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0862NOTE: With proper validation this form constitutes an encroachment permit :,'W WF.W34'+'Yj7.'W.iy..-. :WL'is4+M.;L-+' urw%4�3}�J�M-f"-M.�M,�ts'r-�1W r«w. i:W FW L.a '.:a Ns: ieP fir. T+"�':r. �N w�M1:(gwt�wM�cy4 a.�+r�i p ..� .► r�.1�w- w 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 - October 8, ' 1990 Subdivision Improvement Permit — Class II I DATE:. Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 547960 Awmi,018 Diaz (Street address or Description of Location) PURPOSE OF CONSTRUCTION driVG way Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION saw- out DIMENSION OF INSTALLATION OR REMOVALy 1 Dei attached plan SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 1-0/9 190 APPROXIMATE TIME OF COMPLETION atr�t ESTIMATED CONSTRUCTION COST $ 400.00 (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 permi.t 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;!i" b Signature ofzApplicant or Agent Jr-irUmn Ryan Const. Co PC Eos, 130110 4alm D000rt 560-5000 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Fst�7� on file Contractor's License No. City Business License No. k7erry ,Young on fila 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 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $_I() -()O 'Receipt No. Received by Date 0Q ii32CA�°H AT07AL°13-90 W I - so.00 PERMIT VALIDATION PERMIT NO. 0862 DATE APPROVED 10/8/90 EXPIRATION DATE 10/x/90 DATE ISSUED / 10/8/90 `/ Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE: With proper validation this form constitutes an encroachment permit Tye � F • 4m p. fi+. !+'�r r�A .4s� r.Y`.N..O '.iY„► �i.: i1 fir. �►. r dor • .Y 1W ,C. 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IY� W Y. .W '� � W VV••- M �M •.NiC'Of'IM•M 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 s' A.t. , , October 8, 1990 Subdivision Improvement Permit — Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 54-960 Avenida Diaz K (Street address.or•Description of Location) PURPOSE OF CONSTRUCTION driveway Sketch (attach construction plans if appropriate) DESCRIPTN OF CONSTRUCTION saw cut IO DIMENSION OF INSTALLATION OR REMOVAL 45 1t see attached plan SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 10/9%90 APPROXIMATE TIME OF COMPLETION 5 days ESTIMATED CONSTRUCTION COST $ 400.00 (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. f 1 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 th s work% j Signature of%'Applicant or -Agent Jamas Rue Const. Co PO Box 13810 Zalm Desert 568-5000. Name of Applicant (please print) Business Address Telephone No. j Name of Contractor and Job Foreman Business Address Telephone No. 44.2-764' on file 'Contractor's License No. City Business License No. J6rry Young on file Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I U®.5i8U 744 0._U8_•�?q iQ Public improvements: 3% of estimated construction costs i0 GA. °I~! i' fO�IL i i0.00 Private improvements: 3% of estimated construction costs ` Minor Improvement Permit —Class IV: See attached schedule Ns 0862 Inspection Fee $ Permit Fee 10.00 Penalty -/Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by ' I PERMIT VALIDATION PERMIT NO. 0862 DATE APPROVED 10/8/90 EXPIRATION DATE 10/10/90 DATE ISSUED- 110/8/90 By A J Administrative Authority TELEPHONE: (619) 564-2246 NOTE: 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 ntairt: and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS'" DATE: LOCATION OF CONSTRUCTION (Street address or Description of Loation) , PURPOSE OF CONSTRUCTION Subdivision Improvement Permit —Class III Minor Improvement Permit Class IV A—Z ♦ _ _ ,. DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL®�— SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN O Sketch lattach construction plans if appioptiata)y APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COSTS (Including removal of all obstruction, materials, and debris, ba_Icfilling, com- paction and placing permanent resurfacing and/or replacing improvementsi 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 amd all penalties. liabilities .or loss resulting from claims or court action and arising out, of any accident, loss or damage to persons or propanv - 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•Ouinta and to pay for any additional replacement necessary as the result of this work. Name of Applicant (please print) Sionature of Aoolicant or Aaent Business Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. s Aoplicant'VTnsuratT a CompTny Policy Number x FEES: Subdivision Improvement Permit —Class III Public improvements:. 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor ImorovementPermit Class IV: See attached schedule Insoecuon Fee S Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ Receipt No.. Received by Date Recorded by N° PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (619) 664-2248 .