0981«iNt T..m.an:piev. �' *�+�',r�-':au (,.,T 0 t�t•,fi f:. l.. r.+: 1.. -- 5 g�[ '• i•i I IF ,r,r{f �2 �*� _�✓
$lr R '.` ' V.Y,y� „t�,''4«, •6' 3'�G"�tira�'✓'''F'�x •1¢nyiii••�'%f ircr• y�C�....sy;:yC.:,'vz3.�'i"-+.I'hea�' �'�T-,.e '�«:f'rim•?"-C;:+:lb`�,•„i::.r'�b'•:'i.'�,
- i .;- �� :: } _ � .. « . �.'^..r'•'.•�'.''':.+...4r-'•+f:..: _•.t �.ws •+a- � • _ '.; .. ..s•..nv+e.=�'il•r� r•-.=�-: •rr..�.�:2...r:.,.�.++, sr:,.+...�•�.,..a�r, �.+.v-...r:; — y+-...' ••. ,c.•,�.
NOTE:
'With proper'validation
this form constitutes ani •
CITY OF 'L'A, QUANTA
encroachment permit
'
APPLICATIONi FOR PERMIT-tf
' •1
PUBLIC 'WORKS CONSTRUCTION (ENCROACHMENT) I
OF
r For the construction of 'public, or private' curbs, driveways; pavements, sidewalks, parking lots, sewers, water mains
.an`d other like public works improvements in connection with,MINO'R.IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement•Permit Class III
,7A:nua�ry.• • 1.1 r 1991 +�:' �' :
.'DATE: •^' _- 'Minor Improvement Permit"Class IV
'LOCATION OF"CONSTRUCTION
.51665 Avenida^ Villa '
(Street address or Description of Location) '• ,-
'PURPOSE OF CONSTRUCTION install gas''mainr t `•
Sketch (attach construction plans if appropriate)
• • - DESCRIPTION OF CONSTRUCTION a nC ear
jet 20'' dr�ivewav;�
' DIMENSION OF INSTALLATION OR.REMOVAL 105x2 ° V •wide -'' reference so.:`Cal Gas permit
SIZE•OF EXCAVATION, IFNEEDED - ti.
conditions, of« permit .0959''
a : . . « shall apply. to this - peimit
APPROXIMATE TIME WHEN WORK WILL�BEGIN. 1/1491
^+
APPROXIMATE.TIME OF COMPLETION" .1/14,191
ESTI MATE D.CONSTRUCTION COST t = -
,
(Including removal of all obstruction, materials, and debris, backfilling, com t , }
paction and placing permanent+ resurfacing and/or replacing improvements) « '' •`
:In consideraiionof the granting of this permit'ethe`applicant hereby'agrees"to:
'Indemnify, defend'and save the City, its authorized agents,•officers, representatives and employees,`harmlessefrom an�d'against any and all
penalties, liabilities or loss resulting -from claims•or court action and arising'out;of any accident,,loss or'damage to personsior property
happening,or occurring,aJ.a proximate result of'any work undertaken under the permit gran
ted4pu`rsuant to this application.
r• Notify the Administrative Authority at least twenty-four (24) hours•in advance of t/he timer hen work'will be, started.'
Comply-,with"all applicable City• Ordinances, the terms and conditions of the,permi and all applicable rulesandregulations of the City of, ` �t
y La Quinta and to pay for. anyyadditional replacement necessary as the result of t work. •"
_ y
' Signatu&e\dfApplicant or A�ent
�,t of
Masco, Construction PO'Box 783 Palm Des®rt 0 ,'• .343•-1180 ' -
Name of Applicant (please print), Business'Address/ vti Telephone No.
Name of Contractor and Job Foreman t Business Address,,+� w Telephone No..
s t ,
,259619::., - t. t ' ` '566..1 `.
Contractor's License No. " t * . s City Business License No.'
Rehiarice,Ins. Liability Auto%General •N612535�60 p-
•-Applicani's'Insurance Company ,; ; ' , �� Policy Number• '
FEES: Subdivision Im rovement•Permit — Class I I I • '
p 7 1-11=91` - i0
r CA 3jil S 45:00
Public improvements: 3% of estimated construction costs+ - ,At
,
tPrivate iniprovements:�3% of estimated construction costs,.'
• Minor'Improvement Permit — Class IV: See attached «sche'dule- +
Inspection Fee $ :4 5' Q•0�- �''y -PERMIT IVALIDATION
Permit Fee 0981
• '' `PERMIT NO. •'�
Penalty
.. ' °' •. C,«
•` ,• .1 /11/91
DATE APPROVED Deposit -Surety Bond '
.ifrequired 331i91 •
,.
,
,EXPIRATION DATE•
TOTAL•r ` $• 45.00 k Ka
*' "'r`-DATE.,ISSUED./'/,�t/11/9'1
4 Receipt No: ,' ' ? . ; •`. i .!%�+f'1�'�4t✓�G ',
By
Received b ( - Date ' „ Adrninistra ive
y -• r _ t ! t`ve Authority
Recorded by - + ' - TELEPHONE: (619) 564-2246•
+. _ o _ _ .i5�,y�,�,r�yi ' .e.`�,.� i... r r +� c. rte.. r s r .A.r n+.,.y�w �a .!• � w �. i. �.). Ay w..► �Iw tri er .i. wlw w w� wl. s:►s. wu w.•.....�. � L..r r � fir• ..�..w.
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: January ll.. 19131 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 51665 Avenida Villa
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION install rias main Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION treanch 85' earth
let 20' drivewav
DIMENSION OF INSTALLATION OR REMOVAL 105x2' 6" aide
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WdRK WILL. BEGIN
APPROXIMATE TIME OF COMPLETION 1/14/91
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:
A
reference So. Cal Gas permit
#r 0959
conditions of permit 0959
shall apply to this permit
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 Wh 4ork will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit and all apilicable rules and regulations of the City of
s'�
La Quinta and to pay for any additional replacement necessary as the result ofiiI h•d' rk.
macco Construction TSO Box 783 Palm Desert;
Name of Applicant (please print)
Business Add
ppl
343-1100
Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
.'x.59619 566
Contractor's License No. City Business License No.
Reliance Ins. Liability Auto/General N61253560
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 $. 45.00 II
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
45.00
Receipt No.
Received by Date
,p��tf i n�lTwoif-�f i -9i 45.00i0
PERMIT VALIDATION
PERMIT NO
DATE APPROVED
0981
1/11/91
EXPIRATION DATE 3/31/91
DATE ISSUED.- 1/11/91
y' Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246