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0881NOTE: With proper validation this 'for m coristitutes an, *' CITY OF LA'QUINTAv $ encroachment permit ,APPLICATION FOR• PERMIT . ;PUBLIC .WORKS: CONSTRUCTION (ENCROACHMENT) o For the, construction'+of public or private curbs, driveways, pavements, sidewalks, parking lots,�sewers' water mains 'and othe"r like• public works improvements in connection with MINORIMPROVEMENTS and APPROVED SUBDIVISIONS' October` 25 '1990 `` * Subdivision] mprovement Permit —'Class I DATE: ;. Minor Improvement Permit Class'IV LOCATION' OF CONSTRUCTION - Ar .,%?00, ?4V karinrna,i h_ -S1,7AS AvPni a JUaLXe2 (Street address.or'Description of Location) drive 'approach ;_ ` PURPOSE OF CONSTRUCTION Sketch (attach construction plans if'appropriate) + DESCRIPTION OF CONSTRUCTION ' ' _ z 'r per':attached Rivers id, e, County Std NO. 207 ` DIMENSION OF INSTALLATION•OR REMOVAL 6 �� • 30' • s! •SIZE OF EXCAVATION; IF NEEDED " i y2 APPROXIMATE TIME WHENyWORK,WILL BEGIN asap APPROXIMATE TIME OF COMPLETION as soon -as, &=p0d:6td Y _ _ '•' ` y t ESTIMATED CONSTRUCTION,COST $ ,(Iricluding`removal of all obstruction,'materials,'and debris, backfilling; com =.paction and placing permanent resurfacing and/or,replacing improvements) ,..; In con sideratioAt n of,the granting of this permit; the': applicant hereby agreesito, 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,,courtaction and arising out of any accident, loss o;.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.Administratrve Authority at least: twenty-fodr'(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 o0La Quinta and to pay for.any additional replacement necessary as the result.-of`this work. r' -� j; • Signature of Applicant or Agent r s. General C0ntract'Man ' Agement,, Michael Bang®ter +PO ..Box• 59'.La Quints 6"4-' 1' • Name of Applicant (please print) �'+! Bus,iness'.Address ` ' Telephone -No' Name of Contractor and Job Foreman. Business Address t ; . - ' Telephone No., ,524325,' i . ": - `;1235 . ,. Contractor's License.No.''F`" f City Business License No. - State Fund kOn file r Applicant's Insurance Company, Policy Number F FEES: Subdivision Improvement,Permit — Class l II . _ • ' j h iQ' 10 Z f • , 4(�i� o Y t 'Pu9lic improvements- 3/0 of estimated, construction costs• GASH??'71 tli AL290 r ,. r' ; ' • . 10.0100 . ; Private improvements: 3%of estimated construction costs • . •,+ 0 .l�+ - ' 08.8. Minor Improvement`Permit — Class IV: See attached schedule •, _ ,;, ` �, ..$ '10.00• Fee , PERMITAONInspection , ,.LIDATI • Permit Fee .; ' y - _ c :,� 0881 f PERMIT NO.; '. �,� Penalty�: 10 25 90 • .. Cash Deposit Surety Bond •>k "' DATE APPROVED f i 1 if required + Ar d .. -• �• t` 12/31/90 ; EXPIRATION DATE TOTAL: $-10.00-,10/25/90. ' ! DATE ISSUE -15- _ 'Receipt No: By Received by Date " +° ,, ! ` Administrative Authority Recorded by TELEPHONE: (619) 564-2246 ^� *F •� e•�+1i-4.�w`+ww-..'.-is'.'�'w.�.:-cJac•ta•V;�?�+'�M'7�i �'•:S: ew tn'.r au ar'd. �.. w.r'. W�' o.' !�. �••r+.a wr e► w� +rr i-C'w .0 N� t r w .. o• d. 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 October 25, 1990 Subdivision Improvement Permit — Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION dr-iyccaav annrna6h 53765 Avenida Juarez (Street address or Description of Location) PURPOSE OF CONSTRUCTION drive appraech Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION per attached Riverside Bounty Std. No. 207 DIMENSION OF INSTALLATION OR REMOVAL 6v x 30, SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN asap APPROXIMATE TIME OF COMPLETION as soon as den>sg *bd ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- pactiom and placing permanent resurfacing and/or replacing improvements) ' In consideration of the granting of this permit, the applicant hereby agrees to -.- Indemnify, -defend oIndemnify,-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. Signature of Applicant or Agent General.Oontract Manggement, Michael Bangeter PO Box 59 La.Quinta 564-1486 Name of Applicant (please pr -int) a Business Address Telephone No. , f i - Name of Contractor. and Job Foreman Business Address Telephone No. 524325- 1235 Contractor's License No. City Business License No. SL -ate Fund on file ' Applicant's Insurance Company Policy Number FEES: Subdivision, Improvement Permit — Class I I I Q i 2 Q� 7797 �-25•-40 Pu6lic improvements: 3%of estimated construction costs 3� . CASH TOTAL S. i0: ©v Private improvements: 3% of estimated construction costs tf� Minor Improvement Permit — Class IV: See'attached schedule Inspection Fee $ 10.00 I) Permit Fee . Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by, 414-•. U051. 1. PERMIT,,VALIDATION - PERMIT NO. Q881 10/25/90 DATE APPROVED EXPIRATION DATE 12/31/90 DATE ISSUED- 10/25/90 By Administrative Authority TELEPHONE: (619) 564-2246 DETACH 'AND'RETAIN THIS STATEMENT ' MICHAEL BANGERTER THE ATTACHED CHECK IS IN PAYMENT OF ITEMS � DESCRIBED BELOW. 'HAZEL PIERCE-MANFRA IF NOT CORRECT PLEASE NOTIFYUS'PROMPTLY.. NO RECEIPT DESIRED. DELUXE FORM -WVC--2 V-2 DATE DESCRIPTION AMOUhrr % NOTE:, - With proper. vaikieWn.- this form Constitutes an encroachment permit' - CITY=.OF' LA OUINTA 'APPLICATION FOR'PERMIT PUBLIC' WORKS.. CONSTRUCTION. {ENCROACHMENT) For the construction of public or 'private curbs, driveways, pavements, sidewalks, parking lots, sewer; wabr rrlai>I and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS'- Subdivision Improvement Permit - Class ill . DATE: l Minor improvement Permit Class IV LOCATION OF CONSTRUCTION �t`,,n-i-r -2 (Street aodress'or Des rtboon of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if approprie%a - DESCRIPTION OF CONSTRUCTION " DIMENSION OF INSTALLATION OR REMOVAL —9-1 Y __Nco� r SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN &AJ &•"k*^"''&= APPROXIMATE TIME OF COMPLETION"' ESTIMATED CONSTRUCTION COST S - 2 1W \� (Including removal of all obstruction, materials, and debris, badkfilHng, com- paction and placing permanent resurfacing and/or replacing improviments) 7 In consideration of the granting of this permit, the applicant, hereby agrees to: ' Indemnify, defend and saw the City, its authorized agents, officers, representatives and emolovees, harmless from and against anv and all penalties, liabilities or loss resulting from claims or court action and arising out ot'any accident, loss or damage to persons•or, property,_, happening or occurring as a proximate result of any, work undertaker 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 tOrdinances: the terms and conditions of the permit and all applicabir rules and regulations of the Clty of La (2uinm and to oav for env -additional replaoerttertr netsaswry as the result of this work. j t1L��yr� L - lG Signature of Applicant or Agent A4 4_2 Name of Aopucant (please print) Business Address Telephone No. Name of Contractor and Job Foreman, Business Address Telephone No. Contractor's License No City Business License No. r— -1 z1nHr�.r Applicant's Insurance Company ` Policy Number , FEES: Subdivision imorovement Permit —Class Ill Public improvements: 39'0 of estimated construction costs Private improvements: 3% of estimated construction costs NO Minor Improvement Permit — Class IV: See attached schedule.' y insoectlon Fee S ; PERMIT VALIDATION r Permit Fee ?E RMIT'dO. Penalty DATE APPROVED' Cash Deposit -Surety Bond if required EXPIRATION DATE T ,TOTAL: $ DATE ISSUED Receipt No. - By Received by Date Administrative Authority Recorded b'v TELEPHONE: (61916"2246