0970.+•.x.a..!•c�•s=-......�4.!.k-�5a'y ••4•'-`et?�x�..ti"'e^r•••!-�^�'� "„«•��'�,^�-"'�'*`,r�..'-'.r^�.-�^-•^A'"";v.:•�^`r"�,+–n—i^^��Y'.e",�"'rs ++,�•n��•^..+�eu •'yF �'y.
• NOTE:
With 'proper validation
this form constitutes an'
CITY,.OF, L.A7`,QU-INTA
encroachment permit,.
APPLfC;l%TIOW FOR PERMIT,
PUBLi6'-'WORKS'PONSTRUCT.10N.-(ENCROACHM.EN.T.)
For the construction of public or 'private *.curbs,driveways, pavements, sidewalks,-. parking lots, sewers,. water mains
�an MINOWIMPROVEMENTS and APPROVED SUBDIVISIONS
d �otheHike public works improvements, in connection with
.2-91
Subdivision Improvement Permit,— Class •I I I
DATE: Minor Improvement Permit Class IV
LOCATION,OF CONSTRU'CTION'
MOVE-EQI1 MEN.._
jh.
(Street address or Description of Location)
'235'BACKHOLE
PURPOSE OF.CONST I RUCTI . ON Sketch (at.tach'consiru.6tionl plans if. appropriate)
AVE `47/WASHINGTON SOUTH- TO.
DESCRIPTION -OF -CONSTRUCTION .
TAMPICO AND ]IRONW'
DIMENSION OF INSTALLATION OR REMOVAL'
SIZE OF EXCAVATION; IF NEEDED
-APPROXIMATE TIME WHENNORK WILL BEGIN
APPROXIMATE TIME OFCOMPLETION. - 4&
ESTIMATED CONSTRUCTION COST$
.(Including removal of all obstruction;., materials, and debris, backf illing, com--
paction and placing permanent resurfacing and/or.r.eplacirig improv4ments.)
In consideration. of 'the granting,of thisrm
pe it, the
. applicant hereby agrees.to:'.
Indemnify defend'and, save the City, its authorized agents, officers, representatives and emp16yees, harmle ss�jrom and against any and all
penalties, or loss resuilling fr;rr)' clai6. or court a*ction,and arising . ouf'of any accident,`loss or damage to persons or pr
P operty -
happening. or occurring as:a proxim6t.e result of any Work undertaken under- the permit granted pursua'nt to th'is' application.
Notify the Ad,ministrativd Authority at least twenty-fo'ur'(24) hour�s,in advance of,the time when work will be started.
7:
Complywithall 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, repjacement necessary- as the result of this work.
Signature of;9plJFicant\b11,geht
-JONES.BROS P'.0. .'BOX
I
Name of"Applilcant (please, print).: Bu'iness'Aciclress� Telephone No:
Name of Contractor and Job F6reman business Address Telephone N6.
Contractor's License NO'.e�
City Busiri ss, License No.
A 7.1 r"V, A 8 or -b 9.'A ro J. 0
Applicant's Insurance Company t Policy Number
FEES:
Su.bdiGision.lmprovement Permit — Class III
Public 04,
u ic improvements: 3%'of estimated construction nst ructicin costs T� 10.
Private improv6ments: 3%',of estimated construction costs
0 9
Minor ImprovementPermit'sm"Ciass IV: See attached sched616
InspectionrFee $ - PERMIT -VALIDATION
Permit Fee • 10.'00
PERMIT NO:' 09711
Penalty
Cash Deposit Surety Bond DATE APPROVED 1-2-91'
if required
?XPP.RAT-ION-DAT E
TOTAL: 1 0.700
DATE ISS6-Eml� 1-2-91
Receipt No;
Received by Date -Administrative Authority -
Recorded by TELEPHONE: (619) 564-2246
isq6, k-1110—
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
1-2-41 Subdivision Improvement. Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION MOVE EQfP)~3ENT
(Street address or Description of Location)
235 BACKHOLE
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
r'71 1Za+ 1 7 A:nnnn 11. _
+J `� "_�`� y""� AVE 47/WASHINGTON SOUTH TO
DESCRIPTION OF CONSTRUCTION
TAMPICO AND RONDO
DIMENS/IONy,OF INSTALLATION OR REMOVAL
t
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, 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
JONES.BROS P.O. BOX
Name of Applicant (please print) Business Address % Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Ai 2,0-)1 1 ca
Contractor's License No. City Business License No.
Arrpri71 86F5954610
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.
10.00
$ 10.00
Received by Date
Recorded by
?85'8&§8 P�&T_y' io..6J'
0
PERMIT VALIDATION
PERMIT NO. 0970
DATE APPROVED 1•-2-91
1—�-91.
EXRLRATION-DATE
r .
DATE I.S-SED Uf__ /% 1-2-91
/ w Administrative Authority
TELEPHONE: (619) 564-2246
inoi 0? r01 OG' 00 0103002012 JONEC Dnoc.
NOTE:. _
With proper.- uatlidstion
this form constitutes an CITY OF LA QUDNTA
encroachment permit
APPLICATION FOR PERMIT
PUB�1C. WORKS CONSTRUCTION (ENCROACHMENT)
n. 2. r2
.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
GATE:
LOCATION OF CONVIRUCTION
Subdivision Improvement Permit — Class 111
Minor Improvement Permit Class IV .��.
iStreRt addra� 4r Oetcription of. IAC�tign}
PURPOSE. OF. CONSTRUCTION �.,... Sketch (attach construction plans .if appropriate)
i'Z •J 49d ego I brc
DESCRIPTION OF CONSTRUCTION . -
DIMENSION OP INSTALLATION QR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN v
APPROXIMATE,TIME OF COMPLETION
EST'IMA'TED CONSTRUCTION COSTS -
Ilncluding;removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent .resurfacing and/or replacing improvements)
�r--T- p
� 1 :� PIGo S 14o+Q�
In consideration of the granting of this permit, the .applicant hereby agrees to:
Indemnify, defand and save the City, its authorized'agents, officers, representativei and employees, harmless from'and against any and all
,penalties, liabilities or loss resulting frorn claims or court action and arising out of any accident, loss or damage to persons or proporty
happeniq or occurring as a prouinote result of any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority dt least twenty-four 124i hours in advance of the time when work will be started.
Comply.vritdi all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
to ouinta and to pay for any additional replacement necessary as the result of this work.
Vic..M p6w %G- - 'L & I
Signature of Apnt or•Agent
Name of Applicant. (please print)' Business Address Telephone No.
Name of Contractor an' d 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
�^
Extended Page 2,j' T
Public improvements: 3%
timat6d 6on8truciion costs
r
Private improvements: 3`Yo of estimated construction costs.
, , • �'... "
Minor Improvement Permit —
Class IV: See,attached schedule
�r Inspection Fee.
PERMIT VALIDATION
Permit Fee
4
~PERMIT NO. if '
- Cash Deposit -Surety Bond
i DATE APPROVED - -
if required _�
•
EXPIRATION DATE
TOTAL.: $..`;
DATE ISSUED
Receipt No.
By,
Received .by .a;„ _:q..,_ _ _
Date
, Administrative Authority
Recorded tsy'
'TELEPHONE: (618) 564.2246
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