POOLE (3)U 3S0 o
FEE $35.00 IIIIIIIIII'III
61 II IIII
CITY OF LA QUINTA
78-495 Calle Tampico, P. O.Box 1504, La Quinta, CA 92253
HOME OCCUPATION PERMIT
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.
BUSINESS NAME —mo so p 0wrkLNW PHONE S(Pci--4 3 06
PROPERTY OWNER `T';m o (14 P&DIF PHONE s4V-6 30 (o
PROPERTY ADDRESS 7 kL4 b c5,41u,aro 2up-d LIf Qy%�c!{�� C°a 9 z Z7 3
MAILING ADDRESS '
TYPE OF RESIDENCE (single, multiple, mobil home, etc.)
TYPE OF BUSINESSoNskIA&V. Ales
BRIEF DESCRIPTION OF HOW THE BUSINESS WILL O ERATE ::PSLl sCov.✓/4�(
iJ4 i s{,w►1 &L Se ro e e 0 d4 51 a;( � h � to Pi
NUMBER OF PERSONS INVOLVED IN BUSINESS
LIST NAME OF PERSONS EMPLOYED A)1,9-
• SQUARE FOOTAGE OF USABLE FLOOR AREA
IN HOUSE (EXCLUDE GARAGE) _/6S70
LOCATION AND SQUARE FOOTAGE OF AREA
OF BUSINESS ACTIVITY IN HOME 2 O
(EXAMPLE, "BEDROOM -125 S.F.") SC
DESCRIPTION OF MACHINERY, EQUIPMENT AND SUPPLIES BEING USED IN THE
BUSINESS OPERATION PkOl . , F/hC , hpey Dy LG
I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A
HOME OCCUPATION IS ALLOWED (CONDITIONS ATTACHED).
APPLICANT SIGNATURE
IF APPLICANT IS OTHER THAN PROPER
OR AGENT IS REQUIRED.
/ 40 2� E
OWNER AUTHORIZATION 0 OWNER
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.
Buil n and Safety Department
APPROVED DENIED CONDITIONS ATTACHED
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