0819w . •
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NOTE:.
" With,'prooer validation
c this form constitutes an . f �-,• .�'
CITY OF LA, QUINTA if '
1 encroachment permit',
APPLICATION •"FOR PERMIT'
' PUBLIC WORKS CONSTRUCTION, (ENCROACHMENT) w
OF
' •For the. constructions of.N •y ' ���• � •�`� � �- ; �� ''`' • ~ •
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 -Ill
—A—Q =
DATEQ Minor Improvement Permit Class.IVl.
I
'LOCATION OF CONSTRUCTION'Mj/ L%M T: QT7TUrkLTT7T
(Street address or Description of Location). ' F• '
- PURPOSE.OF.CONSTRUCTION '` - * Sketch, (attach, construction plans if appropriate)
DESCRIPTION,OF CONSTRUCTION ;
RO
HAR
UL ROURE
• DIMENSION OF.INSTALLATION OR REMOVAL VaASHINGTON •OFF I10
• � -750' JD ..DOZER i � •'
_1 1` .FEET • WIDE ALL. ELSE' LEGAL .' AT CITY LIMITS TO AVE 52 TO
BERMUDAS TO NOGALE_ S TO NA_VARRR
SIZE OFrEXCAVATION,'IF NEEDED
•'APPROXIMATE TIME.WHEN WORK WILL BEGIN' -
' APPROXIMATE TIME OF COMPLETION' Aj. Y I
HAUL DATE: 9-6-90
T '
ESTIMATED CONSTRUCTION COST ;
• , (Including 'removal of'all obstruction, materials, and debris, backfilling, com-
paction and.
om paction,and. placing'permane'nt resurfacing and/or, _replacing improvements)
In'consideration'of the granting�of,this. permit; the ,applicant hereby agrees,to:
.Indemnify,.defend 'yand_save the City, its authorized agents; officers, representatives and employees, harmless from and against any and all '
f .,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•prozimate?esultaof any'work,undertaken under.the permit granted pursuant to this application:
` Notify the Admini%W'ative Authority at least twenty -foci (24) hours in advance of the time when work will be started.- '
t' T 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'theresult of.this work.
-.Signature of Applicant.or Agent/
•y' ` ?'A nl. T'Tlf- --A TTy% •T'•TT11 •T /•1 r. T,-
Name of Appl cant (please. print), _+' Business Address' ' `' Telephone No. '
' ';.••Name of Contractor and Job Foreman ' ., Business Address ;' Telephone No. -
' `/STT TTT Y:, t'. , `�, r'•` - ., , . • • ' ~ .+ .`. . , • -
Contractor's License No. _ City BusiHess! License No. `
.Applica'nt's Insurance`Company , _ Policy Number
,FEES: Subdivision Improvement Permit -'Class III
Public improvements: 3% of estimated constructioncosts { -
Private improvements: 3% -of estimated construction costs '
'Minor Improvement Permit = Class IV: See attached schedule ` o �. • '
19
f
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 0819 • •j
PERMIT NO.
Penalty9-6-90
Cash Deposit -Surety Bond DATE APPROVED'
if required.EXPIRATION DATE �9-7-90 -
TOTAL: . $ 10.00
! ' Receipt No. '
Received by Date s '
Recorded by. '
DATE ISSUED �"n-90
Administrative Authority
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
DATE: .g—(;-40
LOCATION OF CONSTRUCTION &1011V P0T1TDMV1Vrrr1
(Street address or Description of Location)
PURPOSE -OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL 750 JD DOZER
11 FEET WIDE ALL ELSE LEGAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
HAUL ROURE
WASHINGTON OFF I10
AT CITY LIMITS TO AVE 52 TO.
BERMUDAS TO NOGALES TO NAVARR8,'
APPROXIMATE TIME OF COMPLETION HAUL DATE: 9-6-90
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.
Signature of Applicant or Agent/
atr
Name _a cc�� _� r xrr� � ntt� nnr•zr_ .
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.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
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.
10.00
$ 10.00
Received by Date
0819
PERMIT VALIDATION
PERMIT NO. 0819
DATE APPROVED 9-6-90
EXPIRATION DATE f —9-7- 90
DAT �S
"�~ /9,,-6-90
By /
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
,r.
NOTE: .. .. , ;:t. •
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 SU13DIVISIONS
DATE:
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION����E�iA�,o�.�'f
DESCRIPTION OF CONSTRUCTION
Subdivision Improvement Permit —Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
Wa.41:r) ;, Off rl o
b4i/ Li?�J.s b Aub So
�3er �t i.�l>9s • � !U v� �l�.s �
DIMENSION OF INSTALLATION OR REMOVAL `%S0 Tp DZ)7.C-P,
JJ Fe* - 4- uJ ;�
�-v
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
A!.Avgrry
cel n& , �-�✓ -90
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.
Name of Applicant (please print)
w
Signature WApplicaint or Agprd
Business Address
Telephone No.
Name.of Contractor and Job Foreman Business Address Telephone No.
all
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements; 3979 of eatlmated conattuction cwri ,
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
9-0
Permit Fee D"
Cash Deposit -Surety Bond
if required U
TOTA6i
Receipt too,•
Aec&68 by .bate
Recorded by
N°
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
By �AdMinlitrasive Authopity
T���PH�Iv�; i��s) �6g•�za�
- _. _ - -- _ _ - _ -
NOTE: t ,
" With proper validation
this form constitutes an
encroachment Permit- CITY OF -CA- QUINTA r
K - APPLICATION FOR PERMIT
Y PUBLIC' WORKS. CONSTRUCTION,
OF
• '*f - 1
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:
x Subdivision Improvement Permit - Class III,
DATE: 9-6-Q O Minor. Improvement Permit Class IV,-
LOCATION OF CONSTRUCTION Mf1VF ?bQUZ&�7�D7� ~
• (Street address or Description of Location)
PURPOSE OF CONSTRUCTION ` " f Sketch (attach construction plans if appropriate)
- DESCRIPTION OF CONSTRUCTION
HAUL ROUTE'-
DIMENSION'OF INSTALLATION OR REMOVAL 750 'JD 'DOER q+ASHINGTON OFF I10
11 FEET WIDE ALL ELSE LEGAL .,AT.CITY LI.RITS..TO AVE:; 52 TO
i- "BERMUDAS TO NOGALES TO NAVAF
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE.TIME WHEN WORK WILL BEGIN P `
APPROXIMATE TIME OF COMPLETION HAUL DATE: 9-6-90
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, Com-' a
t
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 occuring 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 workwill be started. "g .'
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. fr
t
a
Signature of Applicant or Agent }
ame of pplicant please print Business Address Telephone No.
Name of Contractor and Job Foreman Business, Address Telephone No.
+ Contractor's License No. { City Business License No.
Applicant's Insurance Company, Policy Number
i
FEES: Subdivision Improvement Permit - Class III 005182 i0 6876 09-06-90 iC•
10 CASH•i, TOTAL,i i0.00
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 VALIDATION M
Permit Fee, 10 .'00 0819'•
-- ePERM1T NO.
I Penalty •' t , '
Cash De Bond DATE APPROVED 9-6-90 f
„ if required EXPIRATION.DATE 9-7-90
f - I TOTAL: " •S 10-00 DATE I ^ D
- i
t Receipt No. + -
„s xt By
- Received by Date Administrative Authority,
t Recorded by TELEPHONE: (619) 564-2246