0237• �' ' • '• f, . ! ' � fin .t � - I i
.NOTE: r .,� < < i n w . •• , ..I
,With proper validation +;
this form constitutes,an Y CIT'OF ;LA QUINTA •o
r �0
encroachment permit . V `
r r
APPLICATION' FORJPERMIT,—
PUBLIC"
T, `PUBLIC' WORKS CONSTRUCTION (ENCROACHMENT)+
OF
" rFor the 'construction' of public` or private curbs, driveways; pavements, sidewalks, parking lots, sewers, vvater mains
ry and other,like public works improvements,in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS ,
December 4, 1986` - r Subdivision Improvemen ermit — Class III
DAT b Minor Improve_ ent'Permit Class IV'
LOCATI- OF CONSTRUCTION Various: streets• in .tihe Cit off, La Quints ( �� HIGHWAYS)
Ile
(Street address or escription of Location)*"
PURPOSE OF CO TRUCTION Maintain,and. repair qas%lines .Sketch ( tach construction plans if appropriate),
DESCRIPTION OF CO TRUCTIONTO .cut 4-x 4 bellholes as •
needed' BT et 'Permit
DIMENSION OF. INSTALLATI. N OR'REMOVAL' Maim•_ -'� ••
SIZE OF EXCAVATION, IF NEEDED +� �r•
Janu 1987 .' `
APPROXIMATE TIME WHEN WORK WIL BEGIN'
x APPROXIMATE TIME OF COMPLETION cember'.-1987
ESTIMATED CONSTRUCTION "rCOST $
(Including removal of all obstruction, materials, an debris, bac illing, com ��•
paction and placing permanent resurfacing and/or re lacing ` provements) ` >-
In consideration' of •the granting of this permit, the ap i• ht hereby- agrees to: i
�. • ?, ,
Indemnify; -defend and save the City, .its authorized age s, fficers, representatives and employees; harmless from and against any and all
penalties, liabilities or..loss resulting' from -claims or c rt aeon and arising, out of any -accident, loss or damage to persons or property
1 happening or occurring as a proximate -result of any ork,,und taken under the permit granted'pursuant to this application..
Notify the Administrative Authority at least twent ,four'.124) ho sin advance of "the timeJwhen work will be started. 'I
.� . n y
Comply, with all applicable City,Ordirances-.the erms'and conditio' of',the permit and all applicable rules and regulations of theCityof,
La Quinta and to pay, for, any additional repla ement'ne'cessary 'a',the esult of this work. ;
` J.M. Snyder (Sign.'on File)
Signatur of Applicarif'or Agent-
a• .y
'Southern California Ga Company P.O: Box 2200 Ri e�'sid&, CA- 92516,4 369-4512'
Name of Applicant (please print)'. ' �•- Business Addres Telephone No.,
,Name of Contractor and Job Fore an Business Address, Telephone No.
,'. Contractor's License No City usiriess License No.
'i 4 .
Applicant's Insurance Co pan, ': -+ Polic Number
t
FEES: • Subdivision mprovement Permit — Class III
Public mprovements: 3% of estimated construction co is\VALI Priva improvements':- 3% of estimated construction co _ s ryMinorlmprovement Permit — Class IV: See attach edul. '' k 231Inspection Fee $ n a f - % PERTION + `
Permit Fee • .�
��PERMIT N0. 237_
Penalty
Cash Deposit Surety Bond . DATE APPROVED -'12-4-R6 >
if required EXPIRATIOWDATE 12-31-87
TOTAL: $ . * . x.12-4-86' '
{ = DATE ISSUED
Receipt No.
r By
Received by, k Date ; t Administrative Authority
Recorded bY, , • ..TELEPHONE: (619),564-2246 r - '
t
t
- NOTEt -
With proper validation
this form constitutes an
encroachment permit
-
CITY OF LA QUINTA
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 APPROVEDSUBDIVISIONS
Decembeer 4, 1986 Subdivision Improve
DATE Minor Imprc
LOCATII OF CONSTRUCTION Various Streets in .the City of la Quinta
s
(Street address orescription of Location) .
PURPOSE.OF COTRUCTION Maintain and repairqaS lines Sketch
'DESCRIPTION OF CO4kTRUCTIONT0 Cut 4 x 4 bellholes as B
rmit — Class I I
Permit Class IV
MUDES ARTERIAL HIGHWAYS)
construction plans if appropriate)
Permit
DIMENSION OF INSTALLATI%OR REMOVALt•
SIZE OF EXCAVATION, IF NEEDED '
APPROXIMATE TIME WHEN WORK WIL BEGIN January 1987
APPROXIMATE TIME OF COMPLETION Iliecember 1987
ESTIMATED CONSTRUCTION COST $
(Including, removal of all obstruction, materials, and debris, backfilling, com
paction and placing permanent resurfacing and/or re�`cing improvements)
Un' consideration of the granting'of this permit, the appXsSfflcers;'rep�resentatives
ant hereby agrees to:
Indemnify, -defend and save the City, its authorized agenand employees, harmless from and against any and all
penalties; liabilities or loss resulting from claims or co.trt aon and. arising out of any accident, loss or damage to persons or property
" happening or occurring as a proximate result of any ork and taken under the permit granted pursuant to ,this application.
Notify the Administrative Authority at least twent -four (24) hou `S in. advance of the time when work will be started.
Comply with all applicable City. Ordinances, the erms and conditionXof the permit and all applicable rules and regulations of th'e City of
y,r La Quinta and to pay for any addyonarep.,aement necessary as the\esult of this work.¢J.M. Snyder (Sign. on File) ��,CSignatur of Applicant or Agent
Southern Califomniaany P. 01 Box 2200 Riverside,.CA 92516 369-4512
Name of Applicant (please print)' Business Address Telephone No.
Name of Contractor and Job ForetAan .
Contractor's License No.
.Business Address .
Applicant's,Insurance.Co pany',.
FEES: Subdivision/ mprovement Permit Class I I I
r -
Public'
improvements: 3% of estimated construction co is :
Private improvements: 3% of estimated construction co s
Minor.dmprovement'Permit - Class IV: See attached -schedule
Inspection Fee ., $ n/a
Telephone No.
City 13 siriess License No.
Policy`Number
PERMIT VALID TION ..
Permit Fee PERMIT NO. 237
Penalty
Cash Deposit -Surety Bond \ DATE APPROVED 12-4-86'
if required . \ EXPIRATION DATE 12-31-87
TOTAL: $ 12-4-86
DATE ISSUED
Receipt No.
'By
Received by Date Administrative Authority
Recorded by TELEPHONE:. (619) 564-2246. .
NOTE: •
With proper validation f °
this form constitutes 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
Dliombe.r 4, 1986 Subdivision ImprovementiPermit — Class III
DATES Minor Improvement Permit Class IV
LOCATIO OF CONSTRUCTION V.-WiOus stxeets in the City of Ia pinta ,rf (Ex=Es ARrmuAL HimYS)
(Street address or�'D` ription of Location)
,PURPOSE OF CONSTRUCTION �%intalri and rep&ir W lines Sketch (atach construction plans if appropriate)
t DE9CR I PTIONOF CON`S\RUCTIONTo cut 4 x 4 .bellholes as
BlaAzt Permit
DIMENSION OF INSTALLATIQN OR REMOVALt• s
SIZE OF EXCAVATION, IF NEEDED\
APPROXIMATE TIME WHEN WORK WIN_ BEGIN '7anUar'y 1987/
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, I
paction and placing permanent resurfacing and/or replacing
In consideration of the granting -of this permit, the applii
Indemnify,: defend and save the City, its authorized age XK
penalties, liabilities or loss resulting from claims or cqu�rt at
happening or occurring as a proximate result of any �work .ui
�kfilling, com-
nprovements)
hereby'agrees to:
icers, representatives and employees, harmless from and against any and all
)n and arising out,of any accident, loss or damage to persons or property .
'rtaken 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 repla ement necessary:as the esult of this work.
., r ,
IN
Southern Califowda
Name of Applicant (please print)
j.M. Snyder (Sign. on File) f'
Signatu
Costpany P.O Box 22
Business A
Applicant or Agent'
Riverside, CA 92516 369-4512
Telephone No.
Name of Contractor and Job Forem,�an Business Address e Telephone No.
Contractor's License No. City Business License No.
i .Applicant's Insurance Copipa.ny{ Policy�Number
FEES: Subdivisions mprove'ment Permit — Class I I I
Public improvements:.3% of estimated construction costs
Private improvements`. 3% of estimated construction costs
Minor Improvement Permit —Class ,IV: See attached -s6* edule
Inspection Fee $/` t PERMIT VALIDATION
O
Permit Fee , PERMIT NO. 237
Penalty 12-4-86
Cash Deposit -Surety Bond DATE APPROVED
if required`
EXPIRATION DATE 12-31—$7
TOTAL: $ 12-4-86
DATE ISSUED
Receipt No.
By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246