0512,4-
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NOTE:
With proper validation �`• �� Q
y this form const_ itutes an.
♦ encroachment permit,,CIT'Y'. OF♦ LA �'QUINTA
t AP,P•LICATION FOR ' PERM -IT• ` -
f •; � � 5 }
{ `• PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
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AS
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t For the construction '.ofAublic''or private curbs;' driveways,. pavements, sidewalks, parking.lots;�sewers, wafer. mains
and other.like,public.works, improvements in connection.with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit —Glass IIIx.
+
DATE: FAf,ri, a rT7 Vit` ,1 Q o n o .I rovement Per -
�` t .,' ;` "'Min r mp mit Class IV
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LOCATION.OF CONSTRUCTION rt1-.7nn Aysa i v»Aa ni a� t-
(Streetaddress or Description of Location),- y ' t : w; y. �,+y
. « driveway :approach •{ i
PURPOSE O.F.CONSTRUCTIONSketch (attach construction plans;if appropriate)'-
; .. ►
'DESCRIPTION OF CONSTRUCTION." concrete. '^>
DIMENSION OF INSTALLATION �OR•REMOVAL 2'4' 4'•.a ' ` ``
SIZE OF.EXCAVATION' IF NEEDED •
i, APPROXIMATE TIME WHEN WORK WILL',BEGIN ``, ��''�;' '� �� �• ,�
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,:APPROXIMATE TIME`OF COMPLETION �� r #•a.
ESTIMATED CONSTRUCTION COST.$ nnn
r..:
`(Including removal,oiall obstruction, materials; and debris, backfilling, com- g ' • - •` ,
paction and placing permanent resurfacing and/or 'replacing improvements) -
In'considerstion"of.•the•granting of Lhis,permit,.the applicant hereby agrees to:
Indemnify, 6fend�and'save the City; its authorized agents, officers, representatives and employees! harmless,from'and against any and all,
` penalties; liabilijies or lossresulting from claims•or court,action and arising out,;of'any accident}loss or. damage"torpersons or property
ha enin or occurnn as'a; proximate. result of an -work„undertaken under thet ermit ranted °
PP 9 9. P Y ' P 9 puprsuant.to.this application.-
, i� } r• ! .,"'': ', F -.- `� .. 1. t A,
Notify the Administrative Authority at ..least twenty-four (24►' hours; in advance of the time when work will be'started.,
Comply withi"all applicable'City Ordinances,�the terms and conditions of,the permit• and all applicable rules and regulations of the City'of
Y
La Quinta-and,topay'for any additional replacement necessary as the result of this work..'
a }, .' Signature of Applicant or Agent
... :1
Sun)Crown Corp by W.L. shields- ; '564=4977 r
Name of Applicant (please print) } Business Address , ' ' �. '� ,Telephone"No.
Robert• Creek' ;.564-1347..,. Ya
.'Name of Contractor and Job Foreman + ' • Business_ Address 'Telephone No.
Contractor's License`No:r ' ' City Busine
ss License No. ,
• - ,y,-.[. it . � _ •� f - ' _ _
Applicant's Insurance Company '< Policy,Number�
FEES: Subdivision'Improvement Permit — Class III- • p518F 0 4298 1R2- 3•- 10 ao.
90 10 .
' .0 [:AH i'QTL .
Public improvements: 3% of estimated construction'costs a--'
Private.improve ments`. 3% of'estimated construction costs
5'12 r
` Minor Improvement. Permit —,Class IV: See attached schedule
Inspection Fee . } $ PERMIT VALIDATION
Permit Fee 10.00 _
r , 'PERMIT NO. •0512 1: t
Penalty DATE APPROVED ' i 2/23/90
Cash Deposit -Surety Bond
if required y,r . EXPIRATION DATE • -2191190
`•
TOTAL: ' $
DATE ISSUED, 2/23/90
Receipt No.
By—,
- -
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
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NOTE:' .
With proper validation
this form constitutes an,
CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) .cam.
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
w
Subdivision Improvement Permit — Class III
DATE: Fohri,A 7a = 1 QQn Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION r+A—.70f1 AaPiindg T)iia7
(Street address or Description of Location) ;
PURPOSE OF CONSTRUCTION driveway approach.
•DESCRIPTION'OF CONSTRUCTION. concrete
DIMENSION.OF INSTALLATION OR REMOVAL 24
Sketch (attach construction plans if appropriate)
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME -WHEN WORK WILL BEGIN
„APPROXIMATE TIME OF COMPLETION
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 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
Sun Crown Corp by-W.L. Shields 564-4977
Name of Applicant (please print) Business Address ti Telephone No.
Robert Cleek 564-13.47
Name of Contractor and Job.Foreman Business Address Telephone No.
Contractor's License No.
City Business License No.
Applicant's Insurance'Company Policy Number
FEES: Subdivision Improvement Permit —Class III 5182 2-03-90 ' iU '
" CFiSI1 'qT L �o.OQ
Public improvements: 3%.of estimated construction costs
Private improvements: 3% of estimated construction costs
tQ
Minor Improvement Permit— Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
I
Permit Fee0512' 10.00 PERMIT NO. )
Penalty DATE APPROVED 2/23/90
Cash Deposit -Surety Bond y,
if required EXPIRATION -DATE 2/23/90
TOTAL: $ 10.00 DATE ISSUED /• 2/23/90
Receipt No. By—
Received
YReceived by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an
encroachment permit
.. ... gym.,. ,
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 2-Z/ 1�lO Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 0/47--
(Street
i47—
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 9'e 0 el Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION G�oNG2�T '
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION ZM464
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:
V 4/1
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 (241 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
C'20w'4/ 002Pvfi 4_SAS _,x ds SG�f•.4�F7-7
Name of Applicant (please print) Business Address Telephone No.
,t'o�E,2r ee==?tic 5Z Y / 3 Y7
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III w
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs NO
Minor Improvement Permit — Class IV: See attached schedule l�
Inspection Fee $
ti
Permit Fee +
Penalty
Cash Deposit -Surety Bond '.
if required
TOTAL:
Receipt No.
Received by
Date
PERMIT VALIDATION
PERMIT NO
DATE APPROVED
t,
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by TELEPHONE: (619) 564-2246