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encioechment�pem>� It APPLICATION FOR' PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) r MoF'l1� v
,
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
' - Subdivision Improvement Permit. -m- Class I II
DATE: 3 1985 Minor Improvement Permit Class IV.
Fainii-, 1 r�tdge ("hiirr+h of thi.'- Valley
LOCATION OF CONSTRUCTION �—• ,
8-998 8 Ajjje.s la Quinta, CA .'92253
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION PWIiC WOrks jnProvdnents Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION See Plan'
DIMENSION OF INSTALLATION OR REMOVAL
plans OT FILE
SIZE OF EXCAVATION, IF.NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 5-6-85.. y
APPROXIMATE TIME OF COMPLETION -35
'G5t 358:1.0
ESTIMATED CONSTRUCTION COST_$
ncluding removal of all obstruction, materials, and debris, back
(Ifilling, 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 Jrom claims or court action and arising out of any accident, loss or damage to persons or property
result of any work undertaken under the permit granted pursuant to this application.
happening or, occurring as a proximate
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 nuinta and to pay for any additional replacement'necessary as the result of this 'wprk
Signature of Applicant or Agent,
- 347-3094
• .BA 92253 '
Fanil l:eritar�_- Church P.O. Box' 600 La Quinta,
Name of Applicant (please print) Business Address Telephone No.
Ur kMlyn 11 at this ..tjx e ' - Ilio`, B& Provida: prior to start of construction.
Name of Contractor and Job Foreman Business Address Telephone'No.
i • t
Contractor's License No. City Business License No.
i
Applicant's Insurance Company ' . Policy Number
FEES: Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs N(o
119
Minor Improvement Permit = Class IV: See attached schedule_
Inspection Fee $
_ 7,037.88 PERMIT VALIDATION t
. -
Permit Fee nom" PERMIT NO. 119
Penalty DATE APPROVED 5-3-85
Cash Deposit -Surety Bond 12-36-85
if EXPIRATION DATE
TOTAL: $ 7.037.88 DATE. ED —3-85
Receipt No.gy o-
dministrative Authority
Received by Date ;
Recorded by TELEPHONE: (619) 564-2246 ,
F
1
II IYVIwou IOII Lir wiIipluimsy Lieu uut au if may oe reaouy ana correctly
be replaced by a licensed civil engineer or surveyor at the expense of the permittee. A complete set of notes showing the
_
s. This office shall
ties to these monuments shall be furnished to the City Engineer prior to the removal of any monument
be notified upon completion of replacement of all survey monuments for proper project clearance:
o. RD -31
Iv
�,NOTE: c� _• - ';�,�,:�.
With proper validation { • ,
this form constitutes'an k*
CITY OF LA QUINTA
encroachment permit i
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
Subdivision, Improvement Permit = Class II I
DATE:_ M3y 3. 1985 ,Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Family Heritage Church of the Vallev
78-998 Miles La Ouinta CA 92253
(Street address or Description of Location) ,
PURPOSE OF CONSTRUCTION PUblic Works i provemnts Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION See.plans '
DIMENSION OF INSTALLATION OR REMOVALSee plans. ON' FILE
SIZE OF EXCAVATION, IF NEEDED '
APPROXIMATE TIME WHEN WORK WILL BEGIN 5-6-85
APPROXIMATE,TIME OF COMPLETION 1.2-30-85- .
ESTIMATED CONSTRUCTION COST $.265,358.10.
y.
(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 fo'r any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
Family Heritage Church-•• P.O. Box 600 La Quin1la, EA .92253 347-3094,
^' Name of Applicant (please print) Business Address Telephone No. '
Unknown at this time - To Be provided.prior to start of construction.,'
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Applicant's Insurance CompanyPolicy Number
' FEES: Subdivision Improvement Permit — Class III
Public improvements: 3% of estimated construction costs '
Private improvements: 3% of estimated construction costs
7 Minor Improvement Permit — Class IV: See attached schedule ® A.19
=;.'Inspection Fee $ 7,037.88 PERMIT VALIDATION
Permit Fee INCL. 119 r
PERMIT NO.
Penalty 5-3-85
Cash Deposit -Surety Bond DATE'APPROVED
if required " EXPIRATION DATE 12-38-85
TOTAL: $ 7.037.88
DATE ISSUED. 5_345
Receipt No.By
Received by Date Administrative Authority,
�•.
Recorded'by' TELEPHONE:•(619) 564-2246'
• - _ k 1 - ,