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03— .O. Boxx 15050 4
La Quinta, CA 92253
IIIIIIIIII'llllll�ll CITY OF LA QUINTA (619) 564-2246
58
HOME OCCUPATION APPLICATION
• 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.
APPLICANT'S NAME `I-�ti.c�scti f��y�cc�,_d�2 PHONE elf-�6��Zz-�/
PROPERTY OWNER 222'm� PHONE
PROPERTY ADDRESS 5,(
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) <--/±Z:f, G�
TYPE OF BUSINESS
BRIEF DESCRIPTION OF
WILL OPERATE
NUMBER OF PERSONS INVOLVED IN BUSINESS Azel
LIST NAMES OF PERSONS EMPLOYED • 109p,4zlo—
SQUARE FOOTAGE OF USABLE FLOOR AREA IN CPAID$X.pp
HOUSE (EXCLUDE GARAGE) VALID
• LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 S.F.") 75
DESCRIPTION OF MACHINERY, EQUIPMENT, AND
BUSINES OPERATION
SEP 1111992
BUILDING AND
SUPPLIES BEING USED IN THE
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
PL
DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED.
OWNER/AGENT SIGNATURE DATE
IMPORTANT: False or 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.
•
Builging and Safety Department
APPROVED B DATE�'� L CONDITIONS ATTACHED
DENIED BY DATE