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HOME OCCUPATION FORM
WMinor � ZEO Approval Date f ASSESSOR'S USE ONLY:
aior PZC Approval Date Home Occupation Type
Expiration Date Code
Name -
Address of proposed occupation: & L: D `v'r
Telephone & Zone{ 4 Q '
Description of Occupation:
LF
A. PROPOSED SIGN
Please use the boxes or an attached sheet to provide the following:
1. Attach copy of plot plan if applicable.
2. Use box A (or attach sketch)to draw proposed signage
3. Use box B (or attach sketch) to draw the floor plan of the home
occupation area.
4. Architectural elevations for any proposed additions or modifications
• must be provided.
B. FLOOR PLAN (_Basement 1st Floor 2nd Floor)
Floor area of dwelling oC�- # --r-
Floor area of home occupation C�
of floor area (�
leave read the regulations regarding home occupations and intend to comply with said regulations. I
derstand I must notify the Plannin Department in writing upon termination of this occupation at this
address.
Signature of Applicant Date �t $
Siature of Owner A Date
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v ice = Assessor Yellow = Applicant PfnV = Street File