NorrisIIIIIIIIIIIIIIIIIIII � 78-105 Calle Estado
w / P.O. Box 1504
S !� 51 La Quinta, CA 92253
CITY OF LA QUINTA (619) 564-224
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 N6ns PHONE CLQ �Q -- 00310
PROPERTY OWNER S PHONE
PROPERTY ADDRESS _ `I� bsem kowe-xr l / �), Ca q,? WSJ
TYPE OF RESIDENCE (single, multiple, mobile home, etc.) i
TYPE OF BUSINESS
BRIEF DESC IPTION OF IAOW THE BUSINESS WILL OPERATE
��
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE F ORARBA IN
HOUSE ( EXCLUDE GARAGE) .}�},
LOCATION AND SQUARE FOOTAGE OF.AREA OF
BUSINESS ACTIVITY IN HO M ( AM)LE,e
"BEDROOM - 125 S.F.")
DESCRIPTION OF MACHI
BUSINESS OPERATION
I HAVE READ, UND
OCCUPATION IS AL
EQUIPMENT,,
.,10LP t A I Lo lltt2
rt
DEC 07'1992
I�S-B�IR�
D, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
(CONDITIONS ATTACHED).
APPLIVANT ISIGNA
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.
Is Building and Safety Department
APPROVED BY DATE 1 CONDITIONS ATTACHED
DENIED BY DATE