0088'NOTE: J � r � ,', . •� " ' , k�. ' : ; � x
With proper validation
this form constitutes'an- +
CITY'OF. • LA "QUINTA .
encroachment permit > .
APPLICATION FOR PERMIT
- ' PUBLIC WORKS' CONSTRUCTION (ENCROACHM,ENT) - -; a �c� ryS •
< ' OF I R89
r 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
r
Subdivision -improvement Permit — Class I I I
DATE.: 'February 26, 1§85, x Minorlmprovement Permit Class IV
LOCATION OF CONSTRUCTION his Condos Phase II k
(Street address or Description of Location) ;
PURPOSE OF CONSTRUCTION .
On Site and ,Off Slte p appropriate)'
Sketch (attach construction.plans if a
public works improvwmts.
DESCRIPTION OF CONSTRUCTION See plans v a'
TRACT ATO. 18765-2' ;•
DIMENSION OF INSTALLATION OR REMOVAL BEE PLANS
' See plans �.0.
,t= 1-
e .
SIZE OF EXCAVATION, IF NEEDED < =
APPROXIMATE TIME WHEN WORK WILL BEGIN-
,t
APPROXIMATE, TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ aq
fi(Including removal of all obstruction, materials, and debris, backfilling, com ;y •.:
-- actiot n ands lacin
• p p g 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'aganst any and all 1 '
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. t -
' 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 r cult of this work.
r
r.Si nature of Applicant or Agent '
Landmarkband,CC). P.O. Box 1000., ,La Wirita', CA 92253 � r
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 Licerise`No. .;
Applicant's Insurance Company, - 'Policy Number ,. ..+
.'FEES: Subdivision Improvement Permit = Class I I I t ,
Public, improvements: 3% of estimated construction costs
Private improvements- 3% of estimated construction costs + Q
Minor.lmprovement Permit= Class IV: See attached schedule ,
Inspection Fee $ ' PERMIT VALIDATION`r
Permit Fee 790.80
PERMIT NO.
Penalty ': • t 2-26-85
` DATE `APPROVED '
Cash. Deposit -Surety Bond '
if required 8-26=85
EXPIRATION DATE
TOTAL: $ 790:80
DATE ISSUED
Receipt Noy r ,'
By
Received by 3 Date ` ` i Administrative•Author+ity .'
Recorded by + TELEPHONE: (619) 5642246 y k.