MOOTYA
34
- - JUL 22 1996
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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
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