Loading...
1015NOTE: ' L, J• • With proper validation / this form constitutes an CITY ` OF LA QUINTA . encroachment permit K ' 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 111• DATE: February 20, 1991 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 72835 Calle Chillon (Street address or Description of Location) - driveway approach ` PURPOSE. OF,CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION per Riverside' Co. 'Std.. #_207 _ see attached a DIMENSION OF INSTALLATION OR REMOVAL SIZE,OF EXCAVATION,- IF NEEDED APPROXIMATE•,TIME WHEN'WORK WILL BEGIN 2/22/91 t, -APPROXIMATE TIME OF COMPLETION 1' d&V , 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 ernployees,-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. , L '.'Comply with all applicable City Ordinances, the terms and conditions of the permit and all aph able rules and regulations of the City of La Quinta and to •pay, for any additional replacement necessary as the result of this wor fSi .,ter bl Appficant or Agent Dodco construction' PO Bo -x 1012 La Quinta 1564-6478 'Name of•Applicant (please print) Business Address Telephone No. Dan Featheringaill Name of Contractor and Job Foreman Business Address a Telephone No. A0877618 f �. -1375 Contractor's License- No. City Business License No. Farmers Ins. 'Applicant's Insurance Company Policy Number ' FEES: Subdivision Improvement Permit —Class III(�5�$ASSQ,A{iL2' 30Ad, Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ 20.00 PERMIT VALIDATION Permit Fee 10.00 PERMIT NO. 1015 Penalty 2/20/91 Cash Deposit -Surety Bond DATE APPROVED if,required EXPIRATION DATE 2/28/91 TOTAL: $ 30.002/20/91 DATE ISSUED- Receipt No. By— Received y Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 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: February 20, 1991 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 72835 Calle Chillon (Street address or Description of Location) T driveway approach PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 2/22/91 APPROXIMATE TIME OF COMPLETION 1 day 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: per Riverside Co. Std. # 207 see attached 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 apoticable rules and regulations of the City of La Quinta and to pay for any additional replacement necessary as the result of this wo.r ,Si na t r { Np `cant or Agent Dodco Construction PO BOX 1012 La Quinta 564-6478 Name of Applicant (please print) Business Address Telephone No. Dan Featheringaill Name of Contractor and Job Foreman Business Address Telephone No. A0877618 1375. Contractor's License No. City Business License No. Farmers Ins. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class III� �$�CALO-yH 0117011 2? -91 ©.0 0 .. Public improvements: 3% of estimated construction costs O 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 $ 30.00 • 1-044 TOTAL: Receipt No. 20.00 10.00 II PERMIT NO Received by Date PERMIT VALIDATION 1015 DATE APPROVED 2/20/91 EXPIRATION DATE 2/28/91 2/20/91 DATE ISSUED By / I -e_ Administrative Authority Recorded by II TELEPHONE: (619) 564-2246 NOTE: With proper validation this form constitutes an ' CITY ' OF LA QUINTA encroachment permit APPLICATION FOR PERMIT' i PUBLIC WORKS CONSTRUCTION .(ENCROACHMENT) For the construction of public- or private curbi, driveways, pavements, sidewalks, parking lots, sewers, water" maim ` and other like' public. works improvements in connection with MINOWIMPROVEMENTS and APPROVED SUBDIVISIONS J. Subdivision improvement Permit — Class 111 ± - DATE: .• •—•—�_ yror Improvement Permit Class IV LOCATION OF CONSTRUCTION '4 14 (Street address or Oescrii tion of Location) , PURPOSE OF: CONSTRUCTION 1 "�; w'4 a ^ Sketch (attach construction plans if appropriate) - . i rt DESCRIPTION OF CONSTRUCTION` ' ,DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED : f APPROXIMATE TIME WHEN WORK WILL BEGIN ^ Z'Z APPROXIMATE TIME OF COMPLETION, ' ESTIMATED CONSTRUCTION.COST $ (Including-Jremovai of all obstruction, materials, and debris, bawkfilling, com- paction and placing permanerrt 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'salon and arising out of any accident, loss or damage to' peasant or property happening or occurring as a proximate result of any work undertaken under the permit granted pursuant,to this application. t Notify the Administrative Authority at least twenty-four 1241. hour 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 Quints and to pay for any additional replacement necessary as the remit of thi rk. Si re of Appficant or Agent Nanie.of Applicant (please print) Business Address > `.• Telephone No. fav Name of Contractor and Job Foremaff Business Address - -Telephone No. , 7S- Contractor's License No. City Business License No. Applicant's Insurance Company.. Policy Number., FEES. Subdivision Improvement Permit Class ill Public improvements: 3% of estimated construction costs: Private improvements: 3% of estimated construction costs *TO , Minor Improvement Permit — Class lV: See attached schedule • lr Insoectlon Fee S I PERMIT VALIDATION - Permit Fee I PERMIT NO, Penalty f 'DATE APPROVED Cash Deposit Surety Bond if required ' EXPIRATION GATE TOTAL: $' OATS ISSUED ' Receipt No. I By Received by I• Date Administrative Authority - Recorded by rTELEPHONE: (61916642246