TERPSTRA67
CITY OF LA QUINTA
HOME OCCUPATION APPLICATION
78-105 Calle Estado
P.O. Box 1504
La Quinta, CA 92253
(619) 564-2246
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 /ll/ Iyny -�,
PROPERTY OWNER Gy/yf ✓ /(/9AM/ -
PROPERTY ADDRESS �) � —
W12
PHONE 27/-060�
PHONE oS4 M
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
TYPE OF BUSINESS ,�r/iITE/2i0/2 JES/6:;l
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAMES OF PERSONS EMPLOYED
01
SQUARE FOOTAGE OF USABLE FLOOR . Rr'!A IN
HOUSE (EXCLUDE GARAGE) V 8 �
,,HOUSE
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE, JAN 61992
"BEDROOM - 125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT, AND SUPPLIESBB
;M
BUSINESS OPERATION
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED.(CONDITIONS ATTACHED).
GNATURE
DA
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.
Buildinq and Safety Department
APPROVED B DATE CONDITIONS ATTACHED
_ DENIED- BY DATE
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