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' "'With proper validation
this form constitutes an +. '
encroachment permit CITY OF LA QUINTA
s APPLICATION 'FOR PERMIT s
PUBLIC WORKS' CONSTRUCTION (ENCROACHMENT)c� '•„9wSw4� `
t of
For, the construction of public -or
p private curbs, driveways, .pavements, sidewalks; parking lots, sewers, water mains
and other like public works improvements W connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class 111
DATE: March 7, 1985 Minor Improvement Permit Class IV X'
LOCATION OF CONSTRUCTION NIS Eis� Dr 75' .,W/O Washington St.
(Street address or Description of Location)
i
PURPOSE OF CONSTRUCTION service' for'Lacruna De La Paz Sketch (attach construction plans if appropriate) • '
.• c
DESCRIPTION OF CONSTRUCTION a12Rr0x..4' x 8 x 4' deep Pit
DIMENSION OF INSTALLATION OR•REMOVAL
s
SIZE OF EXCAVATION, IF NEEDED
4: X 8' x4'.
AP R6XIMATE TIME WHEN WORK WILL BEGIN 12 2-15-85
'APPROXIMATE -TIME OF COMPLETION 8-15-85
ESTIMATED CONSTRUCTION COST $
(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: w ,
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 gr;nted'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. ,
Frank Fisher r
Signature of Applicant or Agent.
Genex'al. Telephone Co. of Ca. 83-793 Ave. ' 47 Indio, CA .92201
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. j
Applicant's,lnsurance`Compan.y Policy Number
FEES: Subdivision Improvement Permit — Class I I I '
Public improvements: 3% of estimated construction costs
Private improvements: '3% of estimated construction costs , �,7 Q r
Minor Improvement Permit — Class IV: See attached schedule l�
•
Inspection Fee , $ + y PERMIT VALIDATION
Permit F•ee n/a i 096
PERMIT NO. f'
Penalty
Cash Deposit -Surety Bond - DATE APPROVED 3-7-85
if requiredEXPIRATION DATE; 8-30-85 �>
TOTAL:, $r , -'
DATE ISSUED % 't3�7=85 "
Receipt No.
By
Received by Date Administrative Authority
%j l
r Recorded'b
y 7ELEPHONE:`(619) 564-2246
r
�ECEIVWith proper.� validationFEBm constitutes an,At.encroaO, nt,.permit .,CITY OF-.71A_QUINTA. CITY OF LA &N -APPLICATION - FOR -z PERMIT .7.WORKS `.CONSTRUCTIOPUBLIC." N -(ENCROACHMENT).For. the - construction -of - public.'or,�':-'Private -curbs,. drivewayi, paveme . nts,,sidewalks, parking lots; sewers., .water mains.Subdivision Improveme�t Permit —Class I 11.DATEMinor Improvement Permit.Class IV
~"cu""""="p|o�+o�,mn/
.�
PURPOSE
DESCRIPT|ONOFCON8TRUCT|ON approx +~
SIZE OF EXCAVATION, -IF NEEDED '4tx8lx4l
Sketch (a�achconm,vct)onplans �appropriate)
-~
� ?5',
i
---`__- .- �w
-----------
''Rd%|KA -`TIME WHEN WORK WILL BEGIN Ei��uu»w�r
,-
APPROXIMATE.TIM E OF COMPLETION* -8-15-85
(including removal of all obstruction- -materials, and debris,, backf ill ing, com-
paction and.placing. permanent resurfacing irid/& repla�i rg improvements)
In consideration of the granting of this perniit, the applicant hereby agrees to:
lndemnify,'defend and save the Ci'ty, its authorized agents, officers, representati ve . s and employees, harmless fromzand-agains't 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 oc . curring as La 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 con . ditions.of the permit and all applicable rules and regulations o*f the City of
La -Quinta and to,'pay for any- additional replacement I necessary, as the result of this work.
�
Signature ofApplicant u,Agent ���---�----
.
..GENERAL TELEPHONE CO. OF CA. .837.7.93 Avenue 47, Indio, CA. 92201
-,.Name of Apw,coru (p/ea,epr/nq � Busine,,Addm, Telephone N".---------
` ` ^
� ^^=="' C" ,=
"`p'u"oJoo Foreman.
`Con�uuzo/sLicemallo
[ ' .
| ,,Appocanz',Ins u�ncecompanv
FEFS:
Business Address
'
Subdivision
ruo//c improvements: 3% ofest/mateo construction costs
Private improvements: 3%ofestimated construction costs
Minor. | See attached schedb|e
Inspection Fee $ �� H
Permit Fee
Penalty
CashDepbsit'SL�,e?y8ond
' TOTAL:
,
Roci-ipt No.
� . :�`�c,;,:dbv
�wd,d by
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Dam
TelephoneN�.'
'
City Business License' No. ----�
'
Po|icy]Number'
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74'_PERMIT,,VALjbAfI0N
NO. 40 DATE APPROVED�
`
EXPIRATION
DATE,
[J`ATE^'|5SUED`
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�y
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