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HOME OCCUPATION FORM
• Minor ✓ ZEO Approval Dated 100 ASSESSOR'S USE ONLY:
Major PZC Approval Date-07 Home Occupation Type
Expiration Date Code
Name /al?-e 119 I- c!/ A
Address of proposed occupation:
Telephone 1�D ' 2�9- t 6 �'7 Zone
Descriptions off Occupation:
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Please use the boxes or an attached sheet to provide the following. A PROPOSED SIGN
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 2eeep
Floor area of home occupation ;Qz7 yeti
% of floor area 3, 57%u
I have read the regulations regarding home occupations and intend to comply with said regulations. I
.understand I must notify the P D partment in writing upon termination of this occupation at this
address. J
Signature of Applicant Date ✓� /
Signature of Owner Date At 7'
s
White = Assessor a ow = Ap lican Pink = Street File