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CITY OF LA QUINTA
5 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
/_1_111L.
HOME OCCUPATION PERMIT
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 PHONE 9 cS %48S
PROPERTY OWNER L11 HONE -
144jPROPERTY ADDRESS'
MAILING ADDRESS // _ dad zi1s'
TYPE OF RESIDENCE �ge multi A mo it home, etc.)
TYPE OF BUSINESSc-
BRIEF DESCRIRTION OF HOW THE BUSINESS WILL.OPERATE 5 zrz 70
NUMBER OF PERSONS-INVOLYED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED
iSQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE ( EXCLUDE GARAGE) a
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME
(EXAMPLE, "BEDROOM -125 S.F.")
DESCRIPTION OF MACHINERY, EQUIPMENT,SUPPLE BEING USED IN THE
BUS NESS OPERATION
I EAD, UNDERSTAND AND AGREE WITH E CONDITIONS BY WHICH A
H E O ATI IS ALL WE (CONDITIONS TTACHED)_
ICANT SIGNATURE ��� DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER
OR AGENT IS'REQUIRED./J
OWNER/AGENT SIGNATURE �'`' DATE
IMPORTANT:,
OR MISLEADING INFORMATION SHALL DE GROUNDS FOR
DENYING YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH CONDITIONS
LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOR -REVOCATION OF
PERMIT.
i _______®_________________�_____
Hu' and
PERMIT.-
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Department
APPROVED DENIED CONDITIONS ATTACHED /V
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