0553. ,.. ._. .-...vim,... ___•S_..:..:.•.�. r.. -. .-.. .�_ � - ., -..- ___ _ _ .__ _ _ _ __. _ __ _- _ _ __ _ - _
NOTE" • '' � ..� •
With proper.validation, rZ 2
this form constitutes an i o
encroachmentpermit. CITY •O�F LAQUINTA
APPLICATION FOR PERMIT - -
ti
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)��
,f SOF TE1�9
' 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
• 1 Subdivision Improvement Permit — Class I II
DATE: April 2, 1990 Minor Improvement Permit Class IV
#. LOCATION OF CONSTRUCTION 52--565 Avenida Juarez
F (Street address or Description of Location)
'..PURPOSE OF. CONSTRUCTION nntuar Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
uneleraxound.'fiiie for power �` ` . n see. attache_ d drawing
DIMENSION OF INSTALLATION OR REMOVAL
`ry SIZE OF EXCAVATION,•IF NEEDED
fl
APPROXIMATE TIME.WHEN WORK WILL BEGIN�4I/4/9�/
,+ /
s y
-�4 °"'"°ARPROXIMATE TIME OF COMPLETION 4/90u
sn;ESTIMATED'CONSTRUCTION COST $ `
-removal of.all obstruction, debris, backfilling, com(Including/1,�
paction and placing permanent resurfacng and/or replacing improvements). '
Inconslderatio�n 'of he granting of this permihe applicant hereby agrees to: �.
�Indemnify;'defend and save the City,, its authorised agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities `or loss resting 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... .
1. Notify the Administrative Author' at le st twenty-four (24) hours• in advance of 'the time -when work will be started
I \ y r, 1..
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.• t
Signature of Applicant or Agent
1
s : Name of Applicant (please print) 'Business Address Telephone No.
Meadowland Development PO..Box 921 Riilto,..CA 92376. 714 875-6.000..
Name' of. Contractor and Job Foreman Business Address • Telephone No:
261079 1,175
Contractor's LicdnsefiNo. 'City Business' License NO..
Applicant's Insurance Company Policy Number
FEES: `. Subdivision Improvement Permit -Class III �` , Inspection 1 dayl$35, 00''
Public improvements: 3%0 of estimated construction costs�
'Private' improvements: 3% of estimated construction costs 0553
t
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 35 :-00 PERMIT VALIDATION
Permit Fee 10.00 PERMIT NO. 0553
' Penalty DATE APPROVED 4/2/90
*Cash Deposit -Surety Bond
if required EXPIRATION DATE A /'An /man
TOTAL: $ 45.00
Receipt No.
Received by Date
Recorded by
DATE ISSUED 4/2/90
By . .
Administrative Authority
TELEPHONE:'(619) 564-2246
a
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: April 2,, '}1990`' '' •Minor Impr'vemen P ^ "
'' •• .• o t� ermit Class IV
LOCATION OF CONSTRUCTION 52-565 Avenida'Juarez "
(Street address or Description of Location) "
PURPOSE OF•CONSTRUCTION* = nwin r - Sketch (attach construction plans if appropriate) •
DESCRIPTION OF CONSTRUCTION
underqgound line'for ower 'see attached drawing
DIMENSION OF INSTALLATION OR REMOVAL
F r
. SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE
APPROXIMATE TIME WHEN WORK WILL BEGI 4 4 9
APPROXIMATE TIME OF COMPLETION ' 4 90
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, mat rial , an debris, backfilling, com
paction and placing permanent resurfac' g ari /or eplacing improvements),.
In consideration of the granting of this ermit t e 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 re Iting fro claims or court action and arising out of`any accident, loss or damage to persons or property
happening or. occurring as•a pr imate re It of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authori at I ast twenty-four (24), hours in advance of the time when work will be started. A
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
gent
' Name of Applicant (please print) Business Address ,Telephone No. '
Meadowland Development PO. Box '921 Ri•altQ; CA `9'2376 . ,714': 875-6000 ,
Name of Contractor and Job Foreman Business Address Telephone No. ,
261079 :. �; 1175
-,'Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111 Inspectiond day/ $ 35.00 "
Public improvements: 3% -of estimated construction costs t
Private improvements:.3% of estimated construction costs -• -
_ AT0
Minor Improvement Permit —'Class IV: See attached schedule N" 0553
•Inspection Fee , $ 35 .00 PERMIT VALIDATION. ,
Permit Fee 10.00 0553
PERMIT NO.
Penalty ;
Cash Deposit-Surety.Bond' DATE'APPROVED 4/2/9-6
s
if'required • A EXRIRATION DATE 420 496
A $- 45 00 4/2/90
TOTAL: _ .` DATE ISSUED f
Receipt No.
BY
Received by Datel• - ' Administrative Authority .
Recorded by '• y TELEPHONE: (61 9) 564-2246
With proper validation Q
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: April 2, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 52.-565 Avenida Juarez
,(Street address or Description of Location)
PJRPOSE,OF CONSTRUCTION powE'►" Sketch (attach construction plans if appropriate)
t
DESCRIPTION OF CONSTRUCTION
underground line for power �' n see attached drawing
DIMENSION OF INSTALLATION OR REMOVAL ,\ `
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN/_4V4/90,J ;
PPROXIMATE TIME OF COMPLETION 414/90
,
EST IMATE D`CONSTRUCTION COST $ 7 ;
(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'e 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 resiting 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'.
.Q,.
Name of Applicant (please print) Business Address Telephone No.
'Meadowland Developmen't,PO Box 921 Ri<o, CA 92376 714 875•-6000
Name of. Contractor and Job Foreman Business Address Telephone No.
261079 1175
Conteactor's License No. City Business License No. '
Applicant's Insurance Company Policy Number
FEES: Subdivision improvement Permit — Class III Inspection 1 day/$35.00 z.
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
0553
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee3 $ - PERMIT VALIDATION
Permit Fee 10.00 0553
PERMIT NO.
Penalty 4/2/90 '
Cash Deposit -Surety Bond V DATE APPROVED
if required EXPIRATION DATE.- 4/30/90
TOTAL: $ 45.00 ._' 4/2/90 ,
DATE ISSUED_
Receipt No.
- By
II
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246