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0149Public improvements: 3% of estimated constructior _a Private improvements:r3% of estimated cons tructio Minor Improvement Permit — Class IV: See attached s Inspection Fee $ VA Permit Fee Penalty ` ,Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Date Recorded by, )sts osts ,dule ltii. 149 J PERMIT VALIDATION a PERMIT•1\10. 149 DATE APPROVED '9-13—_85 EXPIRATION DATE 11-30-85 r?' ., y :D SUED 'y i i, Administrative Authority ' TELEPHONE: (619) 564-2246 'r �. I NOTE:` With per validation as this fm constitutes an encroachment permit. CITU. OP',LAx�QUINTAr • 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' t . SeptPltibf?Y. 13, 1985 Subdivision,lmprovement Permit- Class'I I I' -DATE: 4,Minor Improvement Permit Class IV' LOCATION OF CONSTRUCTION f- r`mGsinrr on .TafferSon annrox 400' N/O�Ave 54 also ' l street crossing on Ave'54•approx. 40' W/O Madison and 400' •south on Madison. (Street address or Description of Location) r PURPOSE OF CONSTRUCTION Pr.'ov2P fac-i.14i.e4 for fire , , Sketch (attach construction plans if appropriate) S.taaf-i on and mai 4 h7 dcrfor PrA We ,t `, • t 'DESCRIPTION OF CONSTRUCTION 2. Gtrw?e{' rroiasina's and ann' of httriPd rah P DIMENSION OF-INSTALLATION OR REMOVAL trench to he atorOx. V �'` vlN�!i dROr Janrr.16" dprmn 24" uridP - A �• y �. r,4 t P r SIZE OF EXCAVATION, IF NEEDED SgTic_\-_•nit APPROXIMATE TIME WHEN WORK WILL BEGIN 10-15-85 APPROXIMATE TIME OF COMPLETION + 1-0-30--85 t�,+ ESTIMATED CONSTRUCTION COST $ �� • - (Including removal'of all obstruction, materials, and debris, backfilling, com= paction and•placing permanent resurfacing and/or replacing improvements) 5- 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: r Notify the Administrative Authority at least twenty-four (24) hours.in advance of the time•when work will be startea. �F.• 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 result of this'work. i �•,�' :Signature of Applicant or Agent General Telephone 83-793 Or. Carreoh B1Vd.- indio,.,.CA 92201 347-877.1 ,1 Name of Applicant (please print) Business'Address Telephone No.', r l Name of Contractor and Job Foreman Business Address Telephone No. ,! +'. ' . Contractor's License No. City Business License No:' Applicant's Insurance Company _ Policy Number �•i FPrC• Public improvements: 3% of estimated constructior _a Private improvements:r3% of estimated cons tructio Minor Improvement Permit — Class IV: See attached s Inspection Fee $ VA Permit Fee Penalty ` ,Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Date Recorded by, )sts osts ,dule ltii. 149 J PERMIT VALIDATION a PERMIT•1\10. 149 DATE APPROVED '9-13—_85 EXPIRATION DATE 11-30-85 r?' ., y :D SUED 'y i i, Administrative Authority ' TELEPHONE: (619) 564-2246 'r /NOT W-0-# 543- 89-1 E: ------ — , • W.4'h proper validation ------------ tnis,--form constitutes an �QV I NTA encroach rnent-.Permit CITY: .0 F -1;LA: APPLICATION FOR ,PERMIT PUBLIC 'WORKS CONSTRUCTION _(ENCROACHMENT). 'of., public 'or '�mains For th.e`c6nstruction' or ::!*cur s,,: driveways! .'pay�ments sidewalks; parking Iots;: sewers, -.water, and other,like public works: improvement; inconnection with MINOR IMPROVEMENTS and.APO'ROVEb,SUBDIVISION'S Subdivision Improvement Permit..— Class, I I I September.. 11, 198.5 Minor Improvement Permit Class IV LCCATION,OF.CONSTRUC-hON -..street. crossing". -On Jefferson approx. 4001,.N/0 Ave .54.. also street. crossing,ori-Ave .54.apprgx..401. W/O Madison and.4001 south.*on Madison.. (Strebt addrea brbescription'6f L6catlon)` '--, Tprovide-.facilities for fireURP0SE-oFCONSTRUCTION Sketch (attach construction plans if.ap'pr9priite) station and maint..bldg. -for. PGA.West DESCRIPTION OF CONSTRUCTION 2- street crossing's and 4001. of.buried.cable: DIMENSIONOF !NST,'.LLATION OR REMOVAL, trench to be approx. 400.- long -3611 deep 2,411 wide I IV _4kV Id SIZE OF EXCAVATION; IF'NEEDt-D splice pit -10 9861r T d3S APPROXIMATE IM ATE TIME WHEN WORK WILL BEGIN 10-15-85 APPROXIMATE TIME OF COMPLETION 10-30-85 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: j 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.leait twenty -four -(24) hours in advance. of the time when work will be staked. Comply with all applicable City Ordinances, the terms, and..-condit ions 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. ll Signature of Applicant or Agent GENERALTELEPHONE CO. OF CA.*, 83-7.93,Dr Carreon Blvd—Indio.-CA. 92201 '347-8771 Name of Applicant (piease print) Business Address -Telephone No. Name .of Contractor and Job Foreman business Address Telephone No . Contra'c,t9r,'5' License No. .,City Business License No. Appli, cant's 1 n . su rance Company Policy Number FEES: Subdivision I mprovembnt %Permit — Class I I I Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Min.or Improvement Permit —.Class IV: -See attached schedule Inspection,Fee $ Permit Fee Penalty Cash Deposit-Surety,Boncl if required "TOTAL: Receipt No. Received by Date Recorded by PERMIT -VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE. DATE' ISSUED CA TELEPHONEf'.11619) 564.2246 F;dn-iinis:raiivE A u t t I C. F it I Y 'R.\.vERSIDE Cou.IiTy r.: CITY OF LA awmTA �. MADI SDN %zv f a � 4�: .�FF � � 0��3`• r. w`' �C' •'' ��L � �,� Foy' �® W me 7 LLJ i RIV.ti7 IDE ---- CITY OF L-A ii(AIN7-A fc_A� COWQT Y + i` —7- GEnE.RAITELEPHom O,,I/F CAUFORf11A ------ LOCATION r f FERSt�� 'Y'S kvE S4 iQi^ r EXCHANGE C.O. INnI o LA auIn►TA. �EFFEIJ ISSUE DATE. APPROVALS t 4 ? 4 2 I DWG SIZE J y' a\S-nK3A. _-Iip( A AREA GENERAL'MANAGE,R k DWG. NO. RELATED DWGS. WORK ORDER �`-� Nntl`C 543-31Z8�'1 • - ,y FORM 809510 .r F'FEKs6K� Ys Kvr s4 j�C� EXCHANGE IND!Q C.O. LA Cahn-rR ISSUE DATE APPROVALS y0_rk< A AREA GENERAL MANAGER WG. NO. RELATED DWGS. WORK ORDER FORM W9540