WARREL0
\o►
Read each condition listed on tte attachment to this form to see if the
proposed activity can comply with the City's Home Occupation Regulations.
--------------------------------------------
-----------------------------
(TYPE OR PRINT IN INK) pL
APPLICANT'S NAME �i/� A -j v e (HONEPROPERTY OWNER f gel ✓S ems,a-e-eA.,
PROPERTY ADDRESS % OG��fd
TYPE OF RESIDENCE (single, multiple, mobile home, etc.)
Cw,�
TYPE OF BUSINESS ,✓ L`� (moo ✓`6 ~-�
4IJ-7 CITY OF LA OUINTA
HOME OCCUPATION PERMIT
APPLICATION
78-105 Call* Entad
P.O. Box 1604
Le Oulnta. CA 922
(6/9)664-2246
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE U g 2 c9 kety
NUMPER OF PERSONS INVOLVED IN BUSINESS 7(10
LIST NAMES OF PERSONS EMPLOYED
SQUARE FOOTAGE OF USABLE FLOOR ARE IN ^may ���P
HOUSE (EXCLUDE GARAGE) (� wli
LOCATION AND SQUARE FOOTAGE OF AREA OF J U L 1 9199
BUSINESS ACTIVITY IN HOME (EXAMPLE
"BEDROOM • 125 SQUARE FEET") Z S
DESCRIPTION OF KACHINERY, EQUIPMENT, AND SUPPL ES BEING USED I THE BUSINESS
OPERATION 'SLS Ate_ Tv/��' �'�`�e- Gc Ce" l�!f* r _ /(..✓1 ✓ MAGGI.
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME
OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
� l/' /� " 2 -
--' APPLICANTSIGNATURE! DATE
IF APPLICANT IS OTHER THAN PROPERTY .OWNER, AUTHORIZATION OF OWNER OR AGENT
REQUIRED. ^)
NER/AGENT SIG ATURE 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.
BUILD K i SAFETY DEPAR
L
APPROVED B S DATE CONDITIONS ATTACHED .
DENTED BY DATE