0006NOTE:
With proper validation
this form constitutes an
encroachment permit
L7
0
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
May 27 1983 Subdivision Improvement Permit — Class I I I
DATE: Y r Minor Improvement Permit Class IV RX
LOCATION OF CONSTRUCTION 50th AVerTe BetWem Eiserft* l'x Drive and Wa&ixlgtan Street
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION RPaiCn81 SaWer MElin Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION ReqiOMI Six Magri
DIMENSION OF INSTALLATION OR REMOVAL 94 Feet Within
City Richt of Way
SIZE OF EXCAVATION, IF NEEDED -As Rerauired
APPROXIMATE TIME WHEN WORK WILL BEGIN May 31, 1983
APPROXIMATE TIME OF COMPLETION -- Mlv. 1983
ESTIMATED CONSTRUCTION COST $ 300.000
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this work.
/
~Signature of Applicant or Agent
LML Deaelopumt Corp. of California, P. O. Box 1000, La Quinti, CA 92253 (61.9) 245•-2888
Name of Applicant (please print) Business Address Telephone No.
Janes Brothexs Omistxuctiai tio. , P. 0. LM 905, Coachella, CA 92235 (619) 347-2291.
Name of Contractor and Job Foreman Business Address Telephone No.
#172092
Contractor's License No. City Business License No.
RCM Insurance (nrrn>any BCPB827902
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs �,
Minor Improvement Permit —Class IV: See attached schedule
N� '6
Inspection Fee $
Permit Fee _
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 106.00
Received by Date
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
11.
May 27, 1983
EXPIRATION DATE May 27, 1984
DATE ISSUED May
27, 19$3
By
Recorded by 11 TELEPHONE: (619) 564-2246
Administrative Authority