MOFFITTFee $35.00
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78-495 CALLE TAMPICO - LA QUINTA, CALIFORNIA 92253 - (619)..777-7050
FAX (619) 777-7011
APPLICATION FOR PAID
HOME OCCUPATION OF A BUSINESS
APR 11 1997
Read each condition listed on the attachment to this form to see if ttI UF9JbYK1fA
complies with the City's Home Occupation Regulations. U 1
APPLICANT NAMES (List all owners, partners and/or corporation officers)
PROPERTY ADDRESS 7cl,;,) 4S-- Cay^' " a �' �� o
PHONE (1U =Q 01 -
BUSINESS NAME dI �P -e S
PROPERTY OWNER
• MAILING ADDRESS (if different from business address)
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS Ma3I ovl-dev
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE iMa l l v�rLv- 4 vro o";i^
a C'n v� w.-aYC - u�l� 6 s wt,\ +6-,o i v<,4e� r -e- 4— .
NUMBER OF PERSONS INVOLVED IN BUSINESS I
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (exclude garage) i R5 d
LOCATION AND SQUARE FOOTAGE OF AREA OF .BUSINESS ACTIVITY IN HOME (example, _
"bedroom - 125 sq. Ft.) 12a
10 DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE BUSINESS
OPERATION PC �✓ i �. �� nT c 2 k 1M 0 , Sic V.\ V\ v✓' , 4�kx
MAILING ADDRESS - P.O. BOX 1504 - LA OUINTA, CALIFORNIA 92253
c�
I HAVE- READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS. ALLOWED (conditions attached).
�r Date
Applicant's Signature
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR
RENTAL/LEASING AGENT IS REQUIRED.
Date
Owner/Agent Signature
Date
Agent Company Name . Agent/Owner Contact Phone #
IMPORTANT: FALSE OR'MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING
YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON THE
ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT.
countera
APPROVED DENIED SPECIAL CONDITIONS ATTACHED
1. D. # '3 DATE ✓
0