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With proper validation �". ��_ Q•
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR -PERMIT - -
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)-'`—.. '_ G� '•ten �Sct4�
'SOF Ii�9
' 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: ' 7-19`85' Minor Improvement Permit Class -IV. X
LOCATION OF CONSTRUCTION 'w/S Dune Palms 190 S/_ 0 Fred Warinct Dr. Tract 19903
W/O # 549-713022
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION SOlice in load case.
DIMENSION OF INSTALLATION OR REMOVAL 4 X 41 =116e. SEESIC= r
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 10-1-85 r ,
APPROXIMATE.TIME OF COMPLETION 1-30-86
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:
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.
Chun Ruiz*
' Signature of Applicant or Agent _
General-'_lephone Ccnpany of Ca. 83-793 Darreon Dr. Blvd. Indio, CA • ' 347-8775
Name of -Applicant (please print) Business Address : Telephone•No. '.
Name of Contractor and Job Foreman Business Address ;Telephone Noir
Contractor's License No. _ City Business License No.
Applicant's Insurance Company Policy Number :{
FEES: Subdivision Improvement Per = Class III • f
Public improvements: 3%0 of estimated construction costs
Private improvements: 3% of estimated construction costs
x'41 _ .'Minor Improvement Permit —Class IV: See attached schedule
Inspection Fee $ N/A' F PERMIT VALIDATION
Permit Fee ` PER1VIhT NO. 141
Penalty
Cash Deposit Surety Bond-' DATE APPROVED 7-24-85.
if required' EXPIRATION DATE 1-39:-86.
TOTA L: t .": $ N/A
DATE ISSUED p7-24-85.
Receipt No.By =v -
Received byDate` - �� Administrative Authority.
Recorded by TELEPHONE: (619) 564-2246- ,
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F. LA -QUINTA
+ encroachment permit ; ; ate, . ,,ate
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APPLICATION FOR 0-"'
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;., -•PERMIT 4(
PUBLIC
WORKSSCONSTRUCTION`�(ENCROACHMENT) ,.:v
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For. the construction sof 'public or' private. curbs, driveways, pavements;:sidewalks'-parking'lots .sewers, water mains
and othee like public works improvements in connection'with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit - Class I II '
DATE: ' ,V 7-'19-85= r, •`' ' Minor Improvement Permit Class IV
' ' LOCATION OF CONSTRUCTION Wi S -Dune Palms 190' S/0 Fred Waring Dr I0
i/Afl
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION To provide better service
DESCRIPTION OF CONSTRUCTION Splice, in Load Case
DIMENSION OF INST,:.LI_ATION OR REMOVAL 4' x 4' splice
Pit
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1U-1-85
Sketch (2:tach construction plans il. &pproprt1iate)
+. `, ,, .. •: t� . � tf -�� -.,1 !. = q. ,. ;w'�_.-•'•• �,. w s. � L �'i Y- �2! - .ri, t z =p9'K � - �. I .. __
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WA -IP, VN Com— rt--
14lX41
P I T a ,�
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APPROXIMATE TIME OF COMPLETION "I -3U -8b
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:
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 Quints and to pay for any additional replacement necessary as the result of this work.
Name of Applicant (please print) Business Address Telephone No.
UENERAL TELEPHONE COMPANY Or' CALIF283^_7�3 Dr.. Carreon_ti1.,Indio, CA 619-347-8775
,Name of Contractor and Job Foreman Business Address y22U 1-7099 Telephone No.
Contractor's License No. City Business License No.
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
n
N �*
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
$ /�( "/ n
Receipt No.
Received by
Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
TELEPHONE: (619) 564-2246
Administrative Authority