FERGUSON•
CITY OF LA QUINTA
7e-105 Celle E•fodo
P.O. SOX 1504
Lo OulntaAA.92253
,tit) tts-ttst
664-2246 k PLANNING DIVISION 6/87
Read each condition listed on the reverside side of this form to see if
the proposed activity can comply with the City's Home Occupation
Regulations.
TYPE OR PRINT IN INK
APPLICANT'S NAME �%%)i✓/SI- j"6J0e✓ PHONE r6119 347 -OW
PROPERTY OWNER 4t!".e ^S A400%14 PHONE
PROPERTY ADDRESS - / .Bvv�r"L LR��
(Street)
(City) (State) (Zip)
Type of residence (Single, Multiple, mobile home, etc.) S/-/G[r
\ Type of business G✓IL ji✓�/a/�F,e/.,/Gr
Brief description of how the business will operate Givid f�✓G�.✓66.�%•✓G-
x0'eyIG.Z„f P.0✓/!XP O.-� P4,9- P�PJ�X�►T/o.� c�
Number of persons involved in business
List names of persons employed
•
Square footage of usable floor are in
house (exclude garage) 14190 Validation Stamp
Location and square footage of area of
business activity in home (example:
bedrooms; 125 square feet) 005i 9'4 1i -ib -b3 10
SACPAoDM /60 f 5""r, ty rAV14 S Ttl•t•AL a. •a5,17
Description of machinery, equipment, and supplies being used in the
business operation �«i f�uior,F�S �,2/i6Ti.✓G £ oy��C!
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
APPLIC T SIGNATURE DATE
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.
APPROVED "N 41� initials
CONDITIONS ATTACHED
DENIED initials
LQHOMOCC.PRT
// - /6 - A�& Date
Date