0985',�fh�J""a4tiS�'��'Jc�'j��t."fi:?�ml�:�" .�`S''.f'�T'�'Yi�ti�.s`�°''0�:5r�ai�'��`I�'�•i�i�=ti}.�:l'T�'.SLSo"!:."C�;'�3Fs;.F'-'"''Gi}.51'�11.;t ',r •+�i PIKE+ i� j.•:'fii�:•eFti w
r4Manw.FlY-P►I.r., w �?• r- � ..�..�. , .� T .. �+ !�..w:ii. ^•.. w..ti.r.+ „'1 .w. .•� t� y ' '.ra ice: a �. ...Y., - .. �+
_ t
NOTE:
With proper validation `• 4 2
this form constitutes an
encroachment permit , CITY- OF LA- QUINTA _' U
APPLICATION FOR PERMIT
PUBLIC. WORKS CONSTRUCTION'(ENCROACHMENT)
• QUE. TRIP OVERSIZt L6AD •PEfZM1_T c`�'�0F r��wSw
" For the construction' -of
public�or •Rprivate curb's, driveways, pavements; sidewalks, parkinglots, sewers, •water mains
„ and oth'er.like public works improvements in•connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS.
Subdivision Improvement Permit — Class. -III
DATE: �S 4' r Minor Improvement Per Class IV
` LOCATION OF CONSTRUCTION
(Street address or Description of L+ocation) ^i. `. ` ti S e7
+ t i
MOVE' EQU I PM ENT y
RURPOSE'OFCONSTRUCTION' Sketch (attach construction plan's if:appropriate),
j DESCRIPTION OF CONSTRUCTION , ;' HALL WOuT F_,.
` �t EillR01A/•EP . ' F'EKIVAAID,D `
}
DIMENSION OF INSTALLATION OR REMOVAL ` ���•��'� �' T�` C�Ty . j IT '
, gH4_000 LISS 'ALIL 'ALLELSE LEGAL.
,SIZE OF EXCAVATION, IF NEEDED •~ 1 ; 'y ;
Ti A 1.1 }••_lp; 9i zoFo�4
APPROXIMATE TIME WHEN WORK WILL BEGIN• '
APPROXIMATE TIME OF COMPLETION'
TI
ESTIMATED CONSTRUCON COST $ ' •`AU L' ' ��T� �' •�% _ 9 e
(Including*removal of all obstruction, materials, land debris, backfilling, com r ; Y
'and placing
pactionpermanent 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 oss;or. loss, resulting from claims `or• court action'. and arising rout of any, accident ldamage to persons or property
happening'or occurring as a'proximate result of any work unde-riaken under the permit granted 'pursuant to'this application. ,
Notify the Administrative Authority at least twenty-four (24)F hours ,in,advance of the time•when work will rbe' 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 an'y additional replacement, necessary as -the result of�this work.
' + •Signa ure�of Applicant or Agent'/:''4 %
,EMERY 'L_N1VD CLEl ZTA/G 801,610 AVE y0 80MUDA DUII�_• ,' `
Name'of Applicant (please print)' . t „ Business Address Telephone No.' '
Name of'Contractor and Job Foreman Business Address.- Telephone No.
City Business License:
Contractor's License No. No:
CLONE 1�OYA•L -7 MS'::. C51�11 q�2 q:°
Applicant's Insurance Company , ' • ;Policy;Number'-
FEES: ..Subdivision Improvement Permit — Class -Illi
3 . Public improvements: 3% of estimated construction costs c
.,Private improvements: 3% of estimated construction costs
r MinorImprovement Permit =Class IV::See attached scheduleNs
: 4 '
Inspection Fee, $' ' f �> 'PERMIT VALIDATION, ,
Permit Fee s ,1 /i,• �%�, -3' .„ ' ' ®e� S•
• , PERMIT NO.
Penalty '
./- /.S'
Cash.Deposit-Surety Bond �• DATE APPROVED
' if required
EXPIRATION,
DATE . .
?z TOTAL: 'f $. /D •OCD I S - 57�
DATE ISSUED,
Receipt No. f
By
Received;by Date ®' Administrative Authority
,Recorded by TELEPHONE: (619) 564-2246 , : '
` 1
ilNl./w^��'.W`if'�.. R� A Y 49�.r�D � .+ !� AR M' M�.IIM- M 11\. ow Mt I.S• l : !LY e4 tlh 44 ��.�lSi MST j!� ^ (1 T R•'�'.w���Y. w++N' w � Mr wu � !► � w
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ME TRIP LOAD PEKM1T
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: 1" IS 9
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION / if F— OU I Pry ENT Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL II 11 // I V/
C1g,QAQ 1_91a ALL. ELSE- L F6AL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
W r- EiiiNOWEE I �hIR1�lDb
TD 1504 n E16 0A/ Sb td_
70 CITY LIMITS
flf�?(�iS:LASH f q�O.Ti~L �'���� id .0t4
APPROXIMATE TIME OF COMPLETION 1�14U L
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.
Signe of Applicant or Agent
EMEKY" LAND CLEAUA/6 50-6o610 AVE t10 C£P-`I1a01a Q
Name of Applicant (please print) Business Address
Name of Contractor and Job Foreman
Business Address
- 4 740
Telephone No.
Telephone No.
1g
Contractor's License No. City Business License No.
r_,LD1_,E1L0YAL C -775P gCCZC1
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
'Ita l9
$ /09.,90
Received by Date
T"
PERMIT VALIDATION
PERMIT NO.
-DATE APPROVED
f 9
EXPIRATION DATE
~ 9
DATE ISSUED
L' Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
'91-01-15 15:41 H. D. RY i CALIFORNIA
NOT
Whit Taper vafld *tion
t'hit ft:,,,,, 0onatitut" ea CITY OF LA QUINTA,
encra:�cJ,maryt prrmrt
APPLICATION FOR PERMIT,
PUBLIC WORKS CONSTRUCTION (ENCAOACHMEENTX
DAI r:°
-syr (tit conztrur;tion of pi,bile or private curb$, driveways; peveReants, sidawafke, parkinU lots, strweri, �tlr h1ltNe
^d other like Duolic works ir"prevernentl in conneetion with MINOR IMPROVEMENTS NTS and APP90VED Si;8DIV1Ed""
LOC+, TICK OF CONSTRUCTION
�3trw�dnremo or pesorrpa0n et Los{QrOAi
Subdivision Irnprovermflit Perrins — Ciaao III
M119' f Irftptot+eamnj Ptmiq +aloes Ill
E C,F�CCNiSTRWTi�1 .�!.°. Sk®tch {fttMoh awstmetlom piens if ebpp 11ft)
DE6CMIPTION OP COOMMUCTION
DIMFNS1ON OF INSTALLATION OR REMOVAL
Mt OF EXCAVATION, IF NE2020
APPROXIMATE TI ME(WHRN WORK WILL SEOIN
APPRQXIMATE TIME OF COWLITION
ESTIMATED CONSTRUCTiON CT =
(Inc!-idino rariml of all obstik a!lian, motorists, and d6brie, backfilling, 4*M.
pWIVA and pl*1Cinq perrrlafttnt resuriftin® ondler .replacing Improvemtif+ta)
In cor:mdafation of the groating of this permit, the applicant hereby agreall to:
,idemr.dv, dehne end saw the City. in svtriavitoo sprits, off1mrs, r'oprCNer14 "Y" s"d smplava", hermisdi 0" old ApiArt wkv go %II
;,;anemia$. HODAlties or lap resulting from a!sime Of 004Aft 110e0 erof e0e1110 tilt Of any accident. +o# er dstVnp 10 Den" gr prapo"
71ps"W4 of 00Eurr1wo t» 0 efelormts rMa of illy work urrrereavon uAdw. Int very"" grprn9a 04aredeer to this appkwil",
Ne.,tify the Aarnrnsatnnnre Aathorit'V 1t Ion rmri v -four (lilt howl in ednples of the tido 1*6ft warts wrll toe stef1.
:'or"aly wit" Jill epwitmie Clty Ordlnenjoe. trio ream and 06061119nl of t"o ve"nit end ail wpiidhfe mass and reNjations of "a Gj* e,
Oul"te ens 10 -Nv for &AV loWhimw rooialrtniant noccoo y as the reeuit of tq 4 wont, ;
st 041 of Applicant or earit
Name .9f Aoo)Grit tPleese print) ausi.-eel Address alapnaine No.
Nfimr ,f CQ1,trortor 01,014Job Foramen Business Address 1°aiesktan® N1a.
C0nv.+rtor'9 License No. _ C;ty Euslness Licomm Nio.
Appl!cint't i^suranp�prrrtra�y Polidy fdurrber .
PRIES. Subdivision lAtorwipmrtt Permit -• Clan Ill
Public imorayerrfang: 3% of @sit mated oenstruction *altos
Private imDPeoff enti: 3% of ostirristed construction costar
10 0
.... .-'91-01-15 15:38 H. D. EMERY i CALIFORNIA,.. W.. �.. w._. ,�... -,a a.., �. ,._ ,P
NOTE'.
With 17toper validation
Fhb ti-ri 0onatitutaa as CITY OF to QUINTA
enor�•::xtment Aorrtl+r •
APPLICATION .FOR PERMIT
PURI.K; W09tKS CONSTRUCTION (ENCROACHMENT)
or thr construction of public or r;rivata curbs, drivlfwAV6. oavern*Mi, iiaa+watks. parking !ott. tevvit . W@W "talft
+tf ether like Dubai: warn= imorovarnenti in cpnnartion with MINOR iMPROVIMENTS ana APP84OVED 8U»CIId18KM
Subdivision Improvement Permll . Clain III
Darts "' �� A ter= ; Mlnos' IprWoveil"ertt Permit Claws IV INEWPERIM-10-6
LOU f;CiIN OF CON8TNUtr-,n0N
.fto _
IItm! ,eearaa or 044W+01e6n or Loonivin)
Skotch tettset afwnruation piens if ad~ltd)
DESC H Ipno# 1 II* Cow 11iLI&ION
DIMENSION OF INSTALLATION On REMOVAL �At7-
$126
.)P EXCAVATION, IP EVf1EDED
APPROXIMATE TIMI WHEN WORK WILL BEGIN �.e,
APPFOXIMATE TIME OF COMPLEnON
ESTIMATED CONSTRUCTION CCgr _
ilne!uding twAvval of ail obavt#pn, rnato!r+ala, afid debris, backfilling, corn-
pavticl1t Ond 040rlo permanent miurIftfts and/or febiae11V imarovernmm)
In ::-adoration of t% grantin® of this permit, the applicant hereby agrms to:
naafl+mty, dgtvna and aseee the City. its autharited Mlartts. offisere, r"mmome"ves and arnplova", ihpfi t m tram and apleot WV WM rAl
,.r0n0ltiat, !i6wirtles or !ep resultleI freta claims or coyrt action enf arlaing R+tt at aev wident. loaf et dam" to pettOM or tPr1�eA1v
1,1096660119 of am"ind ai a "Kinreata r"Mit at any yVark uney"ll" urldat 1141 pormn onmed purawr►t to this cep Imidn.
yntity t!sa Aerrtinnttat+ve Authistity at ism r*orwyk faur (24) hours in tiol"We of the nef►i V*an aerk Wlll be 0t1+�tl,
:'arnpry with n++ $004Abia Cih• orailts"M, the tort arm wrollsans of rho ®snnit and all applklob" lulto and moul"lia"s of t" city of
.A Qwiptf and -a :Ar for env ado lam iovie cement neomiv to the raauit of rjitt anile. /1
Nam-; .yf Aero cant IDIOM prlrn)
Applicant
Business Address
No,
CQ11trppQr and Job FOramatln Sus+nmss Address Talopltono No.
Coni i.-tor's License No. City Avo+ness Licome NO.
Appiecam'i insurance Company Policy Number
Faf •. subdivislolt itwfstovsrttett4 f'armit -ciao III
public irnpro""Wnm: 3% of estimated;nstruction Costs
Private irnorev®rwii: 3% of aftimaW comtruetian costs
?99