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0824
.�-w+w.e+•++i.+a.—!+a.a�•s�'F'eva°«n-*-+:.w a.,. tie.,-:..,..,,a•;`w..:._...<...:'...,•,..,:i.•,.c....o.a.`a;.�..'.. ..._.e, ..,. ..rev .", �";,.. ,r. .ea «. ►,a...._...:.....�>... ..«. ... ... ..: •,;;.-.,,.... NOTE-: With proper validation �� • r� 2 this form,constitu'tes an CITY OF LA QUINTAr,. •�; encroachment permit APPLICATION FORPERMIT , PUBLIC WORKS CONSTRUCTION (ENCROACHMENT).c� OME 'TRI.(? OVERSIZE. LOAD PERMIT` .� 0FT>�� For the construction #of public or private curbs, driveways, pavements, sidewalks' parking lots, sewers, water mains N and•other like public works. improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit — Class III ,DATE: "IOq� Minor Improvement Permit,Class IV LOCATION OF CONSTRUCTION *N06A -.EG 4, NAVARR, 0 (Street address or Description of Location)' " PURPOSE OF CONSTRUCTION' MOVE EQUi PM EN T• Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION LRAIJ E' iAAU K0 U 1 E ,iw u oA5 N/e) To �5 Z AID EM DIMENSION OF INSTALLATIQN OR REMOVAL I,%�"y (D r�� WA`Ji'� ` N C�T�� AI W OCEGAL 1 E-19T"1"I,.' It LEI�.ITH �"0 C..ITX. LIMITS SIZE OF EXCAVATION, IF NEEDED 1 APPROXIMATE TIME WHEN WORK WILL BEGIN, t APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ ` s; (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent, resurfacing and/or. replacing improvements)AIAl� DAT. • 9 I©�• 01,0 In consideration of .the granting of.this permit, the.'applicant hereby, agrees to: Indemnify, defend, and save 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, -Joss 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 OWL 1_9AAIE_ .1 KI&&.1 & I I'll CREKEY'AVE' IONTANA J 900 (37g --39i2 . Name`of Applicant (please print) Business Address Telephone No. MA55EY 'e.-.)ANh 4 ROLK Name of Contractor and Job.Foreman y Business Address Telephone No.. QAi Ell- A Contractor's License No. City Business License No. Applicant's Insurance Company, '.Policy Number FEES: Subdivision Improvement Permit — Class] II. 0 SJBT18 9 9— 0-90 g 0.0010 Public improvements: 3% of estimated construction costs �A y Tod ^)- Private improvements: 3% of estimated construction costs Minor Improvement Permit•— Class IV: See attached schedule ` �� 0824 v' Inspection Fee . $ PERMIT, VALIDATION ` Permit Fee Penalty Cash Deposit -Surety Bond , if required TOTAL: $ �Q' 00 Receipt No. Received by Date Recorded by PERMIT NO. 082..4 DATE APPROVED- EXPIRATION DATE'_9 711- 90 ' ' DATE ISSUED By .9 — ` 90 Administrative Authority TELEPHONE: (619) 564-2246 .+.,,.r.�r.-•-:IFM.+t^...,+,-;�'�''q�r*sa-f�3.+i�e+.-k-rrra.. w..w � �s � r ... ..-.r w-�. r r. rt rw �.- �.. ti... a�. �..... e. �s. w. +� .�. u [r w..r ..+.- .. r .. r w» r..r+.. r r .....► .n ►r.r �. NOTE: . p With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) �ki�_: -1ARIF 5V is51ZE k.DAQ • FERMI T 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: `-� Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION N06ALES 4, N AVA If Q (Street address or Description of Location) PURPOSE OF CONSTRUCTION MWE Et.1h1I F- M EN T Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL Vl-'(�,tf H ;T SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 44L1 L KO LIT E b �KMPAOAS W/5 ` D 5 ^ E/Z TO NNA�I W GTC i�d M/5 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)" �� " 10- '10 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. f Signature of Applicant or Agent OWL C.SA NI F I S 16[1 1616 11 111 EA E V R 700 T NIA # son 87'4 -29 1/_ Name of Applicant (please print) Business Address Telephone No. HA-.5EY "-,)AAIA d ftf K Name of Contractor and Job Foreman Business Address Telephone No. e),A./ F/ I- A, Contractor's License No. City Business License No. e%! %r LE ON F Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class 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: $ 10100 Receipt No. Received by Date iW�U�'� 940--5'0 i o 1 p ivy © ,914 PERMIT VALIDATION PERMIT NO. DATE APPROVED' ! �� EXPIRATION DATE DATE ISSUED 10 �r By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE: With proper vaiidation this form constitutes an encroachment permit t� M i s CITY OF LA QUINTA APPLICATION FOR PERMIT , PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) r";40409.� - _. 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:�% Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or'Oescription of Location) PURPOSE OF CONSTRUCTION -Sketch (attach construction plans If appropriate) DESCRIPTION OF CONSTRUCTION A' ' DIMENSION OF INSTALLATION OR REMOVAL ,4 P<' sz'���kUd �vrR.N.frl. SIZE OF EXCAVATION, IF NEEDED ' APPROXIMATE TIME'WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ !c� (Including removal of all,: obstruction, materials, and.debris, bar±tfilling, 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,underta6n 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 ®"?�fp7-2— e 111-71 Name of Applicant (please print) Business Address Telephone No. tLlf35SeY Sofa-4� 4 - Name of Contractor and Job Foreman Business Address Telephone No. &7N f�L�. /�41_1 -e Contractor's License No. City usiness License No. ®�f :t L fes, F1 Le Applicant's Insurance Company Policy Number FEES: Subdivision improvement Permit — Class Ill Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit —•Class IV: See attached schedule Inspection Fee $ II Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ �.,�® C Receipt.No. 4 Received by Date Recorded by No. PERMIT VALIDATION PERMIT NO. DATE'APPROV ED ' EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (6191)1564-2246 ,