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0740| .1� o ^ ^` NOTE: ` With proper Yu|iclaion this form,constitutesan / ' -^~' T� ��F LA K�UUyNT�`� encroachmentpermit — ^^ APPLICATION FOR PERMIT .. ' PUBLIC. WORKS CONSTRUCTION. (ENCROACHMENT) ' - For �ho� construction of public o, private curbs, driveways' pavements, sidewalks, parking lots, sewers, watermains ' . and other -like public works "improvements in connection with MINOR IMPROVEMENTS APPROVED SUBDIVISIONS ^ . ` ' . . SubdivisionlmprovomontPormit-, Class U| -_--�---_-- OATE: Minor Improvement Permit Class |V __-_-_---_ LOCATION OF CONSTRUCTION AVE 50 SCHOOL � (Street address mDescription mLocation) ' PURPOSEOFCONSTRUCTION Sk�o -if appropriate) ---__ 'DESCRIPTION O+CONSTRUCTION ' DIMENSION OF|NSTALLAT|[)NORREK�OVAL � ~ . . � .. S|�EOFE�CAVA�|ON.|FNEEDED ' . � APPROXIMATE TIME WHEN WOEG ` - J . ~ APPROXIMATE TIME OF COMPLETION ..- ' 'ESTIMATED CONSTRUCTION ~ $ ' (Including removal of all obstnuotion, mam,io|o' and debris, backfilling, oon, ' 'paunon and placing permanent resurfacing onu/u, mpiaongimpnmemonto) In. -consideration of the granting of this permit, the applicant hereby agrees to: Indemnify, -defend and save the cxv' its authorized agents, oemon representatives and omp/d*ee' harmless from and against any and all n�nam�' liabilities or loss resulting from claims m court action am arising out of any accident,�� m damage m persons o, property' > happening or mzun/nn as u »mxmam result of any work undertaken under the perm xoonqu.pursuant to this application. mvtnv `Administrative-Aumon� m least twenty-four �« ovvm�in advance o/ um^ume ^ un work will uo started.� , Comply with all applicableoxv Ordinances,the terms and conditions of the permit and all applicable rules and regulations of the City of La Qu i . nta and to pay for any additional replacement necessary as t!:.e result of h �J.S Name of.Applicant (plea�e print) Business Address, Telephone No. . . Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. ' City 8uoi"oo License No. . . �. ' FEES: Subdivision Improvement Permit Class U ��O5�R�—�0 ��7-i8-9O iO � ' ' iQ �CA�H i TOTo� z 0.00 Public improvements: 3%ofestimated construction costs / Private improvements: 3%ofmstimaiodconstruction costs Koi u, Improvement PermitO $ |V � Sooaaohod schedule hod�|e /v- ^^ .« -��^ Inspection Foo lin- on Permit Fee Penalty Cash Deposit -Surety Bond if required ` TOTAL: $ ' ` Receipt No. ' Received by Date Recorded by U ' ' PERK8|T'VAL|QATI8N PERM|TNO. DATEAPPROVED 7-18-90 Acl&iri,istra,five Authority TELEPHONE: (619) 564-2246 t `. i +. .41131. "'Y 3�".'t ylr.:rw^:ic ..•{'•%.�i lr?r-f a .r'"'r.•r•. -f.�.--J=1a..�„j�:•^ ,•.;i ''..et"�1.k." ;. ,''� t .. 2 k�•r`�. J7 ^.� 4 r^ ; - ;Y?, .. T �ty,,S�{; w�N+•td•� ' �. '�� ! 4}�r •.�a._ M�.r�.�»?^a' _ . +'lt+w`*'S.'+-�'�'-w.'�f ro.. �r .r .r .: -.�.r w..'.. b. w.+r'o^.c...•as•w.-v..> ..•�. w.a .a.:w ir. rwr .:.:.. lr..�-.. .... rY�-'c. e�So rte, w-� r. ^w��as-'�Y `o t NOTE: With proper validation // K ,,✓ this form constitutes an l.r� 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 II I DATE: JULY 18-90 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION AVE 50 SCHOOL (Street address or Description of Location) PURPOSE OF CONSTRUCTION n+rnt!� CORADVR Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL 10-1() SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN JtIT.V 1 R—tan APPROXIMATE TIME OF COMPLETION •TTTT.V 1 A_qn ESTIMATED CONSTRUCTION COST $ 200 00 (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, harm less.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 thi w" 1XK* Sign ure o Applicant or Agen' . .J.''S JS 1 T0WFT.LS" JR P.O. BOX 1059 INDID 774-1359 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No.. Contractor's License No. City Business•License No. kL FTS11-U-11 Applicant's.lnsurance Company Policy Number FEES: Subdivision Improvement Permit —Class III �� 10051' CASH V 5.6_. L? -i8-9Q 0.0014` Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit —Class IV: See attached schedule 0740 t Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. $ 1n -nn 1n,nn $ ; tL n n Received by Date Recorded by PERMIT ,VALIDATION PERMIT NO. n7An DATE APPROVED 7-18-90 EXPIRATION .,DATE -7-1,8-9 0 DATE ISSU.QP3 w, AildListrfa:tive Authority TELEPHONE: (619) 564-2246 -----------------.--------------_-----� NOTE: With proper validation this form constitutes an encroachment permit ln� v' CITY OF. LA QUINTA APPLICATION FOR PERMIT. • PUBLIC WORKS CONSTRUCTION (ENCROACH 045iS" ,10 5856 07-0-90. P i 10,.00. ERMITS. For the construction of public or private curbs, driveways, pavements, sidewalks,, 0013400034011 10.00 and other like public works improvements in connection with MINOR IMPROVEMENT! i0 CASH 1 TOTAL 1 10.00 i AMOUNT TE THANEDERED , 00 Subdivision Impro. DATE: JULY 18-90 Minor Imp THANK -YOU. LOCATION OF CONSTRUCTION —AVE 50 SCHOOL (Street address or Description of Location) PURPOSE OF CONSTRUCTION0349- _2f,RA12UR- Sketch (attach construction plans if appropriate) ' DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL,G::aO SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL,BEGIN JUT -Y 12-9.0 APPROXIMATE TIME OF COMPLETION^TT1T.V 1 S2..Qn ESTIMATED CONSTRUCTION COST $ ?QQ nn (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 thetimewhen 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 E_.TS STOWrLLS JR P -Q_ _,AnX 1059 INDI0 774-1359 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business.License No. F icant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class III 005182 gpOT. 5856 07—i8-90 10 IO . CASH i DAL i io.00 Public improvements:. 3% of estimated construction costs. Private improvements: 3% of estimated construction costs , Minor Improvement Permit— Class IV: See attached schedule N! 7 4 Inspection Fee $ 10_ 00 PERMIT VALIDATION Permit Fee 10 _00 PERMIT NO. X74.0 Penalty % Cash Deposit -Surety Bond DATE APPROVED 7'=1 3-90 if required EXPIRATION DATE i —13-9 0 TOTAL: $ 1-A ^^ Receipt No. Received by Date Recorded by r 0 Sj By t }r� Authority y TELEPHONE: (619) 564-2246