0918x.
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NOTE: ;
,With proper validation / Q
•'`� s'form.constitutes'an,
r+ CITY -OF L'A.
•encroachment permit OUINTA
" APPLICATION FOR PERMIT
�.
PUBLIC,WORKS CONSTRUCTION (ENCROACHMENT)
z ,• 0 TH$9wS'
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: •11-16-90 r Minor'.l'mprovement Permit Class IV
LOCATION OF;CONSTRUCTION
'(Street address or Description of Location) ¢ '
PURPOSE OF CONSTRUCTION Sketch (attach constru'c'tion plans if appropriate)
DESCRIPTION OF CONSTRUCTION
' •: AVE FERNANDO TO'EISENHOWER TO
DIMENSION OF INSTALLATION OR REMOVAL WASHINGTON TO' `111'
SIZE OF EXCAVATIONJF NEEDED 1_l i."R"• W -VA" 7.1! H
HAUL,DATE: 11-19-90.
APPROXIMATE TIME WHEN WORK -WILL BEGIN. - --r • .
i. 11=19—�3t1
ONE,. OVERSIZE TRIP .ONLY
APPROXIMATE TIME OF..COMPLETION
ESTIMATED'CONSTRUCTION COST $; DO' NOT - MOVE BEFORE 7 : 00AH
t(Including,removal of all obstruction,` materials, and debris, backfilling,
4
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 authorizedagents, 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
."� - a
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.
t Comply with all applicable City, Ordinances, the terms and conditions 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.
r • ��, ,. $ignatu`re of Applicant or Agerit�7
SCHWAB SALES,:
Name of Applicant (please print) BusinessAddressV Telephone No...
Name of Contractor and'Job Foreman Business Address r Telephone No.
ON .FILE y .. .. ON OFILE '
Contractor's License,No_. r "CityBusi6ess License -No.
Applicant's Insurance Company. *. Policy Number'
FEES: Subdiyision'improyement Permit = Class III
Public mproverrients: 3% of estirnated construction,costsv
+ • *Private improvements: 3% of estimated construction costs �`
Minor;lmprovement Permit - Class IV:See attached schedule lei` w 9 ?
:
Inspection Fee $ , ' y. PERMIT VALIDATION -
Permit Fee --in-nn PERMIT NO. 0918 ;
' Penalty
Cash. Deposit Surety Bond • DATE APPROVED._' 11-16-90
if required• EXPIRATfON"DATE` � 1 .1—,)A—art
TOTAL: $ .10.00. l' ' _ V v
_ . DATE ISSUD /1 1(11 r,—Qn
Receipt No. T. R%/
Received by Date i f �`'�Ad`ministrative Authority ,
• Recorded by TELEPHONE: (6 19) 564-2246 ry
F
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NOTE:
With proper validation
4 2
this form constitutes an
CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
s;Q
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: 11-16-90 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
q2Q,jj—t6-90 14
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION.
DESCRIPTION OF CONSTRUCTION '
DIMENSION OF INSTALLATION OR REMOVAL
-691. fi('RAPF.R
Sketch (attach construction plans if appropriate)
AVE FERNANDO TO EISENHOWER TO
WASHINGTON TO 111
SIZE OF EXCAVATION, IF NEEDED 11,12811 W 14121 H
871 T, HAUL, DATE: 11-19-90
APPROXIMATE TIME WHEN WORK WILL BEGIN
11-1.9-90 ONE OVERSIZE TRIP ONLY
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ DO NOT MOVE BEFORE 7: OOAE
(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.
NotifNthe 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
SCHWAB SALES
Name of Applicant (please,,print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
ON. FILE ON FILE
Contractor's License No. City Business License No.
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 costs09
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
NOTAL' $ 10.00
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 0910
DATE APPROVED 11-16-9.0
EXPIRATION -DATE i fin—aA
DATE ISSUED e 1 90
» Administrative Authority
TELEPHONE: (619) 564-2246
` NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
✓y encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
f pp O
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: 11-16=90 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION "
_90
14
A TTIS 10.00
(Street address or Description of Location) .
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
AVE.FERNANDO TO EISENHOWER TO
DIMENSION OF INSTALLATION OR -REMOVAL WASHINGTON TO 111
9171 RCRAPRR
SIZE OF EXCAVATION, IF NEEDED 11'82 W 1411211 R
` R71 T. - HAUL DATE: 11-19-90
APPROXIMATE TIME WHEN WORK WILL BEGIN
11 -i9 -9n ONE OVERSIZE TRIP.ONLY
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ DO NOT MOVE -BEFORE 7 : OOAM
(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 andarisingout 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.
r
Notify the Administrative Authority at least twenty-four (24) hour-s,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.
• nature of Applicant or, Agent
SCHWAB'SALES
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
r)N FILE - ON FILE
Contract is License No. City Business License No.
f Y
App f�c fit'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
t�aii 4
1V2 0
,Minor Improvement. Permit — Class IV: See attached schedule
.
Inspection Fee $
PERMIT VALIDATION
Permit Fee 10 (`0
PERMIT NO. 0918
Penalty
Cash Deposit -Surety Bond
DATE APPROVED 11-16-90
if required
EXPIR ATE
TOTAL: $ 10.00
DATE ISS D
Receipt No.
13y
Received by Date
. Administrative Authority
Recorded by
TELEPHONE: (619) 564.2246
:J
r
NOTE:
With proper validation
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, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
J Subdivision Improvement Permit Class III
DATE: ` / o. ^ �v Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction
/�y� plans if appropriate)
DESCRIPTION OF CONSTRUCTIONv/ O
I :tea `T, , i 9- P T" 4
DIMENSION OF INSTALLATION OR REMOVAL W A-S4bnl -6.-7—.0 jj
SIZE OF EXCAVATI�)N IF NEEDED • a
APPROXIMATE TIMWH N WORK WILL BEGIN
2= G 7v
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
pricludina removal of al '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. thepermit 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
/V S CIS
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License 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 NO
Minor Improvement Permit.—Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty '
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
PERMIT .VALIDATION-
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority,
TELEPHONE: (619) 564.2246