1013Jill
—49%•r --+.r � �".,e+3„- '�J6 ;'+S � .•t,_ "�` n ' '� -. - .e, M r �_,� , `u f_ a.,,y.--,,.-^•r
_'..•.' _�.a •.KM, {i �ry -. w, a.. - tf i' , �. _ n. _ 5 {{ ..• ,� -1, ... r. ..w.w .. _ a.r -i .......- 1 ..
_ t
`NOTE: '� i F• �� '
With proper validatiori
this''form"constitutes' an " CITY OF LA QUINTA
encroachment�permit x
APPLICATION FOR PERMIT
: - PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
4- ' 0F
For the construction, of .public or private curbs, d.riveways,pavements, sidewalks, parking lots, sewers, water mains'
and other like .public work's improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
February .19 ,} 1991 Subdivision Improvement Permit — Class III
DATE:
,. `; Minor Improvement'Permit Class IV
LOCATION OF CONSTRUCTION * s/d Calle TMm ico' 150' 'east; of Eisenhower
(Street address or Description of Location)
PURPOSE OF'CONSTRUCTION 8/8 Calle Tampico Sketch (attach construction plans if appropriate)
=; 150' e/(b Eisenhower
sAlDESCRIPTION OF CONSTRUCTION dig_ telephone
spla.ce-epi in asphalt street' �reference GTE permit 0983
coniditons of . permit 0953,..shall
y --.f . DIMENSION -OF 'INSTALLATION OR REMOVAL 1 appl. to . this permit _
SIZE OF EXCAVATION, IF NEEDED 4 1 x5.1 {
APPROXIMATE TIME WHEN WORK'WILL BEGIN 2/27/91—
'
} APPROXIMATE TIME OF COMPLETION •3/11/91
A . ESTIMATED CONSTRUCT°ION'COST $ 2#000 a
(Including ;removal of.'all 'Obstruction, materials, and debris, backfilling, Co. m- „
pactioin ''and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this -permit, the applicant hereby agrees to:, •"••
Il, -lflndemnify,•defend and save the City, its authorized. agents, officers, representatives and employees, harmless from and against anyand all-
. - penalties, liabilities or lossresultingfrom 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`.
} ` ` Notif the Administrative Authorit
Notify,the y at' least twenty-four (24)i.hours in advance of the time when work will be started..
'v. Complyhwith all'applicable City Ordinances, the terms and conditions of the permit and ally applicable rules and regulations of the'City,of
La Quinta and to pay for any additional replacement necessary as the result of this work:, `
r ? c •Jil
'" r .... Signature of•Applicant or Agent '
'It•He man Wei ssker,;Iric.2820 Industrial -Dr: Blogmington, CA'714/877-2470-
y - Name of Applicant (please print) Business Address. -4!N Telephone No.
f. Gary 'Wieser same d
Name, of Contractor and 'Job Foreman ` Business Address Telephone No.
183556 _ „ 1661 n
Contractor's'Lic4hse No. City Business License No.
on 'Elle J
Applicant's,insurance Company Policy Number
71 .. - • _ 1.
FEES:, Subdivision Improvement Permit — Class I I I o 5S8p3 6-91 i
i� Wi?l 3 OPOR`L `i 80.000
4 Public improvements: 3%.of estimated construction costs ti
Private{improvements: 3% of estimated construction costs 1 0111-
Minor Improvement Permit — Class IV: See attached schedule
00 N� '
Inspection Fee . $ 80.PERMIT VALIDATION
Permit Fee '� ; PERMIT NO. 1013
Penalty
Cash Deposit -Surety Bond '
if required
TOTAL
Receipt No
$ 80.00
Received by Date
DATE APPROVED
EXPI1 _T4O•LV_DATE'
2/19/91
TE ISSUES I A'yI1_-L '
.1
Recorded by TELEPHONE: (619) 564-2246
tive Authority`''
l•. f
NOTE:
With proper validation
this form constitutes an
Y
encroachment permit
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
Subdivision Improvement Permit— Class III
DATE: February 19,{ 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION s/s Calle Tampico 150' east of Eisenhower
(Street address or Description of Location)
.PURPOSE OF CONSTRUCTION s/s Calle Tampico Sketch (attach construction plans if appropriate)
150' e/& Eisenhower
DESCRIPTION OF CONSTRUCTION dig telephone
splice pit in asphalt street reference GTE permit 0983
• '�. •mak:, .. r,;. -
' coniditons of permit 0983 shall
DIMENSION OF INSTALLATION OR REMOVAL apply to this permit
41
SIZE OF EXCAVATION, IF NEEDED X5'
APPROXIMATE TIME WHEN WORK WILL BEGIN 2/27/91
APPROXIMATE TIME OF COMPLETION 3/11/91
ESTIMATED CONSTRUCTION COST $ 2,000
(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
r•
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 or Agent
Herman Weissker, Inc.. 2820 Industrial Dr. Bloomington, CA 714/877-2470
Name of Applicant (please print) Business Address Telephone No.
Gary Wisser same
Name of Contractor and Job Foreman Business Address Telephone. No.
183556 1661
Contractor's License No. City Business License No.
on file
Applicant's Insurance
surance Company Policy Number
FEES: Subdivision Improvement Permit —'Class III _ 518' 3o?o,°
b-91 0
CA�� -.M� 80.06
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs 10 i'
I.3
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 80.00 PERMIT VALIDATION
Permit Fee PERMIT NO. 1013
Penalty
Cash Deposit -Surety Bond'—
_✓f
if. required
TOTAL: $ 80.00
Receipt No
Received by
Recorded by
Date
DATE APPROVED 2/19/91
EXPIRAT-I.ON DATE 8/31/91
iDDAATEEISSUE_D
By
TELEPHONE: (619) 564-2246
� • F urea . +�at?�.t`..y.
istrative Authority