WISE (2)i
IIIIIIIIIillllllllll
49
FEE $35.00
Titt f
,� 4 4V axins
CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La
HOME OCCUPATION PERMIT
A�rf_ �455,r X^?
a/�D05.oFLA QUANTA
,1M 141994
Quin��!!2
c�4
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.
BUSINESS NAME r. Co PHONE De�I
PROPERTY OWNElf . L-, • W PHONE
PROPERTY ADDRESS 5_(vR5 Z:7W1y1,AxuaCL-
MAILING ADDRESS :522= =-
TYPE OF RESIDENCE (single, multiple, mobil home, etc.)
TYPE OF BUSINESS 77_;,-,7y - Co ✓`i'r-Ae-T '
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
6 M C r, -
NUMBER OF PERSONS INVOLVED IN BUSINESS Z.
LIST NAME OF PERSONS EMPLOYED -3- 14"SAMAJO/tu/ r -t
SQUARE FOOTAGE OF USABLE FLOOR AREA
• IN HOUSE (EXCLUDE GARAGE)/E70),K
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION a
�&2UAaa-
:::X'QhrUh.g 66
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPAir6,W_7iS D?TfONS ATTACHED) • '� - / 5�� 9
APPLMANT SIGNATURE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
r OR AGENT IS REQUIRED.'
OWNER/AGENT�S, GNATURE DATE
IMPORTANT: FALSE OR -MISLEADING INFORMATION SHALL ---BE GROUNDS FOR
DENYING YOUR HOME - OCCUPATION; FAILURE TO*COMPLY WITH CONDITIONS
LiS'TEb ON THE �,KTI�ACHED PAGE SHALL BE GROUNDS FOR 'REVOCATION OF
PERMIT.
• Building.and ;Saf& y Department
PP V-ED,',� DENIED CONDITIONS ATTACHED