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0190
NOTE: • • With proper validation this form constitu K, an CITY OF LA QUINTA encroachment permit 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 I I I DATE:.,May 9, 1986 Minor Improvement Permit Class .IV LOCATION OF CONSTRUCTION i." sert- Club Dr. and La Fonda (Street address or Description of Location) PURPOQF CONS�RUCTyON_- r`'1 '" "'`"a-`�titq t�31'epl'one Sketch (attach construction plans if 'appropriate) cone tuito c ear VI.) propose -a storms DESCRIPTION OF CONSTRUCTION I 'encn an raiSe existing aoncuit system as srDwr.. DIMEN IO OF INSTALLATION OR REMOVAL conduit system., SIZE OF EXCAVATION, IF NEEDED 4 4. en — wi SB: ATI'$I'�EM- DPOkM3^ 4 depth APPROXIMATE TIME WHEN WORK WILL BEGIN work to be. adipatable with proposed APPROXIMATE TIME OF COMPLETION ° + 3—inch 1cmering and xemnstructioil ESTIMATED CONSTRUCTION COST $ of. Desert Cluk). (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. Signature of Applicant or Agent .:+enPxal Tele.)hone Co.: of Ca', ;1-793 Dr. Carreon Blvd., Indio, CA 92201 347-8775' 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. . Applicant's Insurance Company fPolicy Number FEES: Subdivision Improvement Permit —Class I I I Public improvements: 3% of estimated construction costs A`�T Private improvements: 3% of estimated construction costs Minor Improvement Permit =Class IV: See attached schedule , y` 1.90. Inspection Fee $ n�ru II PERMIT VALIDATION Permit Fee ,Penalty Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Date Recorded by PERMIT NO. 190 DATE APPROVED 5-9-86 EXPIRATION DATE 8-30-86 DATE ISSUED 5-9-86 By Administrative Authority TELEPHONE: (619) 564-2246 .y. �,.+..., ....,., ,. ..a... ��nwY-4i ..... ,�- :.dr ..:+:Mt. .� ry. ..s r.,�P,'�if':Si�k. b,. n•.a.3.c�,.#.::..x. rae.. rl+t,..�+.-.....:i.ir:'�.:i%i:.w�.?;.:�,w.-,.a.. ..�.�....... ....�.n .. � ,«. .. . NOTE sPL_ III DJ61!' As SHOW Al Ta mRSCIAAurA DEPTNof Z7"WITll -3" COnlL2ETE E NL 145 EM EN T' Ia iN't-LuDE.D. EXISTN% LdVJQL 3& To P.. I►ItN. 7_U (4) G) 10®�+O® SoUTN WALL To P Ex t 5Ti N G DL1 LT -siOOOTDRE TO BE SPLAJEDAS OS © -silow►J A&OVE • LIi. 1� . Fo N D A LooK SOUTH PE2 M iT 9 . SMERAL TELE FILUM OF CALIFCOUM LOCATION DESERT UjiR ORJ ILA - EXCHANGE, Z'w f QjQ _ C, O, A �w - .ISSUE DATE '. APPROVALS TF e_ AI 1L 1- DWG SIZE - cv- AREA GENERALM%1 NAGER .- - ~ A WORK ORDER 3a�--E A 6. J L2 VEL NUTS �f3-3142-K ., LT6 P D F PRO plow -b ZDn I Z' I2 R L P To N AVE 3 o"'LCVEk • ,."; Z. Dv�LT, # / L H AVE F. .�Z�a'�PR. bt/Q2KiNG LA&ES `':' IN THEM V R. -L5, 2U L- 39� -cl a U(; E. LA F- I�VGI NOTE sPL_ III DJ61!' As SHOW Al Ta mRSCIAAurA DEPTNof Z7"WITll -3" COnlL2ETE E NL 145 EM EN T' Ia iN't-LuDE.D. EXISTN% LdVJQL 3& To P.. I►ItN. 7_U (4) G) 10®�+O® SoUTN WALL To P Ex t 5Ti N G DL1 LT -siOOOTDRE TO BE SPLAJEDAS OS © -silow►J A&OVE • LIi. 1� . Fo N D A LooK SOUTH PE2 M iT 9 . SMERAL TELE FILUM OF CALIFCOUM LOCATION DESERT UjiR ORJ ILA - EXCHANGE, Z'w f QjQ _ C, O, A �w - .ISSUE DATE '. APPROVALS TF e_ AI 1L 1- DWG SIZE - B AREA GENERALM%1 NAGER .- - DWG. NO. RELATED OWLS. ,S WORK ORDER A �f3-3142-K ., FORM 009SU 1 " 4�