WILSONIIIIIIIIIIIIIIIIIiiI • 78-105 Calle Estado
P.O. Box 1504
23 La Quinta, CA 92253
�
CITY OF LA -�QUINTA ( 619 ) 564-2246
`�-�✓ HOME OCCUPATION APPLICATION
• or T .
'i
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 �1 O��r� �\� PHONE
PROPERTY OWNER PHONE
PROPERTY ADDRESS S �- 1 S! S k= i3�►-ti-�-e,
TYPE OF RESIDENCE (,single, multiple, mobile home, etc.)
TYPE OF BUSINESS
BRIEF DtSCRIPTION OF HOW THE BUSINESS WILL OPERATE
NUMBER OF PERSONS INVOLVED IN BUSINESS I
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) 3 Dtr6
'• LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 S.F.") / 3.S
C6.0F LA QUINTA
VALIDA QYN fA1�2
Ir
BUILDING AND SAFE+.,
BY
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BE,NG USED IN THE '
BUSINESS OPERATION IM,u,,f QA/` t _4?,P-,A -2.�
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
APPLICANT SIGN
S� / 5
DATE]
IF APPLICANT IS OTHER THAN, PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGENT
REQU Ep/.-� /7 --N
` GENT IGNATURE DATE
IMPORTT. 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.
Building and Safety De a ent [,� 13 p
4 APPROVED BY q DATE J CONDITIONS ATTACHED
DENIED DATE