0832y �t �� aY"�-y.- �•,r�w-.� s .. ... .� M Y;,r,�,r { �. �.. : yr:��s,�y� 1. .rw xv, ,,=*t S•w,.' X t:�7+Y, '{' �. ��1G
.. s�i,:�=� y\ ,�,:.�iy�d�`�u`;�.;;,,Y��'•s+1r.�L�••E•�`'.• �S^'��`,c�•.=��"���•i�-�•-2;.wts•y�'�L'• �--'.K�a�' ""w..Y;,M'�ry'",'s.�„J• '�t*�+�r •.
t - yrly _ • V i I �•'
s
NOTE4 -'' t
With proper validation
this form constitutes'an CITY OF. LA QUINTA
I! encroachment permit �. �• t'
. _ r. • APPLICATION FOR,PEWIT ,
s' - L - y . • L f � .. �, � � • • r.moa.o Qy
PUBLIC WORKS CONSTRUCTI(ENCROACHMENT).:, �Sw
(ONE . "i9rF?:pVF1LSi2, LDRDON, 2Mt7") . ' ,' of-�
For the' construction of -public "or private':' curbs,.'driveways,, pavements, sidewalks, .parking ",lots, sewers, water 'mains
f "and other like public works improvements in `connection with MINOR,IMPROVE, MENTS and APPROVED SUBDIVISIONS
" �" • Subdivision Improvement Permit - ClassyI I
DATE: C�i�� 7M-� " , Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location):. " - :" 'M `
PURPOSE OF CONSTRUCTION MOVE EQU.I-PAr-NT , t' , 'Sketch (attachiconstruction`plans if appropriate):
DESCRIPTION.OF CONSTRUCTION_�" ;eL�> ' }
r < - Ne,T`O�t
-, _. . ' - = h�� S/ti T0. S Z �I13;►.��y MILE• • .
: DIMENSION OF INSTALLATION OR REMOVAL } 11) W
SIZE OF«EXCAVATION, IF, NEEDED
APPROXIMATE TIME�WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION " ` ' PAWL.DAA o• '
'ESTIMATED CONSTRUCTION COST $' • ' ` y '' �' ' ' ' -'
• K. -r
(Including remoV.al of all,obstruction, materials, and debris, backfillinc,,com
` paction°and,placing permanent resurfacing and/or-repla(ing improvements) r'
In consideration'of the granting of'this,permit, the applicant hereby, agrees,to:
s�
Indemnify,•defend and save'the' City, its. authorized agents, officers, +.repres ntatives and employees; harm Iess,from and against any and all
penalties,. Iiabilities'or. loss. resulting from claims or. court +action'and.arising out of any accident, loss or damage to persons 'or.property •e '
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)Ihours'in advance of the time.`when work will be started. F. i
Comply with, all applicable.City Ordinances, the'.terms andreonditions•o_f the permit and all•applicablb,rules and regulations ofxthe.City`of
i La Quinta and,to pay -for, any additional replacement, necessary•as the''result;of this works j ', t'• '
,�• i. Signature of Applicant or Agent
LU
N tit'vvg; -_ EN6111.i �1 E. I� 1 N t 79
Name'of Applicant (please. print) '' B'usinesrAddress .. , 'Telephone No.
Name of Contractor and Job.Foreman Business Address Telephone No.
c
,T Contractor's License No. t; City:Business License No. ,
Applicant's Insurance Company : Policy Number
FEES: Subdivision- Improvement'Permit —Class III
_ + 4 -
* ' Public improvements: _3% of estimated' construction costs - 005 Y82 'f 0 '7057- 09-1'7-90 10
Private improvements: 3% of'estimated construction costs' qq E 9TAL' 1 10.00
Minor Improvement Permit — Class IV: See 'attached schedule' rr� • '
Inspection Fee $ PERMIT VALIDATION
Permit Fee` /C% !i 4 083e.
PERMIT,NO.
Pena
CashlDeposit-Surety Bond t ,. DATE APPROVEDx �+'17 � 9�
if'required EXPIRATION DATE 9--90
TOTAL: $ '10,0 O =
% O '
DATE ISSUED q
Receipt No. By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
���Jl � �, .x., � -.y _,�--^' ..: -�- .r., �.--- i"-, _.�-_- ,. _ �. � ..- •, - -._ - .,- .. ..., _ -. ,., __^^ -, _, � � - ., _ ,tet". A-
�,�!°�r'"e'M•�+�"�"+i�+Y.�'Mr.T+"��^bw-�^x4....+.` C+ a► c� w w... .•�.�• r r w r pr r w .a r. Y. r r .r .s .r ws .r .�. r+ r r.. w .rte ,.w .. �. r c.. r .r r..� .� �... « r M� •�
;J
w
NOTE:
Withro er validation
P P
this form constitutes an 1
CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
(ONE TiZIP OVEff-SIZE L0D40 PEIZ IT)
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: 9-I - 90
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit— Class III
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION All E E 0 Q I Fiji E At Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 12Z PJ R.
DIMENSIONOF INSTALLATION OR REMOVAL��
SIZE OF EXCAVATION, IF NEEDED
H.
APPROXIMATE TIME WHEN WORK WILL BEGIN
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:
iAl.l..��a i.
HM111 zt VV �,H IN,61TDN
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 thej result of this work.
Signature of Applicant or Agent
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
0M FILE Cit Fill
Contractor's License No. City Business License No.
6M FILE nAl Fi LF -
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
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.
$ f0' 09 0
Received by Date
00�518�:; 7057 MAL i � U 10.00 0
PERMIT VALIDATION
PERMIT NO. 01�1 ') Z.
DATE APPROVED 9- 7 9C)
EXPIRATION DATE 9 d i S " 90
DATE ISSUE'D�f I? / go
By -
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
TOTE:
Nith proper validation
his form constitutes an
ncroachment permit
, a
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
[)ATE:=1- L Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location) R
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate►
13 U
DESCRIPTION OF CONSTRUCTION w_j -
r\011 n.
DIMEN l0a OF INS �LLATIO OR R OVAL _ae r f\U L" -
\i4
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
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 1241 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 Quints and to pay for any additional. replacement necessary as the result of this work.
evo tngineerin
of Applicant (please print)
Inc.
of Contractor and Job Foreman
License No.
Signature of Applicant or Agent
—811 Country Club, Bermuda Dunes 619-345-1778
"Business Address Telephone No.
Business Address Telephone No.
' L .
City Business License No.
pplicant's Insurance Company Policy Number
EES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit - Class IV: See attached schedule
ction Fee $
it Fee i
natty
ish Deposit -Surety Bond
required
TOTAL: $
No.
ived by Date
rded by
,No
PERMIT VALIDATION
r
PERMIT NO.
DATE APPROVED
EXPIRATION DATE.
DATE ISSUED
By
Administrative Authority-
TELEPHONE:
uthority•TELEPHONE: (619) 564-2246
----------- --------- -------------------- --------------------------
V
-------- ---------- --_VNOTE:
With proper validation
this farm constitutes an CITY OF LA QUINT^ UU
encroachment permit
^P1PLIC^'r10N FC)R P'ERNIIT
IC WtpRKS C0J%16TRUCTION , (ENCROACH ENT)
<_=C:LTMP'-OV EJE`5IZE d.Oi90 14
jpZ:/Z/"T�
Far • the oonatructlon of public or ,private ourbs, driveways. pavements, sidewalks, parking lots, sowers, water mains -
and other like public works Improvements In connection with MINOKI+IMPROVEMENTS and APPROVED -SUBDIVISIONS
9-/ - 91O Subdivision Improvement Permit — Class 111
DATE: Minor Improvement Permit Class IV
LOCATION.OF CONSTRUCTION
(Street address or OosorlpTten of Loeatlon)
PURPOSE OF CONSTRUCTION =r, 0yF-- - �QU e-/1-1 a"-1 Sketch (attach oonetruction plane if appropriate) -
OESCRIPTION OF CONSTRUCTION.1-4A LA L. . TZ41ATW_
OI SI NOF 1 BTALLATION'OR REMOVAL �j'� �� �� Z ��® ��~ Js/41L-� .
SIaB"OP EXCAVATION, IF NEED -EO -
APPROXIMATE TIME WHEN WORK WILL SEWN
APPROXIMATE TIME OF COMPLETION - hlAVWL - OA -1M
ESTIMATEO CONSTRUCTION COST$ '
(Including removal of -all obstructlon. _material*, and debrle, backfilling, cam-
pactlon and Wooing permanent resurfacing and/or replacing Improvements)
In considorstion of the granting of this permit, the applicanthereby agrees. to: ,
Indom nify,.defend and mavo the City. atm euth orlsed- aaoms;effloera, represenlatlygs and emMoy sem, hermleas from and against ony and elf
Penalties. Iiebrrltlom or Joan - result(ng' frem oleins er •court eotlo and' mrtsln(i eu of any Pao tdant, lose 'Or damage to pets... er propo Ry
hopponing Or eaourring as a proximste..re Jx of cny Werk un.1--ko under the permit wanted pursu9nt to this epplloetlon.
Notlfy the Aktimtnlstrative Authority at least twenty-four 124) hours In orlvenve of the 't11ne whom work will be stortad. -
ComplV with elf pp1lcsb1. City Ordlna ncem, the tarns and condltloris of the permit end ell opplt—bl. rules end repulatlons of the Clty -of
Lo c2YinTa and- to pay for any a6clitlona1 roptacemont necessary as the result of This work. p
177$
Name of Contractor and Job Feromen Business Addrase - . Telephone No. -
�1�►
Can tractor's License No. City Business License No. -
_ AM" 1=11_ Ee On/ r P/ LE
Applicant's Insurance Company - _ Polley Number '
"FEES: Subdiylolon Irmproyement Permit — Cleve -I I I
Public iImpr vernei+t s 3% of estimated construction c do costs ,titcie ip 7p Oq 17-90 1O
Privets Improvements: 3% of®etimetad construction costa ,_�jy'�'j' _ �RCJSEL'il �'�jYpL � 1 SO.OQ
Minor improvement Permit — Cleve IV: Sea attached ephedule - '
Inspection Pee S - - PERMIT VA S-Ib/LT*rUu
Permit Fa.. ,
• TRAIVSf� I SS I 0�1 REPCRT '
THIS DOCUMEiVT (REDUCED . SAMPLE
WAS SENT
��k �CQUiVT �k�
# 1
�k�cxc SEND >k��k
ABLOVE)
NO REMOTE STATION I.D.
START TIME
DURATION
#PAGES
COMMENT
T 61.93451778
9-17-90 .4:43PM
TOTAL 0:U1 Ub i
7020
XEROX TELECOPIER