0948.. ��
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NOTE: 4
With proper validation t At
this form. constituteslan' ':, CITY .OF - LA QUINTA .,
encroachment permit'`
' APPLICATION FOR, PERMIT_.4 y ,
,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: 'December A, 199.0.. , _ •' '
' - +��• Minor Improvement Permit Class IV
. •
LOCATION OF -CONSTRUCTION Miles ` Ave, w/o Adams '.TR'.23268
(Street address or•bescription of Location) T
•�* t ;_ ,
linstall conduit `'for. CONSTRUCTION Sk
PURPOSE OF etch (attach construction plans if appropriate)
GTE �. '� •
DESCRIPTION OF CONSTRUCTION - place :4-4r, conault:
-across miles, concrete Pad, and 1-4 fcoriziul•t A „
on n s o Miles reference GTE 'permit 0874
DIMENSION OF'INSTAL'LATION OR REMOVAL ALL CONDITIONS OF' PERMIT '0874
SHALL -APPLY TO THIS PERMIT
•k; �, ..y; ,ti1 4R
:. SIZE OF EXCAVATION,'IF NEEDED GTE W0.,549771803—I Y
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ "-
(Including -removal of,all obstruction, materials, and debris, backfilling; com
paetion and placing permanent resurfacing and/or replacing improvements) Y
• In ,consideration' of the gr`anting.'of this permit, the applicant hereby agrees to: . .
•
Indemnify, defend and save; the City; its authorised, agents, officers, representatives and employees, harmless from and against'any and all '
Penalties, liabilities•or'loss resultingl, from 'claims or court action and arising out of any accident, loss or damage `to.pers6hs or property
` happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
x ` ' Notify the Administrative Authority at least twenty-four (24) hours in advance of+the time wen,work will; be started., ,
+ Comply with"all applicable City Ordinances, the terms and'conditions of the permit anAll applicable rules and regulations of the City of
' + La Quinta and toy pay .for any;additional replacement necessary as•the result of tmiis work: ; +• `
Signa'tu-rVof Xpplicant, or Agent
I-1nnr1 C'nmmt,n'r.at-inn 494 q. 4th Barinina.' CA 7J4/849-1121' +
Name of Applicant (please print). •. 'Business Address ",'; Telephone No.
Rick•+Sorbel .. ., ,
Name of Contractor and Job Foreman �: Business Address., •- Telephone No:
37,8587 . ,1182
Contractor's License'No. cCity Business License No. ' ;k
CGL .Lhoyds',tof :L'oiidon�345 Wilshire; LA '.90010' .#IO=3034 +• `, �; ;
,.. T
Applicant's Company " ' Policy Number
3 : f
FEES: Subdivision Improvement'Pe mit -Class III , . 005.182 1? '$499' ?-04-90 f0
K' _o to; t;A H Tot, i so:00
} Public improvements: 3/0 of estimated construction costs
Private improvements: 3% of estimated construction costs
a� 09A8
Minor Improvement Permit—.Class;IV: See attached schedule 4 1,
-Inspection Fee ` $ Qn. nn 3'� w -PERMIT VALIDATION, r '
Permit Fee , }; + .�� ''PERMIT 0848
+ w NO. '
Penalty' r+' # '"'r DATE APPROVEDr 12/4/90
Cash Deposit -Su rety,Bond,
f .. .,. �. '
',if required �; f°�t ».ti:` EXPIRATION DATE 12/31/9-0-
y g - `$ .`t+ '.i�,! 8.0...00 ' : ,x ' `'yl2/4/90
4:. TOTAL: "- DATE ISSUED`' _./-
Receipt No. y ` , f r x =. ('Y�-/►� �,'
y . 4 By
Received by Date ' - ' V 7W Administrative Authority
Recorded,by '+ TELEPHONE: (619) 564-2246 '
t/. , r�'!l•'YitWr-y,�{°�5''r.)?�'�r,"'iv Ufa: ?6. w.� .,:.. �_y,�f
�4V x,
i. �!tr i'!"" �{, .,�.+. .fi. ..,,� x'�.a ...�: ...'..-�. A,+'-.s......�..N.,.t-..Ps...,., �-.f.-.l.,-¢-+•si..
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
' J Subdivk oA Improvement (Permit" -Class III '
DATE: .'December 4•, '1990 Minor Improvement Permit Class IV
LOCATION,OF CONSTRUCTION' Miles Ave'•_w/o Adams •TRt• 23263-
{
(Street address or Description of Localtion) ,+
,
PURPOSE OF CONSTRUCTION install conduit for .`
GTE , Sketch (attach construction plans'if appropriate)
r `
-- — . )lace 4• 4 r cQnctult: ~,
DESCRIPTION'OF:CONSTRUCTION ;
acro, s ,mi -Lest. concrete paid ana, l-4! t conault::'
on. °n s qt, 03_1es , ' , reference 'GTE permit 0874
DIMENSION OF INSTALLATION OR REMOVAL ` *ALL CONDITIONS' OF PERMIT 0874
` SHALL'APFLY TO THIS PERtMIIT
SIZE OF EXCA' VATION;'IF.NEEDED, - GTE' WO' 549-71803—L-
.' `�.
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF'COMPLETION 1 �A clQ �
ESTIMATED CONSTRUCTION COST, $
+(Including removal of all obsti•uction,.materials, and debris, backfilling,'com j .
pactiori and placing permanent''�esurfacing•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 anyraccident;-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-,dministrative 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 wok.. ' +
Signature of Applicant or Agent'
fland ("amm"o—iatic�n 4.94 S. 4th, Banning.' CA' 714/8'49=1121 �•
Name of Applicant (please print) Business Address. �', 'Telephone No:
`dick Sorb.el',' ' F • � •
Name of Contractor and Job Foreman r Business Address-, Telephone No,.
37851£ 7 +' �.. "•1182' ", 1•
Contractor's., License No. %{ City Business License:No.
�, • !CGL Ll:oyds' of: ,London'•345 Wilshire, .LA`90010- 10-30 34
Applicant's Insurance Company • �'" • Policy Number y '.
a ,.
FEES:, "Subdivision Improvement Permit — Class I I I. . ? 00S.iI X3491 1k-0-4 10 `'
T 10 4fwAa H 1 QT L i 80.00
,
41 Public improverrients:,3% of estimated construction costs
Private'improvements: 3%-of'estimated construction costs ® 4
- Minor Improvement Permit _ Class IV: See attached schedule'+' J '
Inspection. Fee ,'' 1$ R(1 _'n 0 = - 'PERMIT. VALIDATION
Permit Fee ' 0848,,.. +.
a, PERMIT NO.
• �'' .Persalt •;�;'�,•^ •,• �, ,' .._ :•
Cash Deposit Surety Bond " DATE APPROVED&- 1214190
if required EXPIRATION'DATE 12/31/9'0 ;
80.00 1 q•
TOTAL: $ DATE ISSUED ` 214 0
Receipt No.By—
f
Received by Date .1 V W ' Administrative Authority
Recorded by a' TELEPHONE: (619) 5642246
' i.hF:i �rs.1..�I.l Vie{ ' • i.,.... .J'.•.ti.