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MOOTYA 34 - - JUL 22 1996 f G+Gf�Gt/ gv _� 78-495 CALLE TAMPICO - LA QUINTA, CALIFORNIA 92253 - (619) 777-7050 FAX (619) 777-7011 APPLICATION FOR �I Fee 3S 5.00 HOME OCCUPATION OF A BUSINESS �55L(=V Read each condition listed on the attachment to this form to see if the proposed activity complies with the City's Home Occupation Regulations. APPLICANT NAMES (List all owners, partners and/or corporation officers) PROPERTY ADDRESS l 6 '` l EUSINESS NAME PROFFRTY OWNER 7� PHONE K60 2 • MAILING ADDRESS (if different from business address) TYPE OF RESIDENCE (single, multiple, mobile home, etc.) TYPE OF BUSINESS BEF DESCRIPTION OF HOW THE BUSINESS WILL OPERATE �— 7711 [= Al Il 11 A) f) .4Z,Sn VW) W nu -40.41 _l JL--D/e-' C � /J NUMBER OF PERSONS INVOLVED IN BUSINESS LIST NAMES OF PERSONS EMPLOYED SQUARE FOOTAGE OF USABLE FLOOR AREA IN HOUSE (exclude garage) LOCATION AND SQUARE.. FOOTAGE OF AREA OF BUSINESS ACTIVITY IN'" (example,' "bedroom - 125 sq. Ft.) DESCRIPTION OPERATION _ NERY, EQUIPMENT, AND SUPPLIES BEING USED IN--T-OE MAILING ADDRESS - P`-.& BOX 1504-''= LA QUINTA, 'CALIFORNIA, 92253 SINESS'�, I HAVE READ, UNDERSTAND, AND AGREE WITH THE CONDITIONS BY WHICH A HOME OCCUPATION IS ALLOWED (conditions attached). Date pp icantrs Si ature '4 IF APPLICANT IS OTHER THAN PROPERTY OWNER, AUTHORIZATION OF OWNER OR RENTAL/LEASING AGENT IS REQUIRED. Date Owner/Agent Signature Date Agent Company Name Agent/Owner Contact Phone # IMPORTANT: FALSE OR MISLEADING INFORMATION SHALL BE GROUNDS FOR DENYING YOUR HOME OCCUPATION; FAILURE TO COMPLY WITH THE CONDITIONS LISTED ON THE ATTACHED PAGE SHALL BE GROUNDS FOR REVOCATION OF PERMIT. BUILDING & SAFETY DEPARTMENT/CODE COMPLIANCE DIVISION • APPROVED DENIED SPECIAL C-ONDITIONS ATTACHED BY: I. D. # ' / DATE a • r countera Ll b�l w • •