0880'4►:'•-'�5F.6V.�ia,�•�'T�i•.-•t;�'=E,'+rL���` "•�,e.:}K�`,'�.4�`�+.��,,y�y}'itiU'.��r��3w.�+.�?+•,-`�;..-r•."1'.•.e ,ir a..,'``*�•.:r'��'W�7:�'.�a�'+,4:.f>iiY''a,«S>• ✓;s�.�e;s.�
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1 • �i W �' ` 'fes . - Y' � ' � • • `. ,
;NOTE: f �,
•With proper validation - - i rz 2
y 'this form constitutes an _ CITY OF LA QUINTA •l qj�l
•,^ . encroachment'permit a,
APPLICATION FOR''PERMIT.
• G I. �+�'
. ' , • . .PUBLIC WORKS".CONSTRUCTION• •(ENCROACHMENT)
0110F,'fQi�. iovItiZ 12:•1 - ;ys,��.:p�2 `rte' ��'1�0F
f _ _ ,
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 111
DATE' ' 1 .` 190 ' ,Minor Improvement Permit Class IV'
LOCATION OF CONSTRUCTION F�1il>c'•' ` y�� frI- M' y
(Street address or Description of Location) ;, • _; a •• '
It
PURPOSE OF CONSTRUCTION' +O V F �-Mhk 6AA 11= 10T •" Sketch+,(attach construction plans if appropriate) y
`.DESCRIPTION OF CONSTRUCTION 1
DIMENSION OF INSTALLATION OR REMOVAL �, •� 0� .++`�
Ata I:i a `Tp e,.a �T * L• I M I
` .SIZE OF -EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4Q"- L
• APPROXIMATE TIME OF COMPLETION'
• - � a s .
`
ESTIMATE D'CONSTRUCTION COST'$ _
(including removal of all obstruction, materials, and debris; backfilling, comb • �,� r . f ' }
paction and placing .permanent 'resurfacing and/or replacing imprdvements) `!'t;)AL. �+� � t7'_`?- 4 — 9 a '
1.0 In consideration1of•the granting.of this permit, the applicant -hereby agrees -to: +�y' i�t�. `'�':•
r
'I nd&nnify; -defend. and'save the City, its authorized agents, officeis, representatives'and employees;charmless from and against any and all
r 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.
t Notify+the 'Administrative Authority at least twenty-four (24);hours in advance;of,the4time when work will be 'started.. }' •_
+ Coin'ply with, all applicable City; Ordinances, the 'terms and conditions of:the permit and all'applicable rules and regulations of the,City of
'
"La Quirita and to pay for'any additional'�eplacement necessary,as.the result of this work.I +
J, r y� - /i'
< }� • , SigoatuFe of Applica��ntor�r Agent .
Name, o_ f Applicant (please print). Business Address e:, : '� t .'s Telephone No. _
'Name of Contractor and Job Foreman :� ' . Business Address `` • , Telephone No., '..t
14060 9
Contractor's L;icense',No.' amity Business License No.
AIA
'Applicant's Insurance Company.. �,. . Policy Number
Subdivision Improvement Permit- Class',II I •" ` I ., . a t . - ', f } •- {
Public improvements: 3% of estimated construction costs+ , •Di i8Z j, • 777 ,t q0- W,
Private improvements: 3% of estimated'cons•truction costs. • .. s` 10• a- �rA'1AL i _ X0.00
p ,
Minor Improvement Permit Class IV: See attached schedule ; r ' •� 0 58�. +
Inspection Fee $ 0,4. + ' PERMIT VALIDATION'
'.Permit Fee , ,0 S o Q t -
-r -,PERMIT NO. V
Penalty
..'h f. s 9.0DATE APPROVED
Cash Deposit -Surety Bond r , • , D'
if required ti
EXPIRATION -DATE
-a a 1TOTAL:` DATE;IISSUED 10 -Z4 4
,
`
Receipt No' .. _ /�IJI.�: _ i
f• Received by Date By—
Administrative Authority
Recorded by ' - - . TELEPHONE: (619) 564-2246 -
.gXaM.'�4./�+. moi. i#ir !� a.+ r .... ar 6.. it ati fie. w o w moi. r. i� �b +r T s w ra rr ar it ar n:.r.w w. W. ww w +r r M w� ► M. w b n� r w lM
NOTE:
With proper validation ,� Q
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
Subdivision Improvement Permit — Class I II
DATE: 1�? —. Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION /�<1 ' - FFFF-ea0t,,)
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION aZAf'iO E EM1J11'J�2Pk..1 r- 0*T_
DESCRIPTION OF CONSTRUCTION - IL-Vr- A%jR'i`
DIMENSION OF INSTALLATION OR REMOVAL I;1 ern CAL) � � 4
Q o. no f. :
. ,
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME -WHEN WORK WILL BEGIN 1n'" L.`1—g0
Sketch (attach construction plans if appropriate)
HAWS
`rp C% -T -r, to I M I`t"I'`
APPROXIMATE TIME OF COMPLETION j f} ' 2-1,k" Ck 0
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) I qML. --)A-T� 10CIO
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 nd regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this-1work.
Signature of Appli�cann.t��Agent
n C,.. �� { P n,0 c_-rc to a-r'i 0 IPJ �a . �c.�� 34/ �l
Name of Applicant (please print) Business Address Telephone No.
KAIK r iv::�.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
ZEMAIA Cit " ` 91160 /n C_eA
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I 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:
$ 10.00
Receipt No.
Received by Date
Recorded by
n0 o CASH 7i rQTAL i 90 to. p0
1e 0880
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED 90
EXPIRATION DATE f
DATE ISSUED 10 - ZcI { C�
Bye
4 Administrative Authority
TELEPHONE: (619) 564-2246
• t 7 DETACH AND`RETAIN THIS STATEMENT
• JONES BROTHERS CONSTRUCTION CO. THE ATTACHED CHECK IS IN 'PAYMENT OF ITEMS 'DESCRIBED.' BELOW.
IF NOT, CORRECT PLEASE NOTIFY US PROMPTLY.."NO RECEIPT DESIRED.'
1
'
",
► DELUXE FORM WVO-4 'SPL N-7005
JONES `BROTHERS CONST TION. C0.'
r••
P. 0 BOX 905 347-2
SECURITY PAI'_NATIONAL BANK 0
1921-7 ,
'
- .Indio Office #0318
y
COACHELLA, CA~ 92236 .. r
81-710 Highway 111
Indio, CA 92201
Journal Voucher 7A
,
• 16-4/1220
5)
October
24 194
`.
(10 - 15)
c
5 8Y
1..t
(;p
�.,
PAY
0, 0
DOLLARS $.
• '��
City -of "I(:La,Quin.ta;
- �. h r'
DATE AMOUNT
TO
08 • 19)
(20)
(21 - 39) (40-41) (42-45) (46 -53)
(54� 63)
THE j' ! a
;.+ .NN
01'
1
Perinit
ORDER t _ G•. �,
'
02
1
1 ti•
,OF s
a - r
i
CN¢CKDHEIV¢ ROR PAYM¢NT'
TN¢ LEO IN T6' ,.
_ .. ...
1
s
04
1 .
t
05
1
' - 1110 1,9 2 L 711! ®1: L 2 20000 L,34 3 1iR111114,2 G.6A)I°
a!,r
-
06'
1
t,e11> <K PPIITEQP
• t 7 DETACH AND`RETAIN THIS STATEMENT
• JONES BROTHERS CONSTRUCTION CO. THE ATTACHED CHECK IS IN 'PAYMENT OF ITEMS 'DESCRIBED.' BELOW.
IF NOT, CORRECT PLEASE NOTIFY US PROMPTLY.."NO RECEIPT DESIRED.'
1
'
",
► DELUXE FORM WVO-4 'SPL N-7005
'
Company NO.'
(6)
Batch No.
'^
Journal Voucher 7A
5)
(7 • y)
(10 - 15)
c
5 8Y
1..t
(;p
Page Of
Pages
Description ' ` DIv. Dept: t, 'Account
ReferenceAmount
(16 • 17)
08 • 19)
(20)
(21 - 39) (40-41) (42-45) (46 -53)
(54� 63)
I (64,- 74)'
01'
1
Perinit
02
1
1 ti•
i
03
1
s
04
1 .
t
05
1
06'
1
F
',
08
1
r
X
r 09
1
o
}
10 •
1
CASH ACCOUNT r
( )
14-7005.
.-r ;`
.•
e
�
JONES BROTHERS CONSTRUCTION CO.DETACH-AND -RETAIN THIS STATEMENT
T ,ACHED "CHECK IS IN PAYMENT OF ITEMS DESCRIBED
_ - IW CORRECT PLEASE NOTIFY US PROMPTLY. NO RECEIPT DWD.
DELUXE FORM WVO-4 SPL N-7005
Company No. (6) Batch No.
(1) 2 -5) (7 -9)
G 5811 1
Page Of Pages Description Div. Dept. Account
(16-17) (18 - 19) (20) (21-39) (40-41) (42-45) (46-53)
01 1 Permit -
02 1
03
1
04
1
05
1
06
1 _
07
1
08
1
09
1
10
1 1,CASH ACCOUNT
N-7005
_ Journal Voucher, it
(10-15) .
CD -
Reference Amount -
(54-63) (64 - 74)`
i
4
tl .
NOTE: {
With proper-validatiwn ,
this form constitutes an CITY OF LA aUINTA
encroachrrient permit
APPLICATION' FOR".PERMIT '
PUBLIC .WORKS- CONSTRUCTION. (ENCROACHMENT)- • ,
For the construction of: public :or private. curbs, driveways,, pavements; sidewalks, parking lots; sewers,, vvattar";byq�,;;
and other like public works-improvements•in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS'-
.
t
Subdivision Improvement Permit — Class 111
DATE: �� V b _ Minor improvement Permit Class.IV
LOCATION OF CONSTRUCTION.- 152 0 F,e'er d A
(streat addtassor Oaaamoon of Location)
PURPOSE OF CONSTRUCTION _ Sketch ►attach construction pians if approIxis
►j� �
OM
PTION OF CONSTRUCTION ,� 3`qI1OS.
DIMENSION OF INSTALLATION OR REMOVAL
ICA
SIZE OF.. EXCAVATION, IF NEEDED,.
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTI MATEO- CONSTRUCTION COST $
(including removal of all obstruction, materials, and debris, ba 4(filfing, come
paction and placing permanent resurfacing and/or 'replacing improvements) F
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 anv and all
Penalties. liabilities. or loss( resulting from claims or court action and arising out of any accident, loss or damage to persona or property,.
happening or occurring as a proximate resuit.of any -work undertakerrunder•thel permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four124) hours in-advance,of the time whin work wdi-be parted.
Comply with all applicable City'Ordinences, the terms and conditiorn.of permit and I applicable rules and regulations of the City of
La Quints and to pay -for any additional replacement neeessan as the It of this.wo
a ature of Applicant or Agent h-
CdA) f, O C
Name of Aopucant (please orrint)• Business Address Telephone No.,
,V21 A
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business, License No.
A2 1W 6 Fj S 610 CCA
Aoplicant's Insurance Company Policy Number
FEES: Subdivision Imorovement Permit —Class III
Public improvements: 39:0 of estimated construction costs r'
Private improvements: 3% of estimated construction costs "
O
Minor Imorovement Permit — Class IV: See attached schedule _
insoectlon Fee ,;S 1 PERMIT VALIDATION
Permit Fee ~ ` PERMIT ?;0.
Penalty
DATE APPROVED
Cash Deposit -Surety Bond
I '
if required EXPIRATION DATE
TOTAL: $ DATE ISSUED
Receipt No. By
Received by Date • ' Administratnre Authority
Recorded by TELEPHONE: 1819) 5842246 , -