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NOTE
With proper validation
c� Q
'this form constitutes a
' encroachment permit -�
CITY OF LA QUINTA
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• �
�
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 MINOWIMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision. lmprovement Permit — Class] II
Aug�ist, 1.5;" 1990
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Via Sevilla and Via- Coronado
(Street address"or Description'of Location) ; �r i
'install gas main and
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
services Y
t DESCRIPTION OF CONSTRUCTION excavate trench. ~' Y
install piiJe.: backfill'- Reference Southern California
'x Gas Permit #•0673'
DIMENSION OF INSTALLATION OR REMOVAL 1820.1
ALL CONDITIONS OF PERMIT #6673
shall, apply* to this permit
+ SIZE OF EXCAVATION, IF NEEDED- trench 1830 x 1 112-. x .
3 �.
APPROXIMATE. TIME WHEN WORK WILL BEGIN 7 • am •x/22/90'
1 .APPROXIMATE TIME OF COMPLETION 8/23/90.
-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 andtsave the City, its authorized 'agents, -off icers;•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 'r sult of any work undertaken under the per6t-granted pursuant,to4this 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.
•' . • * � �,�t Igo. 5+t�-,r�.-o ;' `�� � n •
Signature of Applicant or Agent ,
Steve'Ruyolo PO Box 783 Palm. Desert CA'T 343-1`180 "
Name of Applicant (please print)' Business'Address ' f Telephone No.
MacconConstruction ame
Name of Contractor and Job Foreman Business Address Telephone No:
259619 56 -6 --
Contractor's License No. City Business'License No.:,'
Reliance Ins.'Auto/General NG1253560 r 2
Applicant's Insurance Company s _ Policy Number
�-
FEES: Subdivision Improvement Permit' Class III '
Qg5J%) ip b4yg OS-- 5X90 !.0
Public improvements: estirnated.construction costs i0 i;ASH, 1 MA 9Q.00
Private improvements: 3%° of estimated construction costs
Minor Improvement Permit=, Class IV: See attached schedule
N2. 0786 ,
Inspection Fee + $ 90:00 • PERMIT VALIDATION
'Permit Fee0786
PERMIT NO.. • ,
Penalty
Cash Deposit Surety Bond s DATE APPROVED' 8/15/90
if required-12/31/90EXPIRATION DATE
TOTAL: $ 90.00 8/15/90,
DATE ISSUED /
Receipt No. ` r
By //c�liiirll
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)
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
August 15, 1990 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Via Sevilla and Via Coronado
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
services
install gas main end
DESCRIPTION OF CONSTRUCTION excavate trench,
install pipe, backfill
DIMENSION OF INSTALLATION OR REMOVAL 1820'
S13ZE OF EXCAVATION, IF NEEDED trench 1830 x 1 1/2 x
APPROXIMATE TIME WHEN WORK WILL BEGIN 7 am 9/22/90
Sketch (attach construction plans if appropriate)
Reference Southern California
Gas Permit # 0673
ALL CONDITIONS OF PERMIT #0673
shall apply to this permit
APPROXIMATE TIME OF COMPLETION 8/23/90
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.
♦�_ Vie.. r) r
�. (t,e.i �.c'Sb
Signature of Applicant or Agent
Steve Ruvolo
F0 Box 783 Palm Desert CA 343-1180
Name of Applicant (please print) Business Address Telephone No.
MacconConstruction same
Name of Contractor and Job Foreman Business Address Telephone No.
259619 566
Contractor's License No. City Business License No.
Reliance Ins. Auto/General NG1253560
Applicant's Insurance Company Policy Number
FFFC- ;ijhriiviginn Imnrnvpmpnt Permit — rlacc I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
90.00
$ 90.00
Date
10051 i A�l�i i � CiTAoLB..itS -9U 90.00 1.0
,_o 0 7 8fa
PERMIT VALIDATION
0786
PERMIT NO.-
DATE
O:DATE APPROVED 8/15/90
EXPIRATION DATE 12/31/90
DATE ISSUED,, a 8/15/90
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246