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0055NOTE: - With proper validation this form constitutes an encroachment permit 01 � 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 I and other like public works improvements in.connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS a Subdivision Improvement Permit — Class III DATE: hTncromhar Fi Minor Im rove1 QRd pEove .. ment Permit Class IV . LOCATION OF CONSTRUCTION Ww3hington and Eiserihawex (Street address or Description of Location) PURPOSE OF CONSTRUCTION Under=Und power, telephone Sketch (attach construction plans if appropriate) ="A r V T NY DESCRIPTION OF CONSTRUCTION Install CtUC't:S s:or rUtUr_e cable. DIMENSION OF INSTALLATION OR REMOVAL 50 feet approx. SIZE OF EXCAVATION, IF NEEDED 12' wide 54"deep APPROXIMATE TIME WHEN WORK WILL BEGIN 11-8-84 APPROXIMATE TIME OF COMPLETION 11-15-84 ESTIMATED CONSTRUCTION COST $ n/a (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 regulation of the City of La Quinta and to pay for any additional replacement necessary as the esult of this work. ` Signature of Applicant or Johnson Construction Co. P.O. Box.480 La Quinta Name of Applicant (please print) Business Address Telephone No.. , Name of. Contractor and Job Foreman Business Address Telephone No. ' Contractor's License No. City Business License No. 458-367 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 'Inspection Fee $ Permit Fee RkKKK No Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Recorded by Date N i5 . PERMIT VALIDATION PERMIT NO DATE APPROVED N- n1 mnbPr 6. 1984 EXPIRATION DATEdNj@y 6, 1985 DATE ISSUED Administrative Authority TELEPHONE: (619) 564-2246 2950 Airway Avenue, Suite D Costa Mesa, California 92626 714 / 979-3376 M. D. JANES COMPANY INC. May 11,,1986 ED Bob Weddle, City Engineer JUN 13 1986 City of La Quinta . COMMUNITY DEVELOPMENT DEPT Building Department 78-105 Calle Estado La Quinta, CA 92253 Re: Reflections Project TR/18915 Dear Mr. Weddle: Please extend Encroachment Permit #054 which expired in April 1984 on the above referenced project. Should you have any questions, please contact me. Sincerely, Susan Guth Operations