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41
�• ;,,;,`NOTE:
Withproper validation �. 2
this form constitutes an !
a I CITY OF LA QUINTA
encroachment permit ,
` APPLICATION FOR PERMIT
y PUBLIC) WORKS CONSTRUCTION (ENCROACHMENT)
0F9wSw
For the construction of public or private curbs,3 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,l I I
DATE: November 16, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION - b.egins. at manhole #73 305 s'/o . Ave�nuP' 50 />, Ea ��nhc�rtiiPr
Dr soutn on Eisenhower 7.001 n/o Calle Tampico
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION place burled' Cable, t0 Sketch (attach construction. plans if appropriate)
provide cable count refer and future services
DESCRIPTION OF CONSTRUCTION trenching to direct bury WE 543-71318--I
cable placing 2e64#galvanized pipes attaching
to,bridge crossing also splice pit at.southern end, see attached diawings
` r DIMENSION OF INSTALL•ATION,.OR REMOVAL f kAT,BT and CT
ti
SIZE OF EXCAVATION; IF NEEDED
M a.
' '
'APPROXIMATE TIME WHEN WORK WILL BEGIN 4/15/91
' -- @
APPROXIMATE TIME�OF 7/31/9
COMPLETION
`j 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 r=esulting from claims or court action and arising out of any accident, loss or'damage to persons or property
happening or occurring w'a proximate result of any work undertaken under the permit granted pursuant to this application. y�
r, a d .
t 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. '
;• f Signature of Applicant or Agent F
GTE Californila.,Inc. 83-793 Dr. Carreon Blvd, Indio, CA 92201, 619/343/0535
-Name of Applicant (please print) Business Address '• Telephone No.
Name, of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. n� City,Business License No. Ir `
Applicant's Insurance Company. t Policy Number `
FEES: Subd,ivision'lmprovement Permit —Class III
+ t Public improvements: 3% of estimated construction costs
{ Private improvements: 3% of estimated construction costs
Minor'Impi•overnent Permit — Class IV: See attached schedule ® 9 24
Inspection Fee $ —0_ �. _ PERMIT VALIDATION
Permit,Fee PERMIT NO. 0924
•Penalty � ,..r � � � DATE APPROVED 11/19/90
Cash Deposit -Surety Bond
+
if'required *,�"' EXPIRATION DATE 1 /Z1 /01
TOTAL: $ -0=
DATE, 4SUD a! A ReceiptNo. ylh1�^,
Received by Date Administrative Authority
,a
Recorded by. TELEPHONE: (619) 564-2246
4,
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�
&OTE:
With proper validation
4
thisfbrm;coCistitdtesan CITY OF LA QUINTA
encroachment permit
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
DATE: November 16, 1990
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION becrins at manhole 473 311193 1 cg /n A.vAntap 5D p/r, Fi r_Pn'hnU?ar
Dr soutn on Eisenhower 700' n/o Calle Tampico
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION dace buried cable to Sketch (attach construction plans if appropriate)
prbviva� caLle count reeler and suture services
DESCRIPTION OF CONSTRUCTION trenching to direct bury WE 543-71318-I
cable placing 2^,4#c;alyanized oipesattaching
tc bri6ge croj-i"ng also splice pit at southern end see attached drawings
DIMENSION OF INSTALLATION OR REMOVAL kAT,BT and CT
SIZE OF EXCAVATION, IF NEEDED
~ ,,APPROXIMATE TIME WHEN WORK WILL BEGIN 4/15/91
APPROXIMATE TIME OF COMPLETION 7/31/90
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.
F �
)A) X CsAI �1
Signature of Applicant or Agent
GTE Cali;ornia Inc. 83-793 Dr. Carreon Blvd, Indio, CA 92201 619/343/0535
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
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee . $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
$ -0-
Date
PERMIT VALIDATION
PERMIT NO. 0924
DATE APPROVED 11/19/90
EXPIRATION DATE 17.111 ,/41
DATE ISSUED 11/19/�Ia
ByJ I X (�'� .(� A t /1. A
Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
rl•r ..r ,�� • ,' ' '�� 'ice ;t ��������� +i ��-����—� ��
i + NOTE: REFERENCE GTE W.O.#543-11318-I
' With proper validation '
this form constitutes an . CITY OF LA QUINTA.
encroachment permit �+
APPLICATION FOR PERMIT
t' PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or -private curbs, driveways, pavements, sidewalks, parking lots, sewers; water'mains.
a r and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
" Subdivision Improvement Permit - Class 111
DATE; November 16, 1990 Minor Improvement Permit Class IV
LOCATION .OFCONSTRUCTION begins at manhole #73 305'. S/O Avenue 50 E/S Eisenhower -Dr South on
Eisenhower -700' N/0 Calle Tampico
fStrars address or Oesarptlon of Location►-
PURpOSEOFCON Tj1UCT1ON lace buried cable to rovide Sketch (attach construlonplans 'ifappropriate)
k• - cable count re�a
ief for Curren an u ure services
NSTRucTION• trenching to direct bury cable'.
2- 4' a vamze es attaching to bride coos -
s also s at southern end.
DIMENSION OF INSTALLATION OR REMOVAL W•0.#543=71318 -I'
SEE' ATTACHED DRAWINGS. AT, BT. VCT
,SIZE OF EXCAVATION, IF NEEDED ,
APPROXIMATE TIME WHEN WORK WILL BEGIN 4-15-91
` APPROXIMATE TIME OF COMPLETION 7-31-91
ESTIMATED CONSTRUCTION COST S 1 //
!Including removal of all obstruction, materials, and debris, backfilling, com-
pactioW and plsang permanent resurfacing and/or replacing improvements)
' In consideration a the granting of this permit,, the, applicant hereby agrees to:
` Indemnify. defend and five the City, is authorized agents, officers, representatives and emploven, harmless from and against any and ail •-
pansit n, Itabthtln or lou resultingfrom claims or court action and Olsl out of any accident, lou or
� ng damage to wnonr 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 lent townty-four 1241 hours to advanceofthe ante sullen work will be started. Srty `
Comply min au applicable City Ordieanws, the farms and conditions of the permit and all apolwable ruin and regulations of a City of
La Quints and to pay for any addfrionef replacement necesse i as the result of 7.6 work.
Signature of A licant or Agent.
GTE CALIFORNIA INCORPORATED. 83-793 Or Carreon B1vd,-Indio, Ca 92201 619/342-0535
Name of Applicant (please print) 1 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 Polio Number
FEES: *Subdivision Improvement Permit -Class III, s .•r.r . : ' :;,
Public improvements: 3% of estimated construction cosi
t - t Private improvements: 3% of estimated construction cosi ,
Minor Improvement Permit - Class IV: See attached schedule ^
( �NI Inspection Fee S L' PERMIT VALIDATION'--
_ 7
Permit fee
-- '- � PERMIT NO.
_ _
_.
Penalty
1� DATE APPROVED
Cash Deposit -Surety Bond
_y if required i -> EXPIRATION DATE
til t TOTAL:' S DATE ISSUED
!•
Receipt No. _
By
�- Received by Date _ Administrative Authority
Recorded byT
TELEPHONE: -1619) 564.2246.'
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NOTE: 1 dP,EFERENCE GTE W.O.#543-71318-I
With proper validation
h' f stir res an
DWI
City of La Quiniit
NOV l
t is orm con u CITY OF LA QUINTA
encroachment permit PUBLIC
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: November 16, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION begins at' manhole #73 '305' S/0 Avenue 50 E/S Eisenhower Dr South on
Eisenhower 700' N/0 Calle Tampico
(Street address or Description of Location)
PURTOSE OF CONS)TJRUCTION place buried cable to rovi de Sketch (attach construction plans if appropriate)
caDb a count relief for current an u ure services
DESCRIPTION OF CONSTRUCTION trenching to direct bury cable
placinq 2 4 qalvanized pipes attach.inq to bridge cros-
sing also splice pit at southern end.
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4-15-91
W.O.#543=71318-I
SEE,ATTACHED DRAWINGS AT, BT & CT
APPROXIMATE TIME OF COMPLETION 7-31-91
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 124) 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 appticable rules and regulations of a City of
LA Quints and to pay for any additional replacement necessary as the result of th.s work. 1
Signature of AOplicant or Agent
GTE CALIFORNIA INCORPORATED 83-793 Dr Carreon'Blvd, Indio, Ca 92201 619/342-0535
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 Ill
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.
Received by
Date
PERMIT VALIDATION
PERMIT NO. '
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Recorded by. II TELEPHONE: (619) 564-2246
Administrative Authority
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