CASAS,r
15
HOME OCCUPATION PERMIT
APPLICATION
'CITY OF LA QUINTA
T41-105 Calla 19816d•
P.O. 90x 1504
e 0ulntaAA.92253
k,-(619) 564-114•
664-2246 y� PLANNING DIVISION C 6/87
Read each condition listed on the reverside side of this form to see TF
the proposed activity can comply with the City's Home Occupation
Regulations. 3 -< �
TYPE OR PRINT IN INKl q
A CCO v� fin/ F t (Al Amr_ A l
APPLICANT'S NAME lgpa, 2 {SMC PHONE .3q.2- �oQ7 V
PROPERTY OWNER 14. LA- PHONE X142 _66.1 _
PROPERTY ADDRESS
(City)' (state) (zip)
Type of residence (Single, Multiple, mobile home, etc.) /sin elle_"
Type of business Accoun4;nS s t—VkianCfA1 OnSu�7�hj 1
rief description of how the business will
U, ,
Number of persons involved in business
List names of persons employed SA S J,2
Square footage of usable floor area in
house (exclude garage) F456 Validation Stamp
Location and square footage of area of
business activity in home (example:
bedrooms- 125 square feet) J
Description of machinery, equipment, and sup lies be g used in the
business opeTation a (`nvti.
�`CrcPS�•olrQs
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
g 89 13
AP CANT SIGNATURE U DMX CASH 1 IUIAL 1 35.W
If Applicant is other than property owner, authorization of owner or agent
required.
OWNER OR AGENT SIGNATURE DATE
IMPORTANT: False or misleading information shall be grounds for denying
your Home Occupation, or failure to comply with conditions listed on
reverse shall be grounds for revocation of permit.
"PROVED Initials
• CONDITIONS A HED
DENIED initials
LQHOMOCC.PRT
r-��aDate
Date