
DATE
orizetion of owner or agent
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.
APPROVED Initials / �8 Date
CONDITIONS ATTR ED
DENIED _ Initials Date
LQHOMOCC.PRT
7bD00
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