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0547NOT: With proper validation 2 this form constitutes an permit" CITY OF LA QUINTA ..encroachment APPLICATION .FOR PERMIT - PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) I•>,� w4� OF rte. 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 ^t . March 2T, 1990 Subdivision Improvement Permit. --Class II I DATE: Minor Improvement. Permit Class IV - r LOCATION OF CONSTRUCTION 54-735 Avenida Vallejo r 1 (Street address or Description of Location) PURPOSE OF CONSTRUCTION - driyeWaV dpAroach Sketch (attach construction'plans if appropriate) DESCRIPTIONIOF CONSTRUCTION s, x see attached sketch , DIMENSION'OF INSTALLATION OR REMOVAL SIZE OF�EXCAVATION; IF'NEEDED APPROXIMATE'T:IME WHEN WORK WILL BEGIN APPROXIMATEaTIME OF -COMPLETION F ESTIMATED'CONSTRUCTION COST $ (Including removal of all'obsteuction, materials, and debris, backfilling, com pactionrand,placing permanent resurfacing an replacing improvements) AI In consideration,of the granting of this permit, the applicant hereby agrees to: ,4 fP Indemnify,,dlefend 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 couri 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. ,. ti Signature of Applicant or Agent +' + Don Bruce Name of. Applicant (please print) Business Address Telephone No' Meadowland Development PO Box 921: Rialto, CA 92376• 714/-875-600.0 k Name of Contractor and'Job Foreman Business Address Telephone,No.`" 261'079- " 1175\ Contractor's License No.. City Business License No. 'I r on .file on., f ile i l Applicant's Insurance Company Policy Number Y FEES: Subdivision Improvement Permit — Class Ill Public improvements: 3% of estimated construction costs , Private improvements: 3% of estimated construction costs (�1'. U —27—yU 1U .1 r `�a r a s 10.00 Minor Improvement Permit — Class IV: See'attached schedule j Inspection fee $ PERMIT VALIDATION Permit Fee 10 .00• PERMIT NO. -0547 t Penalty 3/27/90- Cash %27/90Cash Deposit -Surety Bond ,DATE APPROVED if required EXPIRATION DATE A /in/go TOTAL: $ 10.00 DATE ISSUED .3/27/90 Receipt No. By t Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 . .- ,. ,,. .. : ....- _..r w. r. w.�+ 7:. `rL•,G••!ri..`.r"p i+.4a�'�w•.5:� Y iio .,,._. __ _ .._ _ n: an.',r ., > .sem• NOT 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 March 27, .1990 Subdivision Improvement Permit — Class II I DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 54-735 Avenida Vallejo (Street address or Description of Location) PURPOSE OF CONSTRUCTION driveway approach Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION see attached sketch DIMENSION OF,INSTALLATION OR REMOVAL 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. r Signature of Applicant or Agent Don Bruce Name of Applicant. (please print) Business Address Telephone No. Meadowland Development PO Box 921 Rialto, CA 92376 '7,14/875�4000 Name of Contractor and Job Foreman Business Address Telephone No. 261079 1175'x_ Contractor's License No. City Business License No. on 'file orifile Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class III ` Public'.improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs 1F3" U Minor Improvement Permit — Class IV: See attached schedule A TAL i i0.00 Inspection Fee V Permit Fee 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by �'"1` a PERMIT VALIDATION PERMIT NO. 0547 R DATE APPROVED 3/27/90' EXPIRATION DATE 6/30/90 _ DATE ISSUED 3/27/90 By Administrative Authority TELEPHONE: (619) 564-2246 rk, v NOTE::► With proper validation 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 Subdivision improvement Permit Class III DATE:— z V Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 73-c. e i) rLLEZ�l (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction pians if appropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL A " SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ �a (Including removal of all obstruction, materials, and uEuris,.uagk'1i;16iiu; 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 tha 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 Name of Applicant (please print) Business Address Telephone No. -M f4l)Aw i A*d TD '5_'L PC), /Soy 921 ?-AL7_VcA Name of Contractor and .lob Foreman Business Address Telephone No. Contractor's License No. City Business License No. r Applicant's Insurance Company Policy Number 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 N� Inspection Fee • $ Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Date PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority Recorded by II TELEPHONE: (619) 564-2246