0899,
..+.+.a.s+rYi�:aWi+Ml: r.-ar-w...+. ..F .:1� �..""'-.��. r. � W.. ...-wa.�.-r..�.....r-.w..w....� ►+.:
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA OUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
`CONF- T9)P VI/E 5fZE .1 -DAD' AEEMIT)
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 II I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or l escPiption of Location)
i'UIDU� CtaLAIP.
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION I �n HALAL 201ATE: t
�5 Z W /b TD WAS 1+ 1 M&7dlu
N o 2T H 7D 4 1J I I I TO kA I L -ES
DIMENSION OF. INSTALLATION OR REMOVAL ��� TO.
G►—ry L I /�/I ITS
lOf In" VJ 133, SOO LRS
SIZE OF EXCAVATION, IF NEEDED
005182CASHSi4 OTALO1-90 i0.vvy
APPROXIMATE TIME WHEN WORK WILL BEGIN
'APPROXIMATE TIME OF COMPLETION r
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 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 ApIicantLOr Agent
UEVO E A)6 NEE 9 M& �31LI S -1775
Name of Applicant (please print) Business Address Telephone No. c,
F1CVJUI .TZUCJkl/V67
Name of Contractor and Job Foreman Business Address Telephone No.
ON F1LF
Contractor's License No: City Business License No.
6A) ' RLQ DAJ F11 E
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule ii V" . ® 8 99
Inspection Fee $
Permit Fee* zo - o 0
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ /0• 0 O
Receipt No.
Received by
Recorded by
Date
PERMIT VALIDATION
PERMIT NO. �� 9
DATE APPROVED 11-6-90
?� 9
EXPIRATION DATE / 1r 9Q 0
DATE ISSUED. / o
`Administrative Authority
TELEPHONE: (619) 564-2246
. . . _ �-�f.-Mr o +A 5�' "W �..r � +w. 6� �F`lFtl?.-tih^. M.M Cn r-��Lf 15f-�+i � /�•t�• �rtY !!r-hti^r.' w+ .1�. �n.w^�a. �r"�. rr� � �Y to .w. MI.- w-�►•M. M
a
NOTE
With proper validation '
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
~ PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
Y (0/t1iE TEtP OVire5lZr LU141- -eMIT)
For tlie, 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
) 1-
-7 _•• q 0 Subdivision Improvement Permit — Class I I I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION ID 0i u IF.
DESCRIPTION OF CONSTRUCTION I Lo 6 -
DIMENSION
DIMENSION OF INSTALLATION OR REMOVAL i V& & t 14
)01!o11W 93, OO LPk, C--,
Sketch (attach construction plans If appropriate)
HAUL 12 o m. TE
Z_ 7D wA'1,14 I U670AJ
U 0 Rl i -TO 0 IkYr 1 r! TO M 11...E
/ . TO CTTV y L.IM ITS
SIZE OF EXCAVATION, IF NEEDED f
008182C12Fl80%i �-07�-'90 i0.v�4
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 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.
01 Ixe
Signature of Applicant�gr Agent
KRAEVO EM61AEFEIN& x'-145 --17-78
Name of Applicant (please print) Business Address Telephone No.
PIC Obi T9 C9%Ill&7
Name of Contractor and Job Foreman Business Address Telephone No.
C?tU F"1 L C
Contractor's License No. City Business License No.
,6 A) R1 F_ LD AJ F / 1.. E
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 3
Inspection Fee $
Permit Fee o tai
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ /0� 0 0
Receipt No.
Received by
Date
PERMIT VALIDATION
PERMIT NO. 099.2
DATE APPROVED �t%
EXPIRATION DATE JL L. 90
DATE ISSUED
By YZ-2-7
Administrative Authority
Recorded by 111 TELEPHONE: (619) 564-2246
TOTE:
lith proper validation
itis form constitutes an
ncroachment permot
_91
1
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
I Subdivision Improvement Permit — Class III
)ATE: () Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
Street address or Description of Location) '
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATI23,
N OR REMOVAL 11 ' ( o u
_...1.()_W'! 1ti1. E-�.�1'.ss
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
Sketch (attach construction plans if appropriate)
k
0.1UND
(Including removal of all obstruction, materials, and deb.. --is, 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 Ouinta and to pay for any additional replacement necessary as the result of this work.
Nuevo Enl;ineerin�
me of Applicant (please print)
me of Conti
ctor
ntra's L
Inc. 79-811 Country Club, Bermuda Dunes 619-345-1778
and Job Foreman
No.
Business Address
Telephone No.
Business Address elephone No.
City Business LicenWNO• _
14pplicanvs Insurance Company Policy Number
Subdivision Improvement Permit —Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor lmprovement Permit'— Class IV: See attached schedule
ion Fee $
Fee _
Ish Deposit -Surety Bond
required
TOTAL:
eceipt No.
by Date
by
T VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246