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0896i NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) CNE'TRIP OVERSIZE LOAD 'PERMIT' 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: �� q�• Subdivision Improvement Permit — Class I I Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of. Location) PURPOSE OF CONSTRUCTION M OV E EOU) PM E:I+`IT Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION &'Z 5 E5 DIMENSION OF INSTALLATION OR REMOVAL MAUL ko(ATE �52. t,J1 �tis+��PJC�Tv i 4goO SIZE OF EXCAVATION,`IF NEEDED Gi0�'g�GASkl�iALG7r94 fG.J4 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 (24) hours in advanceof 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 ofUApplicant or Agent' ((/_ 7-7g MEVD ENCS1111EEKI Alfa 7q - (911 CODUTRY CLUES _3HRJ [Ak DU)f+,1I~5 Name of Applicant (please print) Business Address Telephone No. PI60k) I 7k CK) .UC1 - Name of Contractor and Job Foreman Business Address Telephone No. t: 6A) FILE Contractor's License No. City Business License,No. DAI FILE 0Al ' FI L E Applicant's Insurance Company Policy Number r FEES: Subdivision Improvement Permit — Class I I I Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs 1'V 0 1 Minor Improvement Permit —Class IV: See attached schedule ®� � '' Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10. OD Receipt No. Received by Date PERMIT VALIDATION PERMIT NO. DATE APPROVED I J' % ` qO EXPIRATION DATE DATE ISSUED //-7-90 By. .! Administrative Authority Recorded by TELEPHONE: (619) 564-2246 -' —: ,"p-tv m -t. a ri-1• ' ia" � ^; ?'ice 'z: r.K"..As.�„�, ! a ir..► 'r+.,"c' S� ":`�3 : `., 'ry i;`:^ r"'s'i"�"+`.•�+`a:l �si-Ga'�',..�±�,t.`L�rr-.e\- �;',{�►%'•'ys'� y`• `,x'`'�r"!J�' ` ..^ '.�' �.�j., '1j�`-.-_.. s �'`1t :.fi.w.' ,a►`MY r 6 4�—iYB:•�+..e �i..@.r •w..� 7_ I!4 M:.. -waw �.I�. �•' Rh T.w�--�f•Olt'..�.. .w �..�, wyw- � •�r •� ^�� - t .. - f - , III NOTE: i With proper. validation this form constitutes an CITY -OF LA QUINTA encroachment permit, _ ' 'APPLICATION FOR PERMIT $ PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)c '"�nps�4ti TRW 'OVERSIZE LOAD PERMIT), 0 For the construction of public or private curbs,,dr`iveways,'pavements,- sidewalks, parking lots, sewers, water, mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS _ Y Subdivision Improvement Permit ' Class III DATE: 1 1- -7 ap Minor Improvement Permit Class IV x LOCATION OF CONSTRUCTION ` (Street address or Description of Location) PURPOSE OF CONSTRUCTION MOVE E&A I PtM EMT Sketch (attach'construction plans if appropriate) DESCRIPTION OF. CONSTRUCTION �nZ•3, 5 14AUL 1< E• 14"K 12W 11D:000 LF5C-7 --2 j ; u,-)/��# 1NC-r`Tati, , - "DIMENSION OF INSTALLATION OR'REMOVAL ' .. � 0?�J.82Cio ASHSiQTf1 L�iM9© •+ SIZE F EXCAVATION 'IF NEEDED f SI O , ,APPROXIMATE TIME WHEN WORK WILL BEGIN 'APPROXIMATE TIME OF.COMPLETION ` ' - ESTIMATED CONSTRUCTION'COST.$ "4 f (Including removal of all''oibstruction,,materials, and debris, backfilling, com- _ •' paction and placingypermanent resurfacing and/or replacing improvements) In 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 sunder 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.' t Comply.,6th.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. , ,_l , _ , • ;• }; Jt' h + ,t . ♦,• \, r i \ A 1.1 fY", I f • r, - „ Signature ofLppligant or Agent' /, i - �%'%8 cV -. N LA F_V0 : F :'VGA I tV J JU�y 7� - l t lJ `f .L. l �_:::� sal l 1 A DIA M S Name of,Applicant,$lease print)' Business Address Telephone No. PiCOM V, 72 toCKlU& , Name of Contractor and Jots Foreman •' , Business Address .Telephone No. r 6A1 FIL F Contractor's.License No. T City Business License;No. Applicant's Insurance'Company, Policy Number ' a • FEES:` Subdivision Improvement Permit— Class III • • Public improvements: 3% of estimated construction,costs Private improvements: 3% of estimated construction costs Minor Iniorovemerit Permit — Class IV: See attached schedule® Inspection Fee $ �� PERMIT VALIDATION . , Permit Fee PERMIT NO. . Penalty ' �':..� Cash Deposit -Surety Bond DATE APPROVED ' if required EXPIRATION DATE TOTAL: $ 10. o ` , 1 / -7 9 0 y.. - DATE ISSUED , Receipt No. --�/_ �• � By 'Received by Date V` Ad min istrative,Authority Recorded by TELEPHONE: (619).564-2246 t OTE: lith proper validation tis form constitutes an ncroachment 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 mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS jj Subdivision Improvement Permit — Class 111 )ATE: J..� I /i / _ Minor Improvement Permit Class IV .00ATION OF CONSTRUCTION Street address or Description of location)�- 'URPOSE OF CONSTRUCTION WOW A211 I.1'�-�:�.: .— Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 0 2) 69 0 VP DIMENSION OF INSTALLATION OR REMOVAL _ SIZE OF EXCAVATION, IF NEEDED �U U APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION I 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. l f /N — C -- - evo.Engineering, Inc. of Applicant (please print) of Contractor and Job Foreman actor's License No. Signature 0 ApOj )-811. Country Club Business Address . t or Agent Bermuda Dunes 619-345-1778 Telephone No. Business Address Telephone.No. City Business License No: 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 n Fee $ II it Fee sh Deposit -Surety Bond } required TOTAL: , $ No. I by A by Date PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (6191564'-2246