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0898• .• , yy..� f,•,.,.,, -.�.r � '.� .c.-a� w..:wr. �w_.r•u, �.sw.-M_.bl�_l+ r V .•'Y� �'i. '. -._ - � .. r: -.+._W. Ma NOTE: r Q ' With proper validation � , ' • 4 this formconstitutes ani�� 'encroachment permit .1•' . CITY OF LA QUINTA + y APPLICATION FOR. PERMIT -- PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) . _(DI)E. TR)P .0.UER51ZE LOAD' PEkMJT) 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 III DATE: ) �! q O. Minor Improvement Permit Class IV . LOCATION OF CONSTRUCTION- . - •• .4 ��. t � • d (Street address or Descriptionof Location) ,-PURPOSE OF,.CONSTRUCTION`' �o1iE G( Ui)PM EUSketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION'> f32�-1 R! IA1. ROtJti ASIS 52° 'U -)l5 LOASl+IOGTON ' .."DIMENSION OF•INSTALLATION OR REMOVAL .I _2 14 F)% q �� w �+��� g /�����,�1 L��/�S BAST a'k "1 1) 6 �/iJ 1.PJ S t 1 O l_' I 1 Y L) AA � T � ryg 07-90 'SJZE OF EXCAVATION, I'F NEEDED. - '10051 )A��I 80 TOTAL i iG.vv AAPPROXIMATE.TIME,WHEN WORK WILL BEGIN 4-1 _ N Am- . ATG 41- e, 9 D APPROXIMATE;; TIME'OF'COMP.LETION ' ESTIMATED'CONSTRUCTION COST+$ ` (Includmg.removal,of all ob'str`uction, materials; and debris, backfilling, com .' paction and placing permanent resurfacing and/or'replacing improvements) _ •,.I n cbnsid`eration 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. .H • �. !Notify the 'Administrative Authority at least 'twenty-four (24) hours'in advance of the time when work will be started. 's �, v v'.' r. - .. ~' •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,rfor any additional replacement necessary as the result of this. work. 74, •Signature of Applicant or Agent -,'II:UiAF-VD,`� EKk,IKYEER)0b ` a* F� %IMIADA 1>ir����S s'/778 r Name of Applicant (please `print):, Business Address Telephone No. C, X Name of Contractor and'JoLi Foreman �` r Business Address.. Telephone No, ,. OJT -"FILE. {.. DAJ F/LE ' Contractor's License No.; • t '' '• 'City Business License No. IJV .'FIL'E ; x, L FILE 'Applicant's Insurahce'Company' •'-'K �� Policy Number FEES: Subdivision Improvement Permit — Class 'Ill ' Public improvements`: 3% of estimated construction costs :# , Private improvements: 3% of estimated construction costs a �T 0t Minor Improvement Permit —Class IV: See attached schedule . e Inspection Fee $ II Permit Fee J0. 00 Penalty Cash Deposit -Surety Bond' if required TOTAL: $ ID DD Receipt No. 'Received by Date Recorded by PERMIT VALIDATION PERMIT NO'— 'DATE O' 'DATE APPROVED II 7- 90, EXPIRATION DATE 0 rC16 DATE IS UED By U Administrative. Authority TELEPHONE: (619) 564-2246 4.iW �.7 r .[f�, .rR... h's+riai.e y,,'G,"�sr:w'l'''4•'r-7``:ys,+:i�ye. �r�'!�-:`?1 `�-.1-�a.r'�F.".3�ryjt-:;ani:+.«',r^r'—.-j+,'„j'=;•�'L'i.''a�',«:+%i�.7" �r;•v, ,�%'�'��;� a`^" •'fib"`�.` 5 `K�'r' �� _ . • nva.,-Ma .+. �V �w'tr'..� Ar "..w+r. ar. W l�e`�9n•..✓ �u..q�-.�.. w..ry.,, l:.�9• Pt A M �.+r- ..`��'.M_►.o. �+a r wr..,.a� ..-w. r..n.+•v �, r- we .� ....wti-�.... w a ye NOTE With proper validation- this alidation 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, parkinglots,- sewers,, water mains and other like public works improvements in connection with MINOWIMPROVEMENTS and APPROVED SUBDIVISIONS -7 _ U 0 Subdivision Improvement Permit Class 111 -DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) ° PURPOSE OF CONSTRUCTION' E0 LAI PMEU T Sketch (attach construction plans if appropriate)', DESCRIPTION OF, CONSTRUCTION 4321 %yR�LATE f Alt 5 Z: W15 WA5ff I OGTON DIMENSION OF INSTALLATION ORREMOVAL' I �, I3' `�'a 6 TO M1 L[ CA`> T ' `TO ' CiTV L.)M.ITS SIZE OF EXCAVATION, IF NEEDED � ^� i V_90 "0' iA `uA _ sc.U� APPROXIMATE TIME'WHEN WORK WILL BEGIN ' ,. , r �1ai�l. DA i APPROXIMATE TIME OF COMPLETION 'E STIMATE D CONSTRUCTION COST $ r (Including removal of all obstruction,, materials, and debris, backfilling, com, . .and/or., Z-5 —011 Ik ) Paction and Placing Pemanent resurfacing re lacingimprovements), In consideration of the granting of this permit, the applicant hereby agrees to: s r Indemnify,•clefe4and 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 ? 'happeningor occurring as a proximate result of any work undertaken under the permit granted pursuant to this application. . r Notify' the, Administrative,Authority at least, twenty-four (24) hours in advance of the_timewhen work will be started. Comply'with 'al l'a,pplicable City Ordinances,- the terms and conditions of the permit and all applicable pules and regulations of the C4,of ' �La,Quinta and to pay for any additional replacement necessary as the result of this work. +•i Signature of ApUca+r Agent tLJ LAI✓V©-EfJGfMEF-R)QC-7 sK/�li�li/f1 /J7/�/ Name of Applicant (please print),; .. i Business Address , Telephone No. - Name of Contractor and Job Foreman Business Address Telephone No. - O. J BILE CIA) TILS Contractor's License No: ' City Business License'No. • J F1 L ' - OA% � l L (D A Applicant's'Insurance Company . Policy Number FEES: Subdivision Improvement Permit -•Class III t• .' Public improvements: 3% of estimated construction costs - - Private improvements: 3%•of estimated construction costs - ''.Minor Improvement Permit— Class IV: See attached schedule _ ��" 0 S. 1 Permit +Fee. W IU .0 Penalty - Cash Deposit -Surety Bond if required TOTAL:. $ I Q QQ Receipt No: Received by Date Recorded by r PERMIT N0. d ' DATE APPROVED 90` ' EXPIRATION DATE DATE ISSUED H- 7 W 1 By " t Administrative'Authority - t TELEPHONE: (619) 564-2246r .. 4OTE: Nith proper validation :his form constitutes an .ncroachn�ent 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 Subdivision Improvement Permit — Class III DATE:Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION IStieet address or Description of Location) PURPOSE OF CONSTRUCTION- Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION1� DIMENSION OF INSTALLATION OR REMOVAL s. _ SIZE OF EXCAVATION, IF NEEDED `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: p5a Aj-hi M I IP -5; I's 6-n rk I f5 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. §ignature.ofLAppOcant or Agent Nuevo Engineering, Inc. 79-811 Country Club,.Bermuda Dunes 619-345-1778 Name of Applicant (please print) Business Address Telephone No. of Contractor and Job Foreman No. Business Address// Telephone No. is" �-+ ZQ City Business Licerysq No. jAppliWnt's Insurance Company Policy Number EES: 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 spection Fee !rmit Fee ,natty ish Deposit -Surety Bond required TOTAL: eceipt No. eceived by Date by ` N� 0�98� DATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By TELEPHONE: (619) 564.2246 Administrative Authority