0801�.. yNOTE:
' 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 `
Subdivision Improvement Permit.— Class III'
DATE: Augl Stf'27.,. 1990.1 f '. , Minor. Improvement Permit Class IV
`79780 Fiesta,'La Quinta L
LOCATION OF CONSTRUCTION
+ (Street address or Description of Location)
PURPOSE OF CONSTRUCTION. install gas main, and '
. ,. _ Sketch, (attach construction plans'if'appropriate)
serViye
A j5i
' . DESCRIPTION OF.CONSTRUCTION CUt aDDrox. 75' earth'
'bare'.2_ driveways: " " - REFERENCE SO. -CALIFORNIA GAS
..: PERMIT' NO`. <0784.
'DIMENSION OF,INSTAL'LATION OR REMOVAL 75x2:36"
_ ALL'' CONDITIONS'.�OF' PERMIT 0,784
i' SHALL_ APPLY TO. THIS PERMIT.•
.SIZE'OF EXCAVATION; IF NEEDED
APPROXIMATE TIME WHEN WORK -WI LL BEGIN "• •
8/30/90
.TIME OF MPLETI .'
ldua
'r. APPROXIMATE 0 0N , -
ESTIMATED CONSTRUCTION. COST.$' t'I Y'
((Including removal of all obstruction, materials, arid debris, backfilling" com _ A1 i
• : paction andv.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 authorised agents, officers, -representatives and employees, harmless from and against any and all
penalties,'liabilities or loss 7 resulting from -claims or court .action and arising,out,of any accident, loss or damage to'persons'or,property i
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 tffe7 ime when work will be started.' f,N.
. Com I 'with all':a licable Cit Ordinances the .terms and conditions of the ermhand al �a/ li , ble rules and re la 'i n f t e Cit of
P.Y PP Y pe !) PP ca gu t o s o h y
La .Quinta and to pay!for any additional replacement necessary as the -result of this
r• s., Y'
Signature of Applican or/Agent ,
Macco.Co.nstructionr' PO BOX 783 Palm DesJer CA .343-1180
Name of Applicant (please print) 1 ; Business Address TelephoneNo.
.. same ,•, . W R
Name of Contractor and Job Foreman Business Address �' . Telephone No.
t •259619` #566'
'Contractor's.License No. ,, City Business License No.
•a
Reliance I•ns. Liability Auto/Gena NG12535.60 +
Applicant.'s'Insurance Company # Policy Number
,
FEES:;' -'Subdivision Improvement Permit — Class I
OS`i m-) 6 08 -27-90 i o
Public 'improvemenfs' 3% of estimated construction costs i� '. ;rASV � 84L i 45.00 .
Private improvements: 3%'of estimated construction costs g�� o, - pp
Minor Improvement Permit = Class IV: See attached schedule
l�T' O`O®
Inspection Fee $ 45 .00 1 ;PERMIT VALIDATION.
Permit Fee 0801
PERMIT NO.
Penalty DATE APPROVED 8/27/90
Cash Deposit -Surety Bond '
if required EXPIRATION DATE 12/31/90-
TOTAL: $ 45.00 . DATE ISSUE 8/27/90 r
Receipt No. By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246'
".'Its
G•
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t ,
NOTE: '
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With proper validation Q Y
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT ,•
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT). • ,�� ''� �Sw�ti
'f1OF TH$�
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 ImproJement'Permit =Class III
DATE: AL1QUSt 27 . 1990 r,tiMinor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 7 780 Fiestas La Ouinta x
(Street address or Description of Location) d
as main"an.
. '
' PURPOSE OF CONSTRUCTION install gSketch (attach construction;plans if appropriate)
+ seryiye y
DESCRIPTION OF CONSTRUCTION cut—approx. 75' 'Earth
bore 2 -driveways • � 'REFERENCE •. SO. , CALIFORNIA •GAS ,
PERMIT_ NO. 0784 l
DIMENSION -OF INSTALLATION OR REMOVAL 75x2x36t ,.
. •Y
ALL CONDITIONS.• OFPERMIT 0784
SHALL APPLY TO..THIS -PERMIT
F
SIZE OF EXCAVATION; IF NEEDED
., . , • �. .. -' •.•. - ..... , •• .
APPROXIMATE TIME WHEN WORK WILL BEGIN"' 8/30/90
'APPROXIMATE TIME OF COMPLETION ldua
ESTIMATED CONSTRUCTION COST
-(Including removal' of all •obstructiori, materials, and debris, backfilling, com-
paction
om paction and. placing permanent -resurfacing'' and/or replacing improvements)
a 'Y 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'urider the permit 'granted .Pursuant to this application.
� Notify the Ad1.ministrative Authority at least twenty-four (24) hours in advance of tFie time/w4� work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the' pelt and all'applicabie.rules an d' regulations of the City of
La,Ouinta and to pay for any additional replacement necessary as the result'of this work/ '
• e
Signature of Applicant�or Agent`'.
' Macco' Construction , PO Pox 783-P
alm _Deser, GCA 343-1180-• ,
Name of Applicant (please. print) Business Address / Telephone No.
Same
" Name of Contractor and Job Toreman . Business Address Telephone No. '
259.61.9 #566
'k
Contra ctor's' License No: City Busiriess License No.
,. Reliance Ins. Liability Auto/Gen N61253560
Applicarit'Onsurance Company -Policy Number
FEES: Subdivision Improvement Permit — Class I II
1051 3"' l b 0 08", T -9A i0 +,
,,.. -Public improvements: 3% of estimated construction costs A OTAL i ' ` 45.00
Private improvements: 3% of estimated'construction costs08
;
Minor Improvement. Permit — Class IV: See attached schedule r '€4 ' 01 s
Inspection Fee $ 45.00 =PERMIT VALIDATION'
' •' � ' .
Permit Fee 0801
PERMIT NO.' 1 ,
• .,Penalty �` � • . _
Cash Deposit -Surety Bond' DATE APPROVED 8/27/90
if required." EXPIRATION DATE 12/31/90N!
TOTAL $ 45.00..E_ 8/27/90 .
DATE IS*U�D
Receipt No. By
Received by Date Administrative Authority .
Recorded by TELEPHONE: (619) 564-2246