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0940a .,�..�a�.sM,.wi��' � eriw_�v!trr....: ...-.r .!. wn .r'.......�. .� w •r., n.:•...ca .� w,:-rtP-ws.....t rp..w.�h'..�. r..-.� �.......w+�!!: ..:'w.- o.-.«.�..� ..-�...�. � ......q wr .... ... ra' NOTE: With proper validation this form constitutes an 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 Subdivision Improvement Permit — Class I II DATE: 12 _ �d Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION '59-320 VA LL ESO (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION MWELOM APPROAC-4 DIMENSION OF INSTALLATION OR REMOVAL Sketch (attach construction plans if appropriate) PEZ RNVERSIDE CNAUTY STANDARD NO. Z07 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: i 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 -fou r (24) hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditions of the, ermit and all applicable rules and regulations of the City of 3 La Quinta and to pay for any additional replacement necessary as the result f -this. w r SignatiNre f pplicant or Agent MU) &EPJ BUILDEKS YO. k3DK 2H01 PALIU, DESERT 0Iq 341n— Nto 14 Name of Applicant (please print) Business Address Telephone No. .-ME 9AUEE / MHU IAADDax' Name of Contractor and Job Foreman Business Address Telephone No. �52Z11 1333 Contractor's License No. City Business License No. 13011LDF-0S 51AIZLETY SERVICES 4�OSZLQ3 A2C. 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 $ Z0,00. Permit Fee )0.490 Penalty Cash Deposit -Surety Bond if required TOTAL: $_301 0 Receipt No. Received by Date Q0518H 8i $ OTAL $-9C� 34.©OU N2 094P, PERMIT VALIDATION PERMIT NO. OCI H 0 DATE APPROVED 1 j _Z_0 ^ 90 EXPIRATION DATE 12-05— 90 DATE IISSSSSUED �` 11_Z5_90 administrative Authority Recorded by II TELEPHONE: (619) 564-2246 r r-' `�+oi�."' ° r��. � y isr : i �[ .' �4. - r 5 �ti"/�•rM•.r 4 :...••G-,� ,.., ''y_ R' �.'y-i - r�^•. � ;Y.,-..y7� - •r ' _` �` �ci t"�L ,,J`z %io$�:.��.++^s ^ V ^ f^+vcr t..zitswr•'ti3:,+Yrai! J' 1•#� .i?Ps t hY" n • t .IR+K,•s.►;..�a_.+.r aw s it-�... .r iw hra�.r r► Ru � woe 9 cT': ir.w. 4e-a-\►.44•.!l �-rs, may,.,\., rt.9: `���.-a9.e�..s.rt 'w _ .w•-.w m.s•..w' .� a,-,.wt s t••.�r+a �s NOTE: �' t With proper.validation O this form constitutes an , CITY. OF 'LA QUINTA ,+ " encroachment permit •- APPLICATION FOR ' PERMIT PUBLIC, WORKS CONSTRUCTION •(ENCROACHMENT), ` r OF r 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 96 DATE: Minor'Improvement Permit Class'IV. LOCATION OF CONSTRUCTION r' (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch'(attach construction plans if appropriate)' DESCRIPTION OF CONSTRUCTION. IVIVE--)AY APPROAC- PE, I 1 � t p M TY DIMENSION OF INSTALLATION OR REMOVAL ~SIZE OF EXCAVATION,'IF NEEDED: APPROXIMATE TIME WHEN. WORK WILL BEGIN i APPROXIMATE TIME OF COMPLETION ,. ESTIMATED CONST'RUCTION,COST.$ - (Including removal'of all obstruction,•materials, and debris, backfilling, com l 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 m 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. 3' Comply with all applicable--City Ordinances, the terms and conditions of .the �ermit and all p ('cable rules and regulations of the City of Ga Quinta and to pay'for any additional replacement necessary as the result of•this work r Signature f Applicant or Agent ` I\.11A3 CHFKI .6►.1l.Dl~IZ Ppa�K •2'-10 i.. �'�1�1�h t)SfY2T ' �OIq�tl�--.�-1Le1�t Name of Appl icarit. (please print) Business'Address' ,. Telephone No. .moo F E-A u `fit? 1n.3IAL?��X • ' . ' • 'Nartie of Contractor and Job Foreman Business Address Telephone No:• Contractor's License No.' - - City Business'License No. = ' 1'�fi 11,D L?S % .ICY 'SERVICES', � GOSUeZ)Af�C- + Applicant'sJnsurance Company. Policy Number FEES: Subdivision, Improvement Permit = Class II l ` Public improvements: 3% of estimated construction costs p0�1�� g 9 2I3-9Q • • ,• ° Lc3 SASH ,f'aTAL S 30.0 0 Private improvements: 3/° of estimated construction costs TAI, � Minor Improvement Permit — Class IV: See attached schedule �`�b` , 2.Ur0©•� z , InspectionTee $ PERMIT VALIDATION Permit Fee`. f t� • ' • 0i9 q'p r •• PERMIT NO. Penaltyi:Z'� q0` Cash Deposit-Surety Bond • DATE APPROVED . A if required • EXPIRATION DATE,.�� '�'S-� �� TOTAL: $ j C� : L) ; 1: — Z %� • GI i) ' - - DATE ISSUED, Receipt No., t 4•F •.. / (l��A %%7 ice./.(J/�/��� Received by Date ° Administrative Authority Recorded by TELEPHONE: (619) 564-2246 r _ /s l t NOTE: , With proper vaiidnio,z x this form corutitutaran - . 'CITY OF' LA:-QUINTA'- eneroachment,cermit ' APPLICATION' ,FOR- PERMIT ` PUBLIC _WORKS' CONSTRUCTION (ENCROACHMENT) For the construction,of public- or private. *curbs', driveways, pavemenut . sidewalks,; parking lots, sewers,' warm -maks-.., and other like public works, improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS.=` Subdivision Improvement Permit - Class NI DATE: ��^Z 7- �d h i F 'MiWorlmprovement Permit Class IV LOCATION OF CONSTRUCTION- 41> 2`Cj, /1P,t• (street address orf oascrtptioe of Loeatsonl ,. PURPOSE OF CONSTRUCTION: lam- 12 L -C w"VrA1Sketch (attach construction plans if approprig DESCRIPTION OF CONSTRUCTION!, ro��L: ` y DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHENWWORK WILL BEGIN / t - z 7 "•- o APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST S + (Including .removal, of all obstruction, materials, and debris, ba -*filling, coin= • 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 s.the City, its authorized agents, officers, representatives and employees, harmless from and against env and all penalties. liabilities or "awloss resuiting-from claims or court action and arising out of any accident,. loss Cr damage,to`persons-or pso"ty.^ happening or, occurring as a proximate rasult of any work undertaken under the permit granted pursuant to this application: - Notity the Administrative Authority at least twenty-four 124) hours in advance of the time when'work,will be started.. Comply with all applicable Ciiy Ordinances, the terms, and conditions of the noir and I applicable rules end regulations of the City of ,La* Quints and to oav for any additional replecerrient neteatry as the result f th'• rk. /� - Signatu of Applicant or Agent 4 AA/ C<7 �9-e,ki.pcta 't-1D✓� l\u t��age � Iia 112�a Name of Aoplucant (please print) Business Address Telephone No. r-- &., , Name of Contractor and Job•Foreman Business Address Telephone No. 2 S'Z2 t t I�•�� Contractor's License No. City Business License No. / 1WP _s �LJY - �L �P✓' L1 L Y4 n D S'. Z 6 K Applicant's insurance Company Policy Number FEES: Subdivision Improvement Permit —Class Ill �f Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs O , Minor Improvement Permit.— Class IV: See attached schedule • �- inspection Fee S v PERMIT' VALIDATION Permit f=ee. ?ERMIT 0: 41 PenaltyDATE APPROVED Cash Deposit -Surety Bond if required EXPIRATION DATE TOTAL: $ , DATE ISSUED Receipt No. By Received by Date Administrative Authority Recorded by TELEPHONE: (61915642246 `