1009•
NOTE: . "I" {.,
With proper validation _ }
this form constitutes'an CITY OF., LA QUINTA
encroachment permit t ,
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
a
13
'February 11, 19911 Subdivision Improvement Permit —'Class III
DATE: Minor�lmprovement Permit Class IV
F LOCATION'oF CONSTRUCTION e/ /0 EisenhoWei 935' n/o Tampico
(Street address or Description of Location)
PURPOS °OF CONSTRUCTION .splice in • new .300 pairSketcH (attach construction plans if appropriate)
cable
DESCRIPTION OF CONSTRUCTION dig 5 X 10 splice pit'
refermnce permit 0983 GTE
"';,i.,.DIMENSION OF INSTALLATION OR REMOVAL
4• '
SIZE OF EXCAVATION, IF:NEEDED 5 X 0.
APPROXIMATE TIME -WHEN WORK WILL B� /,9
¢" APPROXIMATE TIME OF COMPLETION x3/11/91
r'^^ := ESTIMATED CONSTRUCTION.COST $ '
I . s(Irigluding 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,-defendsave 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. f
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
i Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable odes and regulations of. the City of
hLa Quinta and,to pay for any additional replacement necessary as the result of this work.
Signature=of_A plicant or Agent
Herman Weissker, Inc. 2820 Industrial: Dar, Bloomington CA' 714-877-2470
Name of Applicant (please print) - Business Address Telephone No.,
Gary Wi'eoer same
Name of Contractor.and Job Foreman Business Address Telephone No.
x.83556 1661
Contractor's License No. City Business: License No
tin .file n . � s l
Applicant's Insurance Company - Policy Number { .
' FEES Subdivision Improvement Permit — Class I I I
Tiii 4Q.060'
t Public improvements: 3% of estimated construction costs ! F , iS
Private improvements: 3% of estimated construction costs.
�� n 1' •�
Minor Improvement Permit — Class IV: See attached schedule t
Inspection Fee $ 40.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 40.00
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 1009
DATE APPROVED 2/11/91
EXPIRATION DATE 3/31/91
DATE ISSUE 3/11/91
By
Administrative Authority
TELEPHONE: (619) 564-2246
4
NOTE:
A, W p U"W
With proper e, evo
this form.c8nstitu't'es an
encroach mTYi OF LA QUINTA
CI
en'"
t permit,
APPLICATION -FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
0 OF;_'
For the construction of public or privatecurbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
rebruar' 11,, 1991 Subdivision Improvement Permit — Class III
DATE: Y -Minor Improvement Permit Class IV,
e/810 Eisenhower 9351 n/o'Tampicci-
Lb 4TIQN OF CONSTRUCTION
(Street address or, Descripti6n of Location),
• PURPQqE OF CONSTRUCTION splice -in newpa3,r8ketch (attach construction plans if appropriate)
cable
DESCRIPTION OF CONSTRUCTION dig 5 x 10 splice p
refermnce pemit 0983 -'GTE
7
7tD,IMENSION OF INSTALLATIONOR REMOVAL
,
. . . . . . . . ............. :_
1
SIZE OF EXCAVATION, IF NEEDED 5 x 0
/1.
APPROXIMATE TIME WHEN WORK WILL-OdAh 9
T
-x",:APPROXIMATE TIME OF COMPLETION 3/11/91
ESTIMATED CONSTRUCTION COST $ 1100
(L
ncluding removal of all obstruction, materials,and debris, backfilling, com-
pac tion -a I nd placing' permanent resurfacing 'and/or replacing improvements)
In consideration of, the qranting,of this permit, the applicant hereby agrees to:
Indemnify, defend and 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 propefty
-happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.,
Notify the *Ad M inistrative Auth6rity'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 conditions of the permit and all applicable pplicabl Wes and regulations,of the City of
La Qui ta and<tb,pay for any'additional replacement necessary as the result of this work.
"
4Signcatu 'r-e-of-ANpli'ant or Agent
c
Herman Weissl(er, Inc. 2820,1ndustrial''Di. Bloomington CA... -714-8'77-2470
Np'me of Applicant (please print) Business Address Telephone No.
Gary Wisser same
Name of Contractor and,Job Foreman- Business Address Telephone No.
18 3 55 6 -1661
'Contractor's b6ens6, No. City Business License N
on 'file -
Applicarit'S'Insurance Company Policy Number
FEES: 'Subdivision Improvement Permit —Class Class III
A 4
60
u improvements: 3% of'estimated constr'u-ction,costs
Private improvements: 3% of estimated construction w c , osts 009'
.,Minor Improvement Permit — Class IV: See attached schedule
40.00
Inspection Fee $
PERMIT VALIDATION:'
P66WWFee , 1009
PERMIT NO.
Penalty .2/11/91
,Cash D eposit-Surety'Bond DATE APPROVED
if reciuired EXPIRATION DATE 3/31/91
TOTAL: $ 40.00
:Receipt No.
Received by _2_ Date
-Recorded by
,fDATE ISSUED, 3/11/91
By
Administrative Authority
TELEPHONE: (619)1564-2246
P, +. NOTE:
With proper validation' + { `� •� '
l •'
` this form•constitutes an , ? �.•
Q'UINTA'
L:I encroach ment`permit CITY <OF .LA +, -
+'�} APPLICATION' FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
a r c
v er,t-; `For .the, construAion"Of public or private curbs, driveways; pavements, sidewal'k's: parking lots, sewers, water mains
and other like public works improvements in, connection with MINOR IMPROVEMENTS and APPROVED "SUBDIVISIONS'
jl
r -• ,;February} 11, 1991 ` MSubdivision Improvement Permit Class, III'
+• DATE: Mi nor. Improvement Permit Class IV.
1OCATION'10F CONSTRUCTION'
e/ /o Eisenhower 9351 n/o. Tampico a �" -r.
(Street address or Description of Location)
`
PURPOSE F CONSTRUCTION 'splice in new 300 pai
OS 0 rSketch (attach constructionplani if appropriate)
a r: cable �¢ �,F F
"r di 5. x 10 .s lice' r`
DESCRIPTION OF CONSTRUCTION ' 4' p p , - ••
' reference permit `0983 GTE"' • - -
i DIMENSION OF INSTALLATION' OR REMOVAL v' ' "/ �T/ " 3' ' • r '
. ; -SIZE OF,EXCAVATION, IF NEEDED, S X 0'
9 T1""'•'J U
L h
r APPROXIMATE TIME WHEN WORK WI LL �+
APPROXIMATE TIME OF COMPLETION 3/11/91
4 ESTIMATED CONSTRUCTION COST $ 400-
,:' (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:
e + „ "
• Indemnify, -defend and save the City, its authorized agents, officersrepresentatives and employees; harmless from and against any and all .. L
• - penalties, liabilities or loss resulting from claims or court action and arising out of any .accident, lois or damage to person or property �� �'�••
,. happening or occurring as a proximate result of any .work undertaken under the permit granted pursuant to this application. . ••if '
' ,Not tha Administrative Authority at least twenty-four (24) hours insadvance of the -time when work will be started. r
. y Comply with all applicable City. ordinances, the terms and conditions of tfie'permit and all applicable and regulations of'the City of "
,La'Quinta and to pay for any additional replacement necessary as the result of this work. ' r`• �'
Ft
. „ rx
f Sig to plicant or Agent �^ �a ' f r
" - w I ,
+ Herman Weissker,. Inc. '',2820 Industrial Dr" -'Bloomington CA F 714-877-2470
,Name of Applicant (please print), Business Address ` Telephone No. ' r •.
' n "Gary Wisser same' 4 rA, r
t ' Name of Contractor and Job Foreman �` Business Address i ^ Telephone No.
a , t
T.
x.183556 : _ f , r' �- -r -1661.
Contractor's License No. • r City Business License -No.'
on file
}'Applicant's Insurance Company Policy Number r
.
r—
" FEES: _ Subdivision Improvement Permit —Class I I I " pppSib?� iQ Q0 '—i2-91 ' i0 `
y f0. CASF 1 %TR, 40.00
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs. " —1.00-9
�.-
e - 71M_inor Improvement Permit — Class IV`. See attached schedule ' �, `
` Inspection Fee t $ £ '40:00 PERMIT VALIDATION
- ' Permit Fee' - '11009
' •'� PERMIT'NO.
'Penalty n k 2/11/91
'DATE APPROVED '
Cash`Deposit-Surety Bond
if required,, EXPIRATION -DATE 3Z 31 / 91
TOTAL: $ 40..00 r ` f /11/91 r '-
J • DATE ISSUE
Receipt No. By �ritL
Received by L Dates = Administrative Authority .
t Recorded by ^~ TELEPHONE: (6191564.2246