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+With proper validation
this form constitutes an
encroachment permit
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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 APPROVED SUBDIVISIONS -
Subdivision Improvement Permit — Class 111
`DATE:- / o l /Ro Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION . Wahl.mngton Street and• HWY- .111, �,anta Rosa Cove
(Street address or Description of Location) S
PURPOSE OF CONSTRUCTION
Construction uCt] On Equip, for Sketch (attach construction plans -if appropriate)
Santa Rosa Cove development '
DESCRIPTION OF QONSTRUCTION To transport. a -D9-Dozer
from .h%W' :1U.sand Washington St. to Santa Rosa
Cove z
DIMENSION OF INSTALLATION OR REMOVAL A,
Public improvements: 3% of estimated construction costs
Private improvements: 3% of -estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee NA
-
Permit
''
Permit Fee - NA
Penalty
Cash Deposit -Surety Bond `
if required
TOTAL: . $ ^ -
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f i
Receipt No.
Received by Date
Recorded by .
38
PERMIT VALIDATION
PERMIT NO.
389
'
SIZE OF EXCAVATION, IF NEEDED
�. •^ .'.�'.
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/31/89
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`
APPROXIMATE TIME OF COMPLETION .4/1/89
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ESTIMATED CONSTRUCTION COST $;,
By ,�%./J
r"
(Including removal. of all obstruction, materials, and debris, backfilling, com-
• F; ;, ' - .`
'
'paction,and placing permanent resurfacing and/or replacing improvements)
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In,' -consideration of the granting. of this permit, the applicant hereby agrees to:40
Indemnify, •, defend and save the City, its authorized agents, officers; representatives and employees, harmless from and against any and
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penalties,'liabilities or -,loss resulting from claims or court action and arising out of any accident, loss or damage,.to persons or property *5 ^ti •, ;
happening or•occurnn as•a
PP g proximate result of any work undertaken under the permit granted pursuant to this
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application#„
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iNotify the+Administrative Authority�at'least twenty-four (24) hours in advance of the time when work will be started.
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";.Comply) all applicable C y"0 nances, the terms and conditions of the permit and all applicable rules and regulations of the City of t.
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, .La QuintaFand to pay for any additional replacement necessary as the result of this work:
; `*: •� ;'I ;, '
.
-Applicant
'
!-Signature of or Agent
•Qay er..,Ccristruction 65150 Poll St. Thermal CA
r . •� r �, s>
^` Name.of-A licant`(please Tint► Business Address
Telephone No , ' �•,
Name of Contractor and Job -Foreman *Business Address
Telephone No.
5240]_1
. `
-
*'
Contractor's License`No City Business License,No. F' �" �• .
\'
Applicant's Insurance Company Policy Number
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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
Inspection Fee NA
-
Permit
''
Permit Fee - NA
Penalty
Cash Deposit -Surety Bond `
if required
TOTAL: . $ ^ -
, !4
f i
Receipt No.
Received by Date
Recorded by .
38
PERMIT VALIDATION
PERMIT NO.
389
3/31/.89
DATE APPROVED
• 4/2/89
EXPIRATION DATE
DATE ISSUED
3/31199
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By ,�%./J
Administrative Authority
TELEPHONE: (619) 564-2246
O ;AM1 Ile,,
NOTE:
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 APPROVED SUBDIVISIONS
Subdivision Improvement Permit— Class III
DATE: '1/31 /R9 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Washington Street and HWY ' 111 ,. Santa Rosa Cove
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _Construction Equip. for Sketch (attach construction plans, if appropriate)
Santa Rosa Cove development
DESCRIPTION OF CONSTRUCTION: To transport a D9 Dozer
from Hwy 111 and Washington St. to Santa Rosa
Cove
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/31/89"
APPROXIMATE TIME OF COMPLETION 4/1/89
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:
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 theyermit 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 .
--Stg-ature of -Applicant or Agent
Gayler Construction. 65150'Polk St.. Thermal CA
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
524011
'Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class
Public improvements: 3% of estimated construction costs .
Private improvements: 3% of estimated construction costs N 389
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ NA PERMIT VALIDATION i
Permit Fee NA 3.89
PERMIT NO.
Penalty 3/31/89
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATIONATE 4/2/89
. D
TOTAL
Receipt No.
-0-
Received by Date
Recorded by
DATE ISSUED 3/31/89
By s
Administrative Authority
TELEPHONE: (619) 564-2246