0858r
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` With proper'validation'-
`11� 4•thls form''constitutes an
r CITY :OF •LA QUINTA
;'.encroachment permit .. ;
APPLICATION ' FOR PERMIT - $
:, ► . + PUBLIC WORKS 'CONSTRUCTION '(ENCROACHMENT)
0 OF
,. c• 3• '� I f.1 tot ••s � ..� •� _ ;
For the construction of public or' private' curbs -.driveways, pavements;, sidewalks, parkilots, sewers,'water,mains '
,and other like public works•.improvements in connection with MINOR;IMPROVEMENTS and APPROVED'SUBDIVISIONS * #
A.
'Subdivision Improvement Permit — Class III
DATE: ? �—� -Q�+ , �ti J Minor Improvement Permit Class IV
:
LOCATION OF CONSTRUCTION- - t—A TO 'n:,,.•'.t T a... r c•a... ,.t mte+ '0)Ar-
(Street address or; Description of Location) ' ' • fi l "'
• �r
<PURPOSE OF CONSTRUCTION xfl'yid8 f8� li f stn• x1E?WSketchj(attach construction plans if appropriate)
Y tract • t
DESCRIPTION,OF CONSTRUCTION
within'r Crht of way
DIMENSION,OF INSTALLATION OR, REMOVAL" r
Y
SIZE`OF EXCAVATION,'IF NEEDED '
,•~ APPROXIMATE,TIME.WHEN WORK WILL BEGIN " asan• "_1 . '�•
„•- ,APPROXIMATE -TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $, -
`�; * (Including,removal of,`all obstruction, materials,''and debris, backfilling; com= +� ;
.pactiori,and placing.permanent: resurf acing, and/or replacing improvements)
In consideration of�'the grantiyn�g of this*'permit, the applicant-�he`reby'agrees to: .Y `
+,�indemnify defend and save•the City, its authorized agents, officers", represen`tatives and employees, harmless from and'against any and all ,
penalties,'liabilifies 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 gran1.ted -pursuant to this application. t I
' * Notify the Administrative Authority at ;least twenty-four (24) hours in'advance of the time 'when'work will be'started'
rd - Comply with all, applicable. City Ordinances, the.terms and conditionsof the permit and all applicable rules and regulations'of the City of
'' r '•LalQuinta and to'paysforrany�radditional replacement necessary as the result of, his work. + , d
s �•. ` i T• Signature o Applicant or Agent • w
.,, General.Telephonr Campanv 83 793L005' Blvd. Indio Ca. .343'-05.35
.Name of Applicant (please print)-'* ' 1.L,, • -. t ,Business AddressTelephone'No. '
- Wil-iiaMi S De*elop*-ritd--Corp 42'•-.6Q0-'d0i0k'�St-: 'St® •1,35• Palm. Desdrt CA` '
Business Address.. Telephone,No.
Name of,Contractor and Job.Foreman{
• on file •'� ,- `
Contractor's License No. ' :'� City Business License
. No.
`tai •_ ,, .r. 1 a
Applicant's Insurance Company 4r r Policy Number
a r L sy 4
•.'FEES: Subdivision Improvement Permit — Class III
•Public improvements: 3% of estimated construction costs
`Private improvements:43% of estimated construction costs . • }
y Minor,lmprovement Permit ` Class 1V: See attached schedule "' �� Q4� � � � �• "��
< t
I ,
Inspection Fees, $• .r0" 'PERMIT VALIDATION' ti
Permit Fee'
PERMIT NO.
Penalty 10-2-90
Cash Deposit -Surety Bond r DATE APPROVED
" if required EXPIRATION DATE 12-.31-90
TOTAL: $
Receipt No;
Received by Date'
Recorded by
, 1U-3—yU
DATE ISSUED'
By
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: 1 n--n--on
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 11+ 1 w;M- r -•
Slip �__�-^^
-o .
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION provide facilities in new Sketch (attach construction plans if appropriate)
tract _
DESCRIPTION OF CONSTRUCTIONxac,�
within rxrxht of wav
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN asap
APPROXIMATE TIME OF COMPLETION 10-30-90
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.
J
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 Quints and to pay for any additional replacement necessary as the result of
of this work. f
Signature of`Applicant or Agent �-
General Telephone Company 83-793 Dr. Carreon Blvd' Indio Ca 248-0535
Name of Applicant (please print) � Business Address Telephone No.
Williams Detelopment Corp 42-600 Cook St. Ste . 135 Palm Desert CA
Name of Contractor and Job Foreman Business Address Telephone No.
r,.n f i 1 ra
Contractor's License No.
on file
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I + a
0 '
Public Improvements: 3/0 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:
$ -0-
Receipt No.
Received by Date
*'S 0850
-,"i,
PERMIT VALIDATION
Imo(' c
PERMIT NO. 0858
10-2-90
DATE APPROVED
12-31-90
EXPIRATION DATE
4U—J— v
DATE ISSUED
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
City of La Quuitg
APR 04 1991
PERMITJ\10.,
0858
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WORK ORDER:-
549
—71791.
4 ' PUBIJC WORKS
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78-10 5 Calle 'Estado
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NOTICE Or' WORE: ORDER START
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WORK ON - P F_.RM I T NO. 0858 H05, J UST BEGUN.
ON •,08-/.:,
AT . ADDRESS e , ,C / 0 FRED' WAFTING. & , ADAMS
PERMITTEE REF'RESENTAT I VE . *IC1 C ,;',C'AL I FORN I A
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(714) 794-97�6
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7,8-105 Calle ;Estado
Lei �QUi. rri a, -CA 9225'
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Gentelman,
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Please 'i_s'aue RIDER to s:t�nd the�•e::piraL * date
for the fol Iow.1ng-
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perilll.tnas a#0858
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AT 'ADDRESS.- C/O,.FRED WARING & ADAMS
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WORk''-ORDEF. 549 -71791
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NEW -EXPIRATION' DATE. 06/� 0 91
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TH k:: YOU,
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EPARTMENT
DEPARTMENT-
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