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0923r 1' uwr.4.►��t' - rt-+�i++w+w•r�"w„r. x�w+��.. r...., yr �d. ..,r.w,.. w.w-w...,,p�:r ,.. r..�.�. ..�.r�w �i�.adc�.n!+t.a.�... ..�. w-....�.r .—..—.�.. .� ... .. .. .. ...-.� b �7 NOTE: With proper validation this form constitutes an' encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) Fors 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 I1 -1a -GID Subdivision Improvement Permit — Class II I Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 54— glpQ ALVARAW (Street address or Description of Location) PURPOSE OF CONSTRUCTION DR\VEVVAY APPROACH Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION PER A77A LVED RWERS1DE CO. `3TAAlDARD NO. ZD7 DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN ASArP 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. Signature of Applicant or•Agent BILL RILEY 1-11- 6&5 BbARDWALK 4112 RD 340-yyL1 S Name of Applicant (please print) Business Address Telephone No. 0W1`i,JEF, / BU1LDEPz 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 Minor Improvement Permit —Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. $ U2.00 $ 10.00 Received by Date PERMIT NO i6", BiJ 3x TOT�L i9-40 to.00 PERMIT VALIDATION OC1 2.3 DATE APPROVED H_ lq r q 0 EXPIRATION DATE 11— 30 ^ q 0 DATE ISSUED J)- /9-90 By %/ II )A; C/' Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 �4a T �••: �� r- '-+. -_ _ t�:��i M4 !'� . t /alp�M r.� w"r, 7 w�► l�y'.R-w►-ay.r{.� R R FtC J0,11"A- Cw il► i.�w• w� bf w^N ' , f� NATE: 0- With`roper 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 Y ) q— Ci O Subdivision Improvement Permit —Class I II DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION S 51PO ALVfARA ©O (Street address or Description of Location) f PURPOSE OF CONSTRUCTION 0R`V F_Ai AFPROACVi DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN A JA P Sketch (attach construction plans if appropriate) VER ATMACHFfD KWF_RSiDC CO. "YTAA.►OARD NO. LU -7 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. Signature of Applicant or Agent � � 'BILL RILEY 1--11. 18b5 ARDWALK z!112. RD �'��-'��1`a" Name of Applicant (please print) Business Address Telephone No. amvjEP / 5U I1.DIF V 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 I I I Public improvements: 3% of estimated construction costs 'Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $_10,00 11 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. $ 10-00 Received by Date PERMIT NO iQ t1& S'1�T L�iI9-90 io.00 V PERMIT VALIDATION D c12 3 DATE APPROVED I)— f9 - L70 EXPIRATION DATE 11-30-010 DATE ISSUED By �f Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE:' with-propeUval— I'M this form constitutes an encroachment permit v CITY OF LA QU1NTA APPLICATION `FOR PERMIT PUBLIC wORKSACONSTRUCTION. (ENCROACHMENT) For the construction of public' or private curbs, driveways, pavements, sidewalks, parking lots, sewers; watae- fttahW, . and other like public works improvement in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS' .Subdivision Improvement Permit - Class ill DATE: % / � J Minor improvemem Permit Class.IV LOCATION OF CONSTRUCTION _,L ��I�py0 Z00 (street a0dress'ar Oeaertpbon of Loeaboni� PURPOSE OF CONSTRUCTION J 40?'/1 Sketch (attach construction plans if applgxig DESCRIPTION OF CONSTRUCTION _T - �T� tj0A DIMENSION OF INSTALLATION OR REMOVAL - (ATTA Lk'�� 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, ba-kfilling, com- paction and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to: I ndemnify, defend -and saw the City, its authorized agents, officers, representatives and emoloyees, harmless from and agauat ahv mW all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persona or on parry- happening or occurring as a proximsta:result of any work undertaken -under- the •parritgranted pursuant to this application. Notify the Adminittrative Authority at least twenty-four (24) hours in advance of the time when work will be started. Comoly with all applicable City ordinances, the terms and conditions of the permit and all aoplicsble rules and regulations of the City of La Quints and to a" for any additional replacement necessary as the result of this work. G Signature of Apgficant or A nt Name of Aopiicant (please incl Business Address Telephone No. nolwv 1_126t,9 30 197 E Name of Contractor and Job Foreman Contractor's License No. Business Address Telephone 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 costs Minor lmorovement Permit — Class IV: See attached schedule inspection Fee S /� 00 Permit Fee PERMIT 040. Penalty Cash Deposit -Surety Bond if required TOTAL. $ I o' a 0 Receipt No. Received by Recorded by Date FN 11 q PERMIT VALIDATION DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: 1819) 584-2248 c'44,1,--,-2' ,/ S'SadfV -i 2.0 op