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HOME OCCUPATION FORM C/
40inor _ ZEO Approval Date / 3 ASSESSOR'S USE ONLY:
, ajor PZC Approval Date Home Occupation Pa Type
Expiration Date Code
r Name _ ]Z(j Low
Address of proposed occupation:
Telephone _ Rq—5-3 A Q Zone
Description of Occupation:
�r-,CW -- /F r (21 f -17, �1
s
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. Y)O
4. Architectural elevations for any proposed additions or modifications
• must be provided.
B. FLOOR PLAN (_Basement V 1st Floor 2nd Floor)
Floor area of dwelling / oy
Floor area of home occu ation
of floor area
I have read the regulations regarding home occupations and intend to comply with said regulations. I
(lerstand I must notify the Planning Depar ent ' writing upon termination of this occupation at this
dress. `
Signature of Applicant . r Date
Signature of Owner C7111<1 Date
White = Assessor Yellow = Applicant Pink = Street File