1028{i}'x�: 7-."�T,ae:* :..�^Sy"„{yer..,._.r. It _ ..' .. 1,. t ._ ..�...,.+«a•=wi ..x....:�. w.•..........r .•n1..f.. �' _r;` ._ _ i ice.
NOTE: ,
With proper validation
.'this form constitutes an
encroachment permit CITY OF LA QUINTA;,
APPLICATION, FAR . PERMIT
PUBLIC WORKS 'CONSTRUCTIOW(ENCROACHMENT)
0F�ti
For the construction • of _public orr`
private curbs; driveways •.' pavements, sidewalks, parking lots; .sewers, water. mains •
and other like public works improvements in connection witl MINO.R:IMPR'OVEMENTS and'APPROVED SUBDIVISIONS
Subdivision Improvement Permit Class 1.1.1
DATE: March 11, 1991 Minor Improvement Permit Class'IV
LOCATION OF CONSTRUCTION 5-235 Avenida Vallejo
.(Street address or, Description of Location)
sfr/ driveway • appraech, ..
PURPOSE OF .CONSTRUCTION . Sketcli (attach. construction plans if'appropriate) . t
DESCRIPTION OF CONSTRUCTION Riverside-Co l
per verside-Co: Std. # 2014
see.attached t
'DIMENSION OF'INSTALLATION OR REMOVAL 2x16 ft
,A-
SIZE OF EXCAVATION, IFNEEDED
e I F
APPROXIMATE TIME WHEN -WORK WILL BEGIN 3/12/91
.APPROXIMATE TIME OF COMPLETION 1 5p b 3^ii=.qs 3
ESTIMATED CONST,RUCTION;COST.$±U�
' ,(Including rernoval 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, `
6' 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,uhder the permit granted pursuant .to this application.
'Notify the Administrative Authority at least twenty-four (24) hours in advance of thetime when work will be started.
` Comply with, all applicable City Ordinances, the terms and conditions of the permit and all applicable rules andregulations of the City of
' -
-La Quinta and to pay for any additional replacement necessary as the,result of this work. _
*Rah u r e of Applicant or Agent;'
Desert; •Vintage• •Development PO Box 5132 LQ 564 -4943 t;.
Name of Applicant (please print) Business Address Telephone.No: ` f
'Steve BuStasini PO Box 5132,La.Quinta 564-4943.`
Name of Contractor and Job Foreman Business Address Telephone No.
• • • . . • -11'3 . .`
Contractor's License No. • •.City Business. License No.
Farmers Ins." Group F90854=85-06
` Applicant's Insurance Company Policy Number
r,
FEES: • Subdivision .Improvement Permit — Class III
Public,improvements:,X/o of :estimated construction.costs _•
Private improvements: 3% of estimated construction costs : R ,•) Q �~
'Minor Improvement Permit —'Class IV: See attached schedule, .�
Inspection Fee $20.00 PERMIT VALIDATION
`Permit Fee 10.00 1028
PERMIT-NO.
Penalty X3/11/91
r Cash Deposit-Surety Bond DATE APPROVED:
if.re'quired EXPIRATION DATE' 3/15/97.
TOTAL: $30.00 X t
DATE ISSUED -3/11/91 T
t Receipt No.
.1.: ,By
,4
Received by Date a `',`-:. Administrative Authority•
Recorded by TELEPHONE: (619)'564-2246-- '
+�.n+`
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
Y
i
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: March 11, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54-235 Avenida Vallejo
I
(Street address or Description of Location) �} i�% I�
PURPOSE OF CONSTRUCTION 5fr/ riyeway appraech
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL 2x16 ft
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/12/91
Sketch (attach construction plans if appropriate)
per Riverside Co. Std. # 207
see attached
APPROXIMATE TIME OF COMPLETION �p p Q o3
ESTIMATED CONSTRUCTION COST $ itipti 5�'%SH i�T�TAC30.04'
(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.
"r- .�
S'ig'�i `ta ure of Applicant or Agent
Desert Vintage Development PO Box 5132 LQ 564-4943
Name of Applicant (please print) Business Address Telephone No.
Steve Bustasini PO Box 5132 La Quinta 564-4943
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
Farmers Ins. Group
. I Applicant's Insurance Company
FEES: Subdivision Improvement Permit — Class I II
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 Fee 10.00 II
Penalty
Cash Deposit -Surety Bond
if, required
TOTAL: $30.00
Receipt No.
Received by Date r
Recorded by
113
City Business License No.
F90854-85-06
Policy Number
1028
PERMIT VALIDATION
PERMIT NO. 1028
DATE APPROVED 3/11/91
EXPIRATION DATE 3/15/91
DATE ISSUED 3/11/91
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:.
With propervalidtdw-1. r
'this form constitutes an CITY OF LA QUINTA' • `
encroachment permit
? - APPLICATION )FOR PERMIT r
PUBLIC. WORKS CONSTRUCTION; `(ENCROACHMENT)
r For- the construction of public or 'private curbs, driveways, pavements, sidewaiks, ,parking lots, sewers, wsttar mains-;
and other like public work: improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS' .
",:
Subdivision improvement Permit — Class III
DATE: • �l 11, c " Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION L '_A _ �3 S
(Street address or Description of Location) '
PURPOSE OF CONSTRUCTION tA.0' ' C-0 I Sketch (attach construction plansifappropriate) 1 ry
DESCRIPTION OF CONSTRUCT ON
DIMENSION OF IN5ALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME.WHEN WORK WILL BEGIN -
- F •
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
(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: j
Indemnify, defend and an the City. its authorized agents, officers, representatives and emplaveeti,harmiess from and against altar end all
Penalties. • iiabilities or toss nnufting from etaims or court action and arising out of any accident, loss or damage ,to persons or peoparty
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 advanee 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
V ,Ouinta and to pay for any additional replacsiment, necemry as the result of this work.
Signature of Appiicanror Agent,'
Name of Appticant (please print) ;. Business Address _ Telephone No.
.. t�C e�e� .� Q �..Sr} �;.� ► ,�, t. e , o � $ , 513 a-' L ; � - ' _ 5t� � - 4 -ti � 3
Name'of Contractor avid Job Foreman Business Address .Telephone No.
.1113
Cant r ctor's License No., t City Business License No.
c.�-C' r�c`S '�' �S►n S �- cy �-� .. S�' , c,` co R %k -g S" 0 h
Applicant's Insurance Company Policy Number,
FEES: Subdivision imarovement Permit - Class III -
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs •TO
Inspection Fee S -
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
w, Received by Date -
Recorded by
PERMIT VALIDATION
?ERMIT NO.
DATE,APPROVED "
EXPIRATION DATE
DATE ISSUED
BY-
Administrative Authority
TELEPHONE: (6191664-224&