WaldoCITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La Quinta,
HOME OCCUPATION PERMIT
10
PAID $352
CITY OF LA QUINTA
DEC 2 01993
BUILDINGAND FETY DEPT..
BY .dam
CA 92253k- 1/3 s
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
PROPERTY OWNER
PROPERTY ADDRESS
MAILING ADDRESS
TYPE OF RESIDENCE si gle, m
TYPE OF BUSINESS
BRIEF.,2&SCRIFTION OF HOW THE
tiple, mobil home,- etc.)
INESS WILL OPERATE
NUMBER OFiIPERSONS INVOLVED IN BU INESS
LIST NAME OF PERSONS EMPLOYED a/Z&7Lt
Io
• SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE
LOCATION AND SQUARE FOOTAGE OF REA
OF`BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINER , XQUI jMENT, AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION \ rll h lY i4 -rt ,
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPATION ISLLOWED (CO DITIONS ATTACHED).
`�ma-A-A� C): -1, 91,0T) /4- 9,�
CANT SIGNATURE- DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS 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.
i and Safet a artment r
LAPP OVED DENIED CONDITIONS ATTACHED
J�S
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