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0967NOTE: 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: 12-27-90 Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 53-825 53-985 53-995 mmdma (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans.if appropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL r7i,111 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN driveway approach shall be constructed per riverside county std no. 207 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 ofthe p re mit and all applicable rules and regulations of the City of La Quinta and to pay for any additional replacement necessary as the,/es140, It of this work. gnature of�Aliplican�t�br Agent Name of Applicant (please print) Business Address P Telephone No. PAA _—nywarit+an bnrrcg aPma S:)MIR Name of Contractor and Job 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 Minor Improvement Permit —.Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Recorded by $ Al. ('7. 30.00 $ --,2=3o.004.G Date %95i8W?I _TQ0T ' �i7-90 30.00 0 N 09"7 PERMIT VALIDATION PERMIT NO. n047 DATE APPROVED 12-27-90 EXPIRATION DATE 01-04-91 DATE ISSUED jI�SUUED12—;7-90 r v .04 Administrative Authority TELEPHONE: (619) 564-2246 .ACt'.:... •�"''dA.•� .:.r'-. _.w._ +'.;i.^t.� ,: j.' •*,:,. ti.� -^_'v' '.r• j: ^.,j �.r��.i* _ .r ...•.�.- .`�. r ..., y.,,.+.r.,.L++...c''.+++�.ay..•..-r-�`. y�'�<j� e .. 'P-.i:-•�. �n e+ rr. ��r. -..-r .r � s �'!� wtr ►5.+..n:. L+.w-a �.+-.�.+6'Y•+Lrw, w. ;.►eA+w. r'+er .�. ....�•.ey-wr..r—o». .. — � w .r Com'+ -.r Y , i r 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 III DATE: 12-27-90 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 53-885 53-985 53-995 mandoza (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION ca,-;+�r•*ar► �x�+„-n�nh DIMENSION OF INSTALLATION OR REMOVAL 0-111 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction plans if appropriate) driveway approach shall be constructed per riverside county std no. 207 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. E Name of Applicant (please print) gnature of Applicanrf,& Agent Business Address Telephone No. ;gAA amraril r,an hcxnaa same scum Name of Contractor and Job Foreman Business Address Telephone No. h75333 Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III f 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 30.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ - 3o.oaA. � Receipt No. Received by Date Recorded by W'4ARI l 6j%.V to 17-90 30.U4 U 0.1% PERMIT VALIDATION PERMIT N0. OQ(Z,7 DATE APPROVED 12-27-90 EXPIRATION DATE 01-04-91 DATE ISSUED 12-27-90 Administrative Authority TELEPHONE: (619) 564-2246 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: '— �eo-�, LOCATION OF CONSTRUCTION ?4--3 -3 (Street address or Description of Location) , PURPOSE OF CONSTRUCTION DESCRIPTION OF COIWSTRUCTION AD' _/a V-- ,.A o� I Subdivision improvement Permit —Class 111 Minor Improvement Permit Class IV DIMENSION OF INSTALLATION OR REMOVALL' l. 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-kfill'Ing, com- paction and placing permanent resurfacing and/or replacing improvements) Sketch (attach construction pians if appropriate►" 7 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 124) 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 asthe o�this wwork. -7, e, // - _ _' Signature of 00 ica r Agent Name of Appli nt (pillase print) Business Addre Telephone No. 0 Name of Contractor and Job Foreman Business Address Telephone No. .13 ji .5-3 3 3 Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision improvement Permit —Class Ill Public improvements: 395 ofestimated construction costs Private improvements: 3% of estimated construction costs 0' Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ a' d D I Permit Fee Penalty Cash Deposit-Stirety Bond if required TOTAL: ; $ Receipt No. Received by Date N. PERMIT VALIDATION PERMIT NO. DATE APPROVED /Z- Z 7 — 9q�. EXPIRATION DATE P %— ,Oy .L j DATE ISSUED /Z — Z7 — 9 45 By Administrative Authority Recorded by II TELEPHONE: (619) 5642246 F. _ F � . �� / qM1,:':iF�. .- _ - l rrxu} 4 !"•^ _ •• < <r.,. ✓ri, y � r. a.o .o N .aada N dls . �ep-Z . L. -. 4 SMO / S/A3d x3' NA19 h%7i�oblddd J/1VM3•HJS• S' ' ap!IUSA Aluno3 �3lif'� �\� N. .,,0 '•t .0 ••Z 9, 7rlldl�fwllo 7Y/1K#53M jV AVtAy SNO/.S1v3xx7'A x xwmw ��� , , • : 31 • • 'NOI115N'gLL 3CTMJ 03uf33dS •� S•00143.133w UON 3N/7 .41Y-7dOHd '' . s. « Y Y7►Af70/SS 3NL !O 3N/7 ;J :39r1Nom-4 A11J3o0&d JNO JOFbV 7VNbn119N07 •illi NOd! ,969 NrNJ 3doN r ANP NINVA1 S4rM7Aly41 N3314139 ANrA ION 77VNS APMIA/d0 Ol 1N3.7rP0r ' '} 03d+ln03N Brn-7 IN913N 77nd d0 ,OI I v3Nr 03d&VAI d0 3do7S 7rN/Onl/�7 313MJN0J' 03N/y18o 3d+r 53d07S' O/vS 7/1N1 07rM30/S•0„ SSr7o 39 77bNS' No/JondISNO.7 17r "7 S53dfd3o' Bbno !O iN913N, d0 3Snro3a 13N i8' f " r JON Nr-? S3d07S • 9N/1/0/7 3A06r 3N3NA Y d K MW03& S/ 40 S1S/X3 '1V7ViM30/S ° 7 al7VA130/S ON N3NM' • : Nfw. 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