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this form constitutes on, •K r , •'
CITY '0P LA OUINTA •`' '
encroachment ` ��. t. 'r� • . ,•` 4• cv
yip Tf-' APPLICATION FOR
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PUBLIC,,rORKS CONSTRUCTION. (ENCROACHME14T) d
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For the' construction of public or private curbs, driveways, pavements, • sidewalks, ' parking lots, sowers, water trains
t and other like ubl;c works inproveimenss-in cone
nction wiih MINOR IMPROVEMENTS and APPROVED.SLJyB,DIVISIONS•-4f 't
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. .xSub jlvision,Improvement Permit,- Class •I_I I
DATE: `June 1987 a, x Minor improvement'Permit Class IV.
LOCATION OF.CONSTRUCTION
Washington Street. N/0 Singing Palms (West:
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(Street,addres. or Oescription of Location)
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_PU� RP�,0,.. RUSC�pp}y� rr e Sketch (attach constryctign plans,iftappropriate)TY 1 _ y
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DESCRIPTION -.QF CONSTRUCTION1,§ee attached, -sketch.•
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DIMENSION 0� II STALL ATION Rti� ,OVAL • f- proyis�otie.'are included and spade
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Y f y } _ part .of J this.. permit'.*,, , �.• , »
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SI S pF,EXCAV.AT�ON, IF NEEDED ' t"tiAll excavation in' ®artb areae
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APPROXIMATE TIME.WHEN WOR k WILL BEGIN 4+ �=15-87•' ' USA Inquiry 1 9 3 /o 3 3 O
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APPROXIMATE TIME OF COMPLETION' 12-31 87 Date+`Issued:
ESTIMATED CONSTRUCTION COST $' ''r.: .,� .,, ;x x r,
(Including removal of .all obstruction,' materials, and debris,'backfilling„coma, `
• paigion:and placings pe manpnt resurfjcing and/nor replacing improvements)
In consideration of the granting of- this perrnit,'the applicant here_by.agrpes to. • ,
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Indemnify, defend'end save the Cit 'its authorized agents; officers, 'representative@ and,employees, harmless .from and against'any and all
• penalties, liabilities orrios; r@lultnq,Ffrgm�clsms or.court ezctlon and_arjsin9:out�of#any a� id�ent,.loss or d made, o Persons or:property
I'dhappening or J ccri irinl�, spat poxir��t�Tres It f @n :wo{kk undertya� u deer th�,permit gr nted.pursuant tq.thts appplicatio'n..
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Notify the AdTipistratiye rgythprlty,at least <twenty-four 1 I) hours .in r;?tly�nce ,of the ;ime, when, work, will be;-
started
Comply twith allrapplicable City -Ordinances,! the' terms and conditions,of'the permit and all applicable•rules and•regu_lations of the City of
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tyt�ta:sf r'�ithe . resul.•t, o,•f,. this •wo.r.kM.
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Signature of Applicant orAgent : ` 619-342-0535 L
CPNFRA�L`PELEPEONE' COMPANY ,RB CALIFORNIA. 83-793, Dr. Carlrea -Blvd., Indio, CA. 92201
Name of Applicant (please print) Tv” r,ffrfxt!>3tiru *-�cll. h"� +
Business :" ''Ct t.,o �;..,•. s. }:Telephone No.
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Name of Corltractor and 'Job`Foremarr''�*� 1 "f '� y;;,y, a s Business Address ' ` ' r - �'rcr Telephone No
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•ontractol's rcepse• (�
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F S: Subdivision Improvement, Permit, Class.11l # t
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Public•improvements: 3% of estimated construction costs '
* ti Priyeteiimp�ovemept�s 39b of estjrriafec( cQnstru5Ar? costs •,y r
' Minor Improvement Permit'=Class IV,fSee attached schedule',, its - - - ^'r•-� `' c ; or r
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InpeoFee,., ,, I- PERMIT VALIDATION ,
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Permit Fee 'i 1` I •`j( kcr ., p
RE�i.MIT
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Penalty ' bl
Cpsh Deposit -Surety Bond '
r� DATE APPROVED,,.'
•,t3, -;vjall
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if required i EXPIRATION DATE��
-TOTAL T F $t,!'� _
-t�ar!r, TE ISSUED
Receipt No.
.Received by Date ..,. •'tv �r a# �,,,t'✓ :.;. fY �l .,;f•• �+'yLf fiw.-•3 ..t �..#,� �A
d strative Authority
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Recorded by. 1 .� : w•t'• TELEPHONE "(619) 564-224614-t,
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ties to these monuments shall be furnished to the City Engineer prior to the removal of any monuments. This office shall
be notified upon completign.of'replacement of'all survey,.monuments for proper:project clearance. ,
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