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K-4191 564-1124e
564-2246 PLANNING DIVISION
ad each condition listed on the reverside side of this form to see
the proposed activity can comply with the City's Home occupation
Regulations. $35.00 fee
TYPE OR PRINT IN INK
APPLICANT'S NAME Thomas w- R P 6 r: n rs PHONE L fl 9) 360-1670
PROPERTY OWNER ��t Qna e W. M a d A e- PHONE
PROPERTY ADDRESS -r- o o n c T T : , ,
LaQuinta California 92253
(City) (State) (Zip)
Type of residence (Single, multiple, mobile home, etc.)
Type of business VCR/Video Camera Repair
Brief description of how the business will operate S � rvi .e -and
rg�}lair 'Vi rPnr a cs�rt.t.P YPrn YN.cYc Pnri tri lY=n r?r,o r A c
Number of persons involved in business 1
List names of persons employed T'hnma g TN _ R�rir'nr�
Square footage of usable floor area in
house (exclude garage) 1400 sq. ft. ValidationSt"i
OJ5M,A�.9f7'? LSf-91 35.000
Location and square footage of area of 00
business activity in home (example:
bedrooms; 125 square feet)
Bedroom 100 sc,,. ft.
Description of machinery, equipment, and supplies being used in the
business operation Tfnn i t nr � IMP T�nhr. ins. 1 M cz R� �i�
I i mac_ .
I have read and understand and agree with the conditions by which a
home occupation is allowed (Conditions on reverse side).
.-71
APPLICANT SIGNATURE DATE
If Applicant ie other than property owner, authorisation of owner or agent
required.
OWNER OR AGENT SIGNATURE DATE
IMIPORTANT: False or misleading information shall be grounds for denying
your Hpme Occupation, or failure to comply with conditions listed on
rever a shall be grounds for revocation of permit.
c%
7APPROVED A Initials • Date
CONDDENIED ATT
initials
Date
LQHOWXC. PRT J.,