Loading...
0949t<_'��"�`�y�'�,•u;,+`-967yp7'a8�;x:�`�- 1'kn:,.�''"47`i��" 24®r�� t. • r'" ' =v"' '.,�� ; z. , f F94,- NOTE: , t With,proper validation this form constitutes an « encroachment permit `• CITY, OF LA ,QUINTA r , . APPLICATION FOR : PERMIT- , •- >. • '.;PUBLIC WORKS- CONSTRUCTION (ENCROACHMENT)' c�oF�wsw For the construction, of public ;or private curbs;' driveways, pavements, sidewalks, parking lots, sewerswater mains . and other like public'`works improvements in connection with MINOR -IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit —Class III i DATE: Debember 5•,' ,1990 Minor Improvement Permit Class IV: ' LOCATION OF CONSTRUCTION - dikieway'approadh, 54255 Avenida.Carranza' (Street address or Descripiion of Location) . PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) - DESCRIPTION OF CONSTRUCTION per attached . Riverside Co. Standard #'207 OF�INSTALLATIN • R REMOVAL •• DIMENSION O 0 , 005.182 i0 8533 U-05-90 14 r r M", CASH i, a L 1OT, i 30100 - SIZE OF EXCAVATION, IF NEEDED �t 's,'APPROXIMATE=TIME WHEN WORK WILL BEGIN 1-215/90 APPROXIMATE TIME OF'COMPLETION-' ESTIMATED CONSTRUCTION COST.$ , ',:; '•' j ' '(Including removal of all'obstruction; materials; and debris, backfilling, com, .' action„ and placing permanent-resurfacin and/or replacing improvements)r ` In of the granting of this permit, the applicant hereby agrees to: j' "t +• ' "- Indemn fy,'defend'andrsave the City, its authorized agents, officers, representatives and erriployees, harmless from'and against any and'all ' penalties„liabilifies or, loss resulting from claims or court action and arising out of any.- accident, loss- or damage to persons orIproperty . 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) hours in.advance of the time when -work will be started. ` Comply'wiih 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 J T,mA So1-t1Pv 41625 Eclectic Ste:- 1',. •Palm Desert 340`=1361 ' Name of.Applicant'(please print) -Business Address' Telephone No. Name of Contractor and Job Foreman' Business Address , i Telephone No. �aRR2a 85.6 ' r Contractor's License,No. tCity,Business License No. t Applicant's'Insurance Company, ,} :' Policy.Number i FEES: ISutidiVisibn Improvement Permit — Class +Ill + ' Public improvements: 3% 'f estimated construction costs ' Private improvements: 3% of estimated construction costs 4 . , � .'0929 Minor Improvement Permit — Class IV: See attached schedule l Inspection Fee 20.00 ` ( $ ` PERMIT. VALIDATION.: ;t Permit Fee 1 o _ nn -0949 '` « PERMIT NO.- Penalty Cash Deposit Surety,Bond DATE APPROVED 1'2/5./90. r if required EXPIRATION DATE 12/7/90 r TOTAL: $ 30.00 ' DATE ISSUED / 12/5/90 • Receipt No. By - Received by Date Administrative Authority Recorded by �' + TELEPHONE: (619) 564-2246 r « 4 P r197-11- ^ I . - . idM, W .� .iY , �2Cf Y"ti��. 1M. w. �'.Y!' �nW. •M."�}` Ili l\.�11M.�.RM1..®•`W.. Nh R�'•�M^�.lt.l9•. t4".��P" ..! Ml� �!-..�-+4- A.. � .4. Q� .q.. 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 Subdivision Improvement Permit.— Class II I DATE: DebeIrik3Er 5, 1990 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION difteway approach 54255 Avenida Carranza (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION DIMENSION OF. INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED Sketch (attach construction plans if appropriate) per attached Riverside Co. Standard # 207 APPROXIMATE TIME WHEN WORK WILL BEGIN 12/5/90 APPROXIMATE TIME OF COMPLETION I't l-, U 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: , 1820 Q 053to4Ri0?. 90 30.004 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. / 1 Name of Applicant (please print) a5ignatt ctic Ste. Applicant'or Agent -J Palm Desert 340-1361 Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. 2)4RR2.4 856 . 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 $ 20.00 Permit Fee 1.0 _ 00 Penalty Cash Deposit -Surety Bond 3 if required f TOTAL: 1 $ 80.00 Receipt No. Received by Date Recorded by ®949 PERMIT VALIDATION PERMIT NO. 0949 DATE APPROVED 12/5190 EXPIRATION DATE 12/7/90 DATE ISSUED' i 12/5/90 By Administrative Authority TELEPHONE: (619) 564-2246 . —;:, 4 e_ NOTE: With PropervsIkkticxr_• this form constitutes an• encroachment'Permir- 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, watW mains,, and other like public works improvemenwin connection with MINOR IMPROVEMENTS'and APPROVED SUBDIVISIONS''' q Subdivision Impro4ementPermit — Class III DATE:/ s ! ` J Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION- '� `l L CL (L/1 -%/'L --a- (Street addressor Description of Locnioni.,* PURPOSE OF CONSTRUCTION I v(. W'+ -t 'APO 2'',r ".t DESCRIPTION OF CONSTRUCTIONa�' DIMENSION OF INSTALLATION OR REMOVAL SIZE'OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHENVORK.WILL BEGIN Sketch (attach construction plans if apprpprisM APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST S (Including removal of all obstruction, materials, and debris, ba-lcfiiling; com- paction and placing permanent resurfacing and/or replacing improviments! In consideration ofthe granting of this permit, the applicant hereby agrees to: ndemnity, defend and saw the City, its authorised agents. officers, representatives and employees. harmless from and against anti and ail 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 proximaq-result of env work undertaken- under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four 1241. hours in advanceof the time when work will be started. Comoly with all applicable City Ordinances. -the terns and conditions of the permit and all applicable rules and regulations of the City of La Ciuinta and to pay for any additional replacement neeessery as the result of this work. Signature of Applicant or Agent J4m9-5 S9'r7 pec{ q/ LL Ciaric �rl �a q l2> L / Name of. Appucant (please print) Business Address Telephone No. Name of Contractor and .lob Foreman Business Address Telephone No. Contractor's License No. City Business License No. Applicant's insurance Company Policy Number FEES: Subdivision Imorovement,Permit —Class II I Public improvements: 3% of estimated construction costs Private improvements: 3% ofestimated.construction costs Minor Imorovement Permit — Class IV: See attached schedule Insoectlon Fee S Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL. $ Receipt No. Received by Date Recorded by N° PERMIT VALIDATION PERMIT N0. DATE APPROVED EXPIRATION DATE DATE ISSUED By fc Administrative Authority TELEPHONE: (619) 664-2246-