0965�-•... n�',y�,. ;..y�, .r .. v-.-zr•w.� "v-t�.-. ,�. _ate:. ��i,•ita"°.L..."-�'-�-�.-.'lw�+..t+..T.`�---•-r �Y...:..:.. , ,� + -. ..,� .- -.w�' r :.ta2"a-+�'�'�� t .c•. -!ti. .n• ..��_�,
-.. ...�.r.c.-s.:..►'�A.:...+....�r-.a..a.�. rt.ew..�.+w::.w..+..+F..,++ewi+...�.Hr-4!—wr+►.�..w„w= .+.w.rr�; .r•r.-- .
NOTE:
With proper validation.
this form con`stitutes`an
encroachment permit
CITY OF• LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
0
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: 12''26•'90 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 51.-����« �7>r'i•tac�n `
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION DRIVMY ASH Sketch (attach construction plans if appropriate)
s
DESCRIPTION OF CONSTRUCTION ASPHALT
DIMENSION•OF INSTALLATION OR REMOVAL 17x18
SIZE OF EXCAVATION, IF.NEEDED•
APPROXIMATE TIME WHEN WORK WILL BEGIN 12-27`90 r
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:
• 1
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 o(Applicant or Agent `
KF%T 4'T'PM M P10 '00 P(W r, -) A ri_AT.u_nn WM7kt-M_a nusi,ressn l_ r+
Name of Applicant (please print) �'' BnAddress Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FIFES: Suhdivisinn Imnrnvement 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 $ 20.00
Permit Fee 110.00
Penalty
Cash Deposit -Surety Bond -
if required
TOTAL:
Receipt No.
$ 30.00
Received by Date
Recorded by
PERMIT'NO,
5.0518tAS#i S,S��TA�Cb-90 30.00
N2 09`5-
PERMIT
9`5.
PERMIT VALIDATION
0965
9
DATE APPROVED 12-26.90
01-04=-91
EXPIRATION DATE
DAT' E ISSUED _7 - .12-26-90
By .� v
Administrative Authority
TELEPHONE: (619) 564,-2246
G, <. qr,L-^ .!. '.•P' w"• :. _ - .' ., :,., & - '+} .- S�. �. ;.r �, ,. r,;,,,;. , . ., a ;���" n^ ::-v- .f..i�:u , y^,Z -
,.T..•.--s-s•r" i.%:�.^�,a,!rt1+d'�',-C1"`�`�.tJ' ��u^".E+5.#-�'.' +i^J�-+-�vi.'t`y^wa-�,r.i+`+`.� i�.'.k,Y� _.f.r-.,Xa•�,.a+.cd
-.. sel�I�a.�PM+,C�+pv'r-`4a.w: .r.-!. ya.• w3 ws.�.� +a .� � •s. c....6 -.r.. �,-e►w. ... ll..s-a: t+•r..T1. ..•`w.+?a., ... ,ti .►.r±..e. fir: c+. T^,?�w.: 1+.6�. ....... � .r a�. �1.. a. w
/ :fit. �• -
f�1 -
If'. j
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 II I
DATE: 12-26-90 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description'of Location)
PURPOSE OF CONSTRUCTION DRI�i1 tkY AtWCACH Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION ASFjMjT
DIMENSION OF INSTALLATION OR REMOVAL 17X1:$
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 12-27-90
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 work41.
,
i
Signature of Applicant or Agent
KFS sT(~Ml4PR T -Y) un)rg�A PAL7 gr) mTD-ar_v ni--)m rz
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.
I
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class II
Q05191 kG 18 6-90 W
Public improvements: 3% of estimated construction costs iUA H UTA 30.00
Private improvements: 3% of estimated construction costs T0 9
ti
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ . 20.00
Permit Fee 10.00
Penalty `
Cash Deposit -Surety Bond,
if required
TOTAL: $ 30.00
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
0965
PERMIT -NO.
DATE APPROVED 12-26-90
01-04-91
EXPIRATION DATE
DATEISSUED"' ""
B 12-26-90
y �/::� 74- s
Administrative�Authority
TELEPHONE: (619) 564-2246
r
•
a- • •'.
• NOTE, S
=_With properbalidation `� < ,r
k! this form constitutes an a•
CITY OF LA. QUINTA
'-encroachment permit z
EB
;APPLICATION FOR PERMIT .. • ,
'PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)-'
of 11i8�
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
w DATE: 12-26-90 Minor;Improvement Permit Class IV
LOCATION OF CONSTRUCTION 51-595" AU I=P -Acm' '
"•
(Street address or Description of Location) t1. e;
e 'PURPOSE OF CONSTRUCTION DRIVamy APPR07�'M" Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION' ASPHALT
DIMENSION OF INSTALLATION OR REMOVAL 17x18 r
`
SIZE.OF EXCAVATION,'IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1 12-27-90
APPROXIMATE TIME OF COMPLETION
ESTIMATE_ D CONSTRUCTION COST $` ' ,•r f,.
" (Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) y
Y.
• ` In consideration of the granting of this permit, the appl icant 'hereby agrees to: '
- Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all s
7
y 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. _ t
- 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 a livable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this work ',
rr
y Signature o Applicant or Agent "
t u
' - KEN Sm R vn t�nx s24 i2�iN�'tir1- ANIS-3+11
26 6
Name of Applicant (please print)' s . -- ' Business Address, c Telephone No. ,
Name of Contractor and Job Foreman S" ' , Business Address 'x = < , Telephone No:'
Contractor's License No. City Business License No.
` Applicant's•Insurance Company' Policy Number }
t'
J FEES: Subdivision Improvement Permit - Class I II
;r 6-90 0
QQ518'tA �
41 Public improvements: 3% of estimated construction costs ' 1V, 18 T07AC 30.00
•. Private improvements: 3% of estimated construction costs f, '.
N2 096"
Minor Improvement Permit— Class IV: See attached schedule r
inspection Fee $ 20.00 T PERMIT VALIDATION
Permit Fee 10.00 t - ,09.65 i s
PERMIT N0.
ye
Penalty DATE APPROVED 12-26-90
`
Cash Deposit-Surety Bond 01-04-91 ,
Or
� if required EXPIR TION DATE• - -
,
- TOTAL:$ 30.00 �� 12-26-90
D EI U
f
+ Receipt No: , r
�r
a By
Received by Date ' 14- Administrative Authority
Recorded by TELEPHONE: (619) 564.2246
,
,�''
•
'' / 1' ' i
f y`l
• r , t. _C r - ..'
A _lar
,,� ; 'IiL.'�
w
r '
NOTE:.
With proper validation•
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION, (ENCROACHMENT)
For the construction ofpublic 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: v v
LOCATION OF CONSTRUCTION � C
Subdivision Improvement Permit — Class III
0 ( Minor.lmprovement Permit Class IV
(Street address or Description of Location)
t
PURPOSE OF CONSTRUCTION-(�-% �` �%� I �1� t p ��� �^' Sketch lattach construction plans if appropriate)
DESCRIPTION.OF CONSTRUCTION
DIMENSION OF INSTALLATION OR -REMOVAL. .� f
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, ba *filling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of thegranting,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 944cabie rules and regulations of the City of
La Ouinta and to pay for any additional replacement necessary as the result of ` work.
f/ n f _ Signature o piicant or Agent
Name of Applicant (please print)
Business Address
�, r.9 S'`
Telephone No.
Name of Contractor and .fob Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
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 . N0
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee S
Permit Fee
Penalty
Cash Deposit -Surety Bond {
if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE -
DATE ISSUED
yBy
`r t y Administrative Authority
,,
TELEPHONE: 161911564-2246