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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
DATE: 12-2151-90
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 5'1-725AR'1-71 y RAMTRP.7,
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION'S HOME, S Sketch (attach construction plans if appropriate)
fft %MiAY APPROACH SHALL BE
DESCRIPTION OF CONSTRUCTIONrr-T-71,+71 C NSTRUCTED POR RIVERSIDE COUNTYSTD NO
.207 (AT.V CHER)
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN ASAP
'APPROXIMATE TIME OF COMPLETION 3' DAY
-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.
Signatur'oof Applicant�'or`AgentR.
,TTM SMTrrT4 Stn -7-n r^urnpV RTT.T. Tn 771..-1 Af1r,
Name of Applicant (please print) Business Address Telephone No.
nFl?TrV 1 7—'2 A 1 '7
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
MARYT,ANn f'AgTTAT. rp7A1 nrantin_an_
Applicant's Insurance Company Policy Number
FEES:. Subdivision Improvement Permit.— Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ nn
Permit Fee 10.00
Penalty
Cash. Deposit -Surety Bond
if required
TOTAL:
Receipt No
$ 30.00
Received by Date
00"182 CA$H EQ 12-26-90
Lb90 30.0D
No
PERMIT VALIDATION
PERMIT NO. 0q4/0 4-/
DATE APPROVED 12-26-90
EXPIRATION DATE 01-04-91
12-26-90
DATE ISSUED
By IVE1147
U Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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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
DATE: 12-2(3--90
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 9;1-177r, r r,1 -71q PZMTT r17
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTIONDA;g��pgl rr,r�Mna�v
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN`
Sketch (attach construction plans if appropriate)
=R=&zt,51X TP '.C2 SHALT. BE
CyJT13TRuC97_M PIVIMSIDL COUNTYS'lD NO
007 (AT'EA=)
APPROXIMATE TIME OF COMPLETIONI MAY
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.
7 rA--).
Signature of ApplicantkorAAgent V
.M1 5-,-T1rv;T X n-7 s -A Ck-r-I PV PITT.T. TrC 771-1 Qr1r,,
Name of Applicant (please print) Business Address Telephone No.
l '7
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
City Business License No.
7,v'ArVT.Li,11) 0.14TTAT, T -7, ;\,l a'!r(trnnll
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.
Received by
$. on nn
10.00
$ 30.00
Date
PERMIT VALIDATION
PERMIT NO. f7r4/n �L/
DATE APPROVED 12-26-90
01-04-91
EXPIRATION DATE
n
DATE ISSUED
Bya�dl,nf�i
r' Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
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NOTE:
With proper validation
this form constitutes an CITY OF LA aU1NTA
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
` q Subdivision Improvement Permit — Class III __�...�
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION - "� ^ 72S 6-27:, — 7.35 RAM tIF,$=`Z
(Street address or Description of Location) // '
PURPOSE OF CONSTRUCTION __/,Vi�Ly _1,1�11A0-k Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
rzs r�Z eo�...T yZ�7
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN7_77SAP
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
o:indemnify,.defend and save the City, its authorised agents, officers, representatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from, clairivor 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 greficed 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 ru es and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result oftthis
� work.
Contractor and Job Foreman ' Business Address Telephone No.
Contractor's License No. City Business License No.
l'YI�9iLY�%✓D ��su AL ��91 �� �Cn�9't/
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
I nsoection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
ter'
if required
TOTAL: $
Receipt No.
Received by
Recorded by
Date
N°
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED 1 Z " Co ' `10
EXPIRATION DATE f�j — Oy 9/
DATE ISSUED /Z " Z6, — 9 0
By
Administrative Authority
TELEPHONE: (61915641-2246
Signatu of Applicant'agent
N me of Applicant (please print(
Business Address
Tephone No.
Contractor and Job Foreman ' Business Address Telephone No.
Contractor's License No. City Business License No.
l'YI�9iLY�%✓D ��su AL ��91 �� �Cn�9't/
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
I nsoection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
ter'
if required
TOTAL: $
Receipt No.
Received by
Recorded by
Date
N°
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED 1 Z " Co ' `10
EXPIRATION DATE f�j — Oy 9/
DATE ISSUED /Z " Z6, — 9 0
By
Administrative Authority
TELEPHONE: (61915641-2246