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28 HOME OCCUPATION PERMIT APPLICATION CITY OF LA QUINTI 78-105 C•II• t•t•f• P.O. Box 1504 L• Qulnf oCA. 9tt53 ,1619) 564 -as ss 564-2246 S� PLANNING DIVISION 5/07 ead each condition listed on the reverside 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 APPLICANT'S NAME PROPERTY OWNER L PROPERTY ADDRESS t =6 PHONE 619- 564"367 PHONE A / 4 - 564/- 13 Z,7 (City) (State) lzip) _ Type of residence (Si� ngle, Multiple, mobile home, etc.) SlIVILe Type of business COrVS%/LUcfio�J Brief description of how the business will operate OIWICc All R~Z< 1n,.n11-- .47' W-3/0 C2c67'1/ieAv T"94e-t LtJAa2 l�au5r STo 4E off . J. Number of persons involved in business 3 eD List names of persons employed ,Fdfwlnl 5#4D©WGE OU V14! R1Xn1 D -- ,p i Square footage of usable floor Area in house (exclude garage) 1335 'Cr Validation Stamp !'"'.tom' Location and square footage of area of business activity in home (example: bedrooms; 125 squad fe t) Description of machinery, equipment, and supplies being used ip the _,p a business operation Nr �F " �� 13 `? k 35.00 I have read and understand and agree with the conditions by which a home occupation is allowed (Conditions on reverse side). rAPPLICANT SIGNATURE DATE If Applicant its other than property owner, authorization 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. ✓ APPROVED Initials ` O Date CONDITIONS ATTA H DENIED _ 'Initials Date LQHOMOCC.PRT ,