ACKERSON (2)32
CITY OF LA QUINTA
HOME OCCUPATION APPLICATION
P.O. Box 1504
La Quinta, CA 92253
(619) 564-2246
L'/
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 C/�� 5 q /j PHONE 5� 7FU
PROPERTY OWNER �dSS //��ti120 �� PHONE
PROPERTY ADDRESS
TYPE OF RESIDENC� single_,,6ultiple, mobile home, etc.)
BRI
DESCRIPTION OF HOW
BUSINESS WILL OPERATE 4& v
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR EA IN
HOUSE (EXCLUDE GARAGE)
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 S.F.") Aio
DESCRIPTION OF MACHINE
EQUIPMENT, .A
BUSINESS OPERATION��, Pi -
veffiPMON
UINTA T�W 3 �.r0
J U L 211993
Me DEPT.
--:74-
I HAV , UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
O UPATLON LS ALLOWED ,-CONDITIONS ATTACHED).
APPLICANT SIGNATURE
DATE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGEN-
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.
Building and Safety rtment
APPROVED BY Y DATE
DENIED BY DATE
CONDITIONS ATTACHED