0148NOTE:
With proper validation - o '� •
this form constitutes an ,CITY OF LA QUINTA -
encroachment permit ' c�
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION- (ENCROACHMENT)
For the construction of public or private curbs, driveways; pavements, sidewalks, parking lots, sewers, water 'mainsy
and -other -like public works improvements in connection with MINOR IMPROVEMENTS and'APPROVED SUBDIVISIONS
r
Subdivision Improvement'Permit — Class I I
DATE: SE'-1�tP.IribEr. 10, 1985 + Minor Improvement Permit Class IV `
LOCATION OF CONSTRUCTION Tntersection of Ave.. 50 and Avila Dr. r '
(Street address or Description of Location
PURPOSE OF'CONSTRUCTION SeWP_3 jMrovement Sketch (attach construction plans if appropriate) ;
DESCRIPTION OF CONSTRUCTION OnPlans '
DIMENSION.OF INSTALLATION OR REMOVAL See RIMS ,
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN. r
APPROXIMATE TIME OF COMPLETION ,
ESTIMATED CONSTRUCTION COST $ 7.600.00
(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; orlossresulting from claims or court action and arising out of any,accident, loss or damage to persons or property
rhappening 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 th perms nd all applicable rules and regulations of the Citylof
La Quinta .and to pay for any additional replacement' necessary as the result of this w8rk. Ih�`
ignature of Applicant or Adent. '
Jones Brothers.Construction 85 -989 -Ave. 52 Coachella, CA 347-2291
'Name of Applicant (please print) Business Address Telephone No.
Don
Name of Contractor and Job Foreman Business Address Telephone No. '
172092 , 153
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
0 1.4`8,
•
Inspection Fee $ PERMIT VALIDATIYO:N - * a• � •'
Permit Fee ' 228.00
PERMIT NO. 148
Penalty
Cash Deposit -Surety Bond t DATE APPROVED 9-10-8R
if required ' /i+ • � �;
EXPIRATION DATE WMEW,Ic7 lid1l'` '
TOTAL: . $ 228.00 '
-.DATE ISSUED 9-10-85 .
Receipt No.
By
Received by Date Administrative Authority
Recorded by r TELEPHONE: (619) 564-2246 ,
y ,: , c i
DATE JOB NO.
GEORGE H. CHANEY-CO. - /0--// t
Inspection Services PROJECT DESCRIPTION
L06AT16N
TO. _ L
J � tig CONTRACTOR - WEATHER t
FROM TO HRS FROM, TO ',; 'HRS
THE FOLLOWING WAS NOTED:: . TOTAL
Ta1� 0 01:13
���,y Ora-�,v � � - - . , . ' • • �.
1 i �r
e ��~
Gey.-
s` t
1
.. .. ' • a 441, z .. _ ,
COPIESTO:�� D R00
J.
SIGNED
WHITE — CLIENT, YELLOW —FIELD FILE, PINK —OFFICE `
N
1
WHITE - CLIENT, YELLOW - FIELD FILE, PINK - OFFICE FILE