0995....a„r-..c..-.,-.-a�w-.�....<.,c.rw...,a.a,.wa..++,.•-••---.,•-•.-•.,�-+,.+,F.•�,J•+�, — .. ��-.r•r.+i;.:.:z-+�,..-..r-�=.,,^..r+.,.�� ^.'� s.�.�•,"}.^-"4.,"-�..+'Sr•�+.... - •�.+t.-^---*--v..-._.
r' h
NOTE:; J
With propel- validation 2
this form constitutes an
CI.T.Y .OF LA QUINTA o
encroachment permit •;
+ APPLICATION FOR PERMIT
F r. .PUBLIC WORKS. CONSTRUCTION- (ENCROACHMENT)
OF
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 '
wi
' C ,
1-29-91 Subdivision Improvement Permit — Class III
DATE, ti Minor Improvement.Permit Class IV'
LOCATION OF CONSTRUCTION
(Street address or:Description of, Location) '
PURPOSE OFCONSTRUCTION Sketch (attach construction plans if appropriate)
~ DESCRIPTION OF CONSTRUCTION 'BARBER GREENE PAVER -_1 0
10`10"' WIDE 'GREEN WEIGHT ALL ELSE LEGAL ROUTE WASHINGTON AT FRED-WARING
- TO 52 TO BERMUDAS TO NOGALES
AND, NAVARO
• DIMENSIO.N'OF INSTALLATION OR. REMOVAL
SIZE. OF EXCAVATION; IF,NEEDED HATE 1-30-91
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION'COST $ - -4 ,
(Including removal of: all obstruction, materials, and debris, backfilling, com-
paction and,placing permanent resurfacing and/orreplacing improvements) '
In consideration of the granting of this permit,. the, applicant hereby agrees to:
Indemnify;defend and save -the City, its authorizedtagents, officers,' representatives and employees, harmless from and against any and all
penalties, liabilities or lossIresulting from claims or court, action and arising out of any,accideni, lois ordamage 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 ofApplicant or Agent {
TARMA(' MACCFV CAATTI aLD 'Dnf'VDD n- M97 I AAGA n�'Ac+T.;nR1
Name of Applicant (please print) Business Address '✓y `� Telephone No.
Name.of Contractor and Job Foreman Business Address Telephone No. -
6M PTT—P" - ON. FILE
Contractor's License No. City Business License No.
ON •FILE
Applicant's Insurance Company " ~
. ,Policy Number
FEES: Subdivision Improvement Permit — Class III .
Public improvements: 3% of estimated construction costs r t pQ5g8? p 96 Q —91 Q
Private improvements: 3% of estimated construction costs iV �AHni�TA 10.0
y,,� 0 :3 .f P 6 `
Minor Improvement Permit —Class IV: See attached schedule `' ` Nw , , L •
Inspection Fee :$ PERMIT VALIDATION '
10._00 ,
Permit Fee t • PERMIT NO. • 0995
Penalty28-91:
Cash Deposit -Surety, Bond DATE APPROVED ✓
if required EXPIRATION'DATE/ 1 a/0-91
TOTAL:. $ 10.00 /�
JL -29-9z -yY ,
DATE ISSUED-
' `•'Receipt No. •� �'��a�_ ��� •,
By�.
Received by Date Administrative Authority
Recorded•by .TELEPHONE: (6i 9) 564-2246
i . fit+ 7t-•Y..�:, 1°ti r _ n. " .z:_ �.».;, w�� •• � A �^ f�. jj ( 4'3{
.. _-1f��R'rr..+v...ANe e�Q Q! Y M .e+:+M w.� .M' w. � �^61t441?fMa.ge. tR.2► w...D- 4� �w' 6L�r�. e? -.!4. i. ;» 2�r-.+fir .w.: h .rflrvw w: MPF .i; .s. .� �.. l:. T .e.. S� ..4 9S -epi
Mr
With proper validation
this form constitutes an
encroachment permit
r
CITY OF LA QUINTA
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 '
1-29-91 Subdivision Improvement Permit —Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
BARBER GREENE PAVER 10
1DOE�S1R01�1?T OINDE COGREENCTIWEIGHT ALL. ELSE LEGAL ROUTE WASHINGTON AT :FRED WAKING
'TO 52 TO BERMUDAS TO NOGALES
AND NAVARO
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED HATE 1-30-91
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 resultof this work.
/,W
Signature of Applicant or Agent
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
ON FTT.P. ON. FILE
Contractor's License No. City Business License No.
ON: FILE
Applicant's Insurance Company Policy Number
FEES: . Subdivision Improvement Permit — Class III?
Public improvements: 3% of estimated construction costs . (pjpp51g'aqbiq 01,—'19 91 0
Private improvements: 3% of estimated construction costs i0 SA H 1 .-I 10. i<�
'Minor Improvement Permit — Class IV: See attached schedule N2 09
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
'-if required
TOTAL:
Receipt No.
$
0.00
$ 10.00
Received by Date
Recorded by
PERMIT NO
PERMIT VALIDATION
0995
.DATE APPROV�ED28-91'"
1-30-91
EX_RIRATIO'N-D.ATE;/ /r
(DAT>E ISSUED"
By
TELEPHONE: (619) 564-2246
strative Authority
lith Pwaf uilldritida
its form constitutes an CITY OF LA C1UINTA
ncroachment 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
TATE: Minor improvement Permit Class IV
.00ATION OF CONSTRUCTION
Street address or Description of Location)
'URPOSE OF CONSTRUCTION .'Sketch (attach construction plans if appropriate)
)E CRIPTION OF CONSTRUCTION
eo s Ll
)IMENSION OF INSTAL ATION OR REMOVAL
O '' Ueil�ZG1Y��s
SIZE OF EXCAVATION, IF NEEDED
PROXIMATE IME WH BE i
AP T EN WORK WILL G N � „-`�% '• '
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 arlsing 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 (241 hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and-4conditions of the permit and all applicable rules and regulations of the city of
La Qulnta and to pay for any additional replacement necessary as the result ofthis work.
Signatur of Applicant or Agent
w A7. //"IV
/---- 1-6215z�
Name of Applicant please print) Business Address Telephone��_
Name of Contractor and Jo Foreman Business Address Te4epho No.
Contractor's License//N/A. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class
Public improvements: 3% of estimated construction cost
Private Improvements; 3% of estimated construction costs No
Minor Improvement Permit — Class iV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee PERMIT NO.
Cash Deposit -Surety Bond
DATE APPROVED
if required .I". T EXPIR
A iON DATE
TOTALI
t �,,,�►
receipt No..* 7'
AecslV�i� by
bete r'. + �y. Adminlstrative Authur111
Recorded by TELEPHQNE;'(919) 664.2246
NOTE:
*= With proper validation
this form constitutes an
encroachment permit CITY OF• LA QUINTA
' < . APPLICATION FOR ''PERMIT - {
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)44"
OF Tib i a
For the construction of public or pr'ivate curbs, driveways, pavements, sidewalks, parking, lots, sewers; water mains -
} and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED.SUBDIVISIONS ,
• - { r : , L
1-29 91 Subdivision Improvement Permit —Class l l l +
- DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION r ('
(Street address or Description -of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) ¢ I
D CR oN BARBER GREENE PAVER
1�$101PTI1�lIDE,COGREENCTIWEIGHT ALL ELSE LEGAL " ROUTE WASHINGTON AT FRED WAILING ~� A
TO: 52.TO BERMUDAS TO NOGALES • } -
y AND NAVA
RO--L
DIMENSION OF INSTALLATION OR REMOVAL '
4 SIZE OF EXCAVATION, IF NEEDED DATE' "1-30-91
!J
�( 1_ APPROXIMATE TIME WHEN WORK,WILL BEGIN
APPROXIMATE TIME OF COMPLETION '
` ESTIMATED CONSTRUCTION COST
^ (Including removal of all obstruction, materials; and debrisbackfilling, com- '
.. paction and placing permanent resurfacing and/or replacing improvements) .
In consideration oftthe 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
• i - 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 ofa-
'La Quinta'and to pay for any additional replacement necessary as the result of this work. ,� Y
d y Signature of'Applicant'or Agent
mAtiMAr fvtnceFv cnrm nrtri RGlCN''P.6L, $(,1�( ,'I.AAgA I?P4 8�6�It
.. + Business Address Tele
Name*of Applicant (please print) phone No.
ir
Name of Contractor and Job Foreman Business Address' " Telephone No. r
' i ON ~PTT�.F ',,' .t ON-. FILE .. Y•. ., s.
. '.Contractor's "License No., - * ` City. Business License No:
ON FILE
tri
Applicant's Insurance Company Policy Number
FEES- "Subdivision Improvement Permit — Class I II • t;. t'- '
Public improvements: 3% of estimated construction costs.' 485i8CATH'91bT�TAL 719-91 10.000 , ••
- Private improvements: 3%:of estimated construction costs
Minor•Improve'ment Permit -Class IV: See attached schedulee 0 9 9
N-
+ Inspection Fee '$ PERMIT VALIDATION "
-.10 ".00 . r ' ..
Permit Fee `
' a � PERMIT N0. 0995
-
Penalty
' • _ DATE APPR0 9-9
Cash Deposit -Surety Bond .• r
tAl
1-30-91
if required ..
TOTAL $ 29-91
10.:00 —
Receipt No. -.� '
t F Received by Date y A mistrative Authority,
, - .'r. v
. ' Recorded by TELEPHONE: (619) 564.2246 ,' i ; • i,^