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La Quinta, CA 92253
UINTA (619) 564-2246
CITY OF LA
/17Q 1111111 IIIII IIII IIII
�FT" HOME OCCUPATION APPLICATION 34
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.
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APPLICANT'S NAME
PROPERTY OWNE PHONE
PROPERTY ADDRESS g -7Co� 1 N C12C I
TYPE OF RESIDENCE single multiple, mobile home, etc.)
TYPE OF BUSINESS 44U)'Sif 601L.0Li2-
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE Kr_c-_u 1J a
CIAL- _S ?P-( F0Mrn5 S'T02F E6u112MG-- T, .CZoLs
NUMBER OF PERSONS INVOLVED IN BUSINESS 1` 2
LIST NAMES OF PERSONS EMPLOYED N
SQUARE FOOTAGE OF USABLE FLOOR AREA IN
HOUSE (EXCLUDE GARAGE) 2O 0`0 S6Z
LOCATION AND SQUARE FOOTAGE OF AREA OF
BUSINESS ACTIVITY IN HOME (EXAMPLE,
"BEDROOM - 125 S.F.") 4W56
DESCRIPTION OF MACHINERY,
BUSINESS OPERATION W00b
oock-""a . Ci LUL se/ZELSu-
VALIDATION STAMP
AND SUPPLIES BEING USED IN THE
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED tCONDITIONS ATTACHED).
/ /IzIM
ATURE
IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR AGE1
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 S-Afetur De artm nt
APPROVED BY DATEr�3
i�
DENIED BY DATE
CONDITIONS ATTACHED