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0956With proper validation 2 ' this form"constitutes an 'encroachment'permit' CITY OF LA QUINTA y APPLICATION FOR. -PERMIT- g PUBLIC WORKS -CONSTRUCTION,.,(ENCROACHMENT) For the construction ofpublicpublic or private"curbs, driveways, pavemerits, sidevJalks parkinglots," sewerswater`= mains and other like public works improvements in connection with,MINOR IMPROVEMENTS and APPROVED'SUBDIVISIONS Subdivision Improvement Permit =,Class III DATE: -Dec. 11, ' 1990' - t • , • • Minor Improvement�Permif Class IV ' LOCATION OF CONSTRUCTION., 5.4 -.015'54 -035. -and , 54-035and '54655 Avenida -Juarez �.. _• (Street address or Description of Location) PURPOSE OF CONSTRUCTION d r i NTPwaav •anpraaches Sketch•(attach construction plans if appropriate) DESCRIPTION_ OF CONSTRUCTION'' Drive appraach ';shal'1 be ,in '•accordancet witri• •Riveride Comity " Standard No._ 207;' (att'ached) " DIMENSION OF INSTALLATIONOR REMOVAL 16 x 12 j , • ' 'SIZE OF EXCAVATION ,I'F NEEDED •' t �. • ' 005: .2 10.$b28 52-11-90 1�I 'APPROXIMATE TIME:WHEN WORK WILL'BEGIN 12/11/90 IO CASH 1 NOTAL 1 90:04. '-'APPROXIMATE 12/12/9© -TIME OF COMPLETION ' ESTIMATED CONSTRUCTION COST $ 25o. 0'0 (Including',removal'of.a'll'obstruction, materials; and debris, backfilling, com- paction om 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:. 'e Not 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 cf'this work.' Signature of Applicant or Agent`s v ; z. Mr.'`Reefer PO Box 981 Rancho Mirage,�CA 92270 -327-8215'~ Name of'Applicant (please print) Business -Address Telephone No. Name of Contractor and Job'Foreman Business Address Address ' Telephone No. . Contractor's License No. City BusinessyLicense No. Maryland Casualty- Assurance of AznPr i ca . ' Rr, J A 1 =R -111 , r, r.; !; Applicant's Insurance Company Policy Number " { FEES:_'Subdivision. Improvement Permit - Class III Public improvements:'3% of estirnated'construction costs., •t` Private.improvements: 3% of estimated construction costs s t:• A0 Minor Improvement Permit — Class IV: See attached, schedule '� `�� Inspection Fee' $ PERMIT'VALID'ATION , Permit Feer s -30.00- 095.6 -PERMIT NO. ' Penalty12 / 11'/ 9 0 " `r 'Cash Deposit -Surety Bond DATE APPROVED .. �' if re wired' w• r ,. .. � Q EXPIRATION DATE .1'2/14•/90' TOTAL: $ 9n fl (1 , ' :• •' s... �.' ' DATE ISSUED y121.11.1/9 G + Receipt No. ./i�f✓J By _ Received by Date q • Administrative Authority Recorded by TELEPHONE: (619) 5642246' ' . .. f.?, M Mft, r ­ ^,7 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 11 19'0 Subdivision Improvement Permit — Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 54-015 s;4-035 and 5055 Avenida Juarez (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION D*'rive npreach sht'.11 he in accoraance c,ith R.ivcriide County Standard No. 207 (attached) DIMENSION OF INSTALLATION OR REMOVAL 16 x 12 SIZE OF EXCAVATION, IF NEEDED 55 y 0 8 628 0-0 90 4 APPROXIMATE TIME WHEN WORK WILL BEGIN �'� 1� osii ., 4"d a 90. 00 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 e` Mr. R(aefer PO pox 501 1,ancho 1 irage, CA 92270 327-8215 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. Naryland Casualty— Fagsurance c�,` Americom 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 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. $ a 0, q` � 30.00 Received by IDate PERMIT VALIDATION PERMIT NO. 019'G DATE APPROVED 12 // 6 EXPIRATION DATE 12/1a/90 DATE ISSUED By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE';'- With OTE:' !Kith propervaiidatsorsfP11- ( this form constitutes°ani - CITY .OF' LAQUINTA encroachment' permit v APPLICATION FOR PERMIT PUBLIC. WORKS-'CONSTRUCTION4 (ENCROACHMENT) Y For the' construction of public or private curbs, driveways; pavements, sidewalks, parking lots, sewers, watW_rMirtst!, and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS'-. O Subdivision Iinprovement Permit — Class 111 - OAT % �"�%� �/� kynor lmprovement Pe t Class IV" LOCATION OF CONSTRUCTION: ` 40 J �U d�i�Z S �l -b $� , �- L a / (Street address or Oescription of Location) PURPOSE OF CONSTRUCTION 47'D lJ Sketch (attach construction plans if appropriate)= DESCRIPTION OF CONSTRUCTIONall_ 4,' DIMENSION OF INSTALLATION OR. REMOVAL S12E OF EXCAVATION, IF NEEDED x APPROXIMATE TIME WHEN WORK WILL BEGIN %F-e� APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION -COST,$ ' (Including removal of all obstruction, materials; and debris, ba-kfill ing, 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 CitV, its authorized 'agents, officers, representatives and empiovees, harmless from and against arty and all .' penalties, liabilities or loss resulting from claims or court action and arising out of any aceident, 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. , r Comply with all applicable City Ordinancesthe terms and conditions. of the permit and all applicable rules and regulations of the Citv of La Ciuinta and to pay for any additional replacement ng", ry as the result of this work. c Signature of Applicant or Agent Name of Applicant (please print) v Business Address Telephone No. Name of Contractor and Job Foreman =, Business Address .. Telephone No. Contractor's License No: G ` City Business License No. 4.4 Jv r,>A_1Se� AL Apoicant'rinsurance Company Policy -Number, .• �(v' ��or=�LrGfl t:CCC• C,.F,ani.ne�nnImnrnvarnaintParmit—rlaee"II1- - ruYlll, IIIIFJI V��i,.G„N- V,o v. wuna eeu w,aaua. a,vn w a Private improvements: 3% of estimated construction costs Minor Improvement Permit - Class IV: See attached schedul Insoectlon Fee : S Permit -Fee J` Penalty. ' Cash Deposit -Surety Bond if required .` TOTAL: Receipt No. ; Received by Date, Recorded by No - PERMIT'VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority -TELEPHONE: (6191564-2246 { 1 1 -1 5 MAX' C. REEFER 110.4 ANNE G.4REEFER P. 0.. -BOX gill PH. 619-328-8215 RANCHO MIRAGE, CA 92270 ,• 9Q-7061/3222 PAYTO THE ORDER OFGLa Y a �,•.A �.�/d! T/! i.4_$:9�'�'77 • .. :..w,.'., :'�•:;.%:"��;,^+r :.> ..-y r^-. .... I .. ro .. mss; - '�' 'L•ARS� . t .. • RANCHO MIRAGE OFFICE ' " ., - v • '`--. 71991 HIGHWAY 111 • ti •�� ,'" �� r "�' " RANCHO - CA 97770 , • ' ""''�`-`� . I.SAVINGS BANK . FOR f2et"WrlS b �aw.pys s r:- • -. r .� �� .� �� �; 'mac/ - }— II800.1�L0411' :o:3 2 2.2.705 LBi: 009746948900p' _a c