BUSHU
IIIIIIIIIIIIIIII I f Calle78-105 Estado
P.O. Box 1504
31 , La Quinta, CA 92253
- �— �� ��CITY OF LA QUINTA (619) 564-2246
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 L,0*\ncw_&b1-C PHONE
PROPERTY OWNER T�_ PHONE ,(
PROPERTY ADDRESS 53 _ I� �0 (M! K!�
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS
BRIEF DESCRIPTION OF HOV? THE BUSIN�ES WIL OPERATE
r 11�1�71 iItA 4-1f �� �n u /.< - � n e s
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR ARE IN
HOUSE (EXCLUDE GARAGE) (�®
• -LOCATION AND SQUARE FOOTAGE OF .AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,.
"BEDROOM - 125 S . F . " ) drMTy_ -�
XOMMMOMATAMP
NOV 23 1992
tiv
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUP ION I ALLOWED (CONDITIONS ATTACHED).
_APPLidwrr SIGNATURE DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED.
C
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.
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• Buildin and Safety D rtment
APPROVED B DATE CONDITIONS ATTACHED
DENIED BY DATE G 6 a- Y7 V,0
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