1065;,NOTE;
+With properwalldatiori • a - ' ' «° '` Q'
this form constitutes an• CITY OF LA QUINTA 4•r.
• encroachment permit.
t APPLICATION FOR 'PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs; .,driveways,, pavements, -sidewalks; parkinglots,•, sewers; water. mains
and•other=like:public works:improvements in connection with MINOR IMPROVEMENTS and:APPROVED SUBDIVISIONS =
_
0,
Subdivision Improvement Permit- Class II I
y �° .A' rid. 16 1991 r ; p
DATE:' r Minor Improvement•Permit Class IV
-� .G• d 54-556 AVeAda Dias v
LOCATION OF CONSTRUCTION
' (Street address or Description of Location)
y
PURPOSE OF CONSTRUCTION' drlyewaq approach, k y:Sketch•(attach construction plans if,appropriate)
DESCRIPTION,OF CONSTRUCTION40 Xt,
' ,
DIMENSIOWOF INSTALLATION OR REMOVAL
•,
< SIZEbF,EXCAVATION, IF NEEDED
? Sys}t,c,
.`..�,.µ,APP,.ROXIMATE TIME WHEN WORK WILL BEGIN r `
s APPROXIMATE TIME OF COMPLETION
300001101
,ESTIMATED CONSTRUCTION COST $ _
(Including •removal of all ob'structio_ n, materials, and debris, backfilling, com r , '
_ J i
paction and placing permanent resurfacing and/or,replacing.improvements)o.
r
{ x
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-tea
,^ -^ • penalties, liabilities -or loss resulting from claims or court *action and arising{out of any -accident, loss or damage to persons or property,' j
f happening,or occurring as'a proximate result of any work undertaken under the permit granted pursuant to this, applicationn
Notify the Administrative Authority at least.twenty-four (24) hours in advanceofthe.time'when:work will be started. -
y.
4 Comply with all applicable City, Ordinances, the t6ms and conditions of the permit and all applicable rules.and regulations of,.the Cityiof•
" La Quinta'and:to pay for'any additional replacement necessary as the result of this work. '
`J, Y ignature of Applicant or Agent.
._
Cri tobs1 C.t Arroyo 45-250 Smurr St fndid 3 7�-3115
Name of Applicant, (please print) Business Address M Telephone.No.'.,
PBA Construction Rade Rama • y
, .Name'of'C ' hector and Job Foreman Business Address Telephone No.,
s
54780.-c,,`. e ° y �.• i469 r
Cit Business,License No. `
Contractor's `License No.-; .. � Y,
.•APCOJ t ;s . GLS 320052
Applicant's Insurance Company Policy Number
FEES: ' �Subdivision Improvement Permit — Class I I I r' '
Pudlic,improvements:.3% of -estimated construction'.costs " - • `' ` J ' "
Private improvements: 3% of estimated construction costs o 05 0 d",
Minor Improvement Permit — Class IV: See attached schedule «
Inspection Fee $ 20.00 _ PERMIT -VALIDATION
Permit Fee -fl- tnl �n1n1 I ' 1065
_ 't* PERMIT NO. ,
Penalty - •- . ; 4/9�7/9l ft
y•' •Cash Deposit -Surety Bond - ,' DATE�APPROVED • `
�± ;4/26/91• .^ _
if. required •• ,. 4 EXPIRATION - DATE:
TOTAL: ' $ , • ' )4/16/91 '
_ DATE ISSUE,,D� •'•"
Receipt No. ` �hJLAif
Received by Date • Administrative Authority
r. Recorded by t
TELEPHONE: i619) 564-2246
P
W
NOTE
With proper validation
-.thisform constitutes an CITY OF LA, QUINTA .
encroachment permit- t7
r
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 II I'
April 16, 1991 '
- DATE: Minor Improvement Permit Class IV
54-550 Avenida Diaz
LOCATION OF CONSTRUCTION
a
(Street address or Description of Location) .
driveway approach
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF iNSTALLATION:OR REMOVAL
SIZE_ �OF EXCAVATION, IF WEEDED.
._A_PP,ROXIMATE 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/result of .this work.
ignature of Applicant or Agent
Cristobal C'..Arroyo 45-250 Smurr St.Indio 347-3115
Name of Applicant (please print) Business Address Telephone No.
PBA Construction' same same
Name of Contractor and Job Foreman Business Address Telephone No.
547897 1469
'. ..Contractor's License No. City Business,.License No.
AFCO GLS 326052
Applicant's Insurance Company Policy Number
'FEES: Subdivision Improvement Permit — Class III
Public improvements: 3% of estimated construction costs
i005 0 aQ—i6-90,00 ga.
Private improvements: 3% of estimated construction costs o
�.� 1
Minor Improvement Permit — Classf IV: See attached schedule
20.00
-Inspection Fee" $ PERMIT VALIDATION. "
�i
Permit Feet- 10 '00 PERMIT NO..'1065
.
Penalty
Cash Deposit Surety Bond DATE APPROVED 4% /91
4/26 91
if-required30.00 EXPIRATION DATE
TOTAL: $ DATE ISSUED ;4/16/91
Receipt No.
By5''�
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an CITY 'OF+ LA QUINTA ,
endroachment 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 lit
DATE: �— f • - Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION �6%' �-S��� • " �`� `�'
(Street address or Desrnption of Location)
PURPOSE OF CONSTRUCTION�o� �'a`�� Sketch (attach constri.iction plans if appropriatal • ' '
DESCRIPTION OF,CONSTRUCTIOIN ;
DIMENSION OF INSTALLATION OR REMOVAL
. r y
SIZE OF EXCAVATION, IF NEEDED,e
APPROXIMATE TIME WHEN WORK WILL BEGIN z/"Z 7- 9� '
APPROXIMATE TIME OF COMPLETION
ESTIMATED'CONSTRUCTION COST $°�'�
(Including removal of all obstruction, materials, and debris, bae-4cfilling, com-
paction and placing permanent resurfacing and/or replacing improvements).
In consideration of the granting `of this permit, the applicant hereby,. agreesC to: '
Indemmfy,.defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and ail
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 Quints and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent "
62
Name of Applicant (please print) `� Business Address Telephone No.
31 /57
Name of Contractor and Job Foreman Business Address - Telephone No.,
7?JF 7
Contractor's License No. City Business License No..
Applicant's Insurance Company Policy Number ,
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 31/a of estimated construction 'costs
Private improvements: 3% of estimated construction costs r'
Minor Improvement Permit — Class )V: See attached schedule
N°
• Insoectlon Fee S PERMIT VALIDATION
Permit Fee PERMIT NO. n
- .Penalty ,, • • - . • '
DATE APPROVED
Cash.Deposit-Surety Bond
if required . EXPIRATION DATE
TOTAL: $
OATEr ISSUED
Receipt No.
Received by Date Administrative Authority
Recorded by TELEPHONE: .1619) 664-2246,
' r PINSON.BROS:'&.ARROYO`' • "
GENERAL CONTRACTORS
r+ r LIC.4547897.
45-250 ,SMURR ST.'. SUITE 12 • , + . y
INDIO, CA 92201 •
� (619) 347-3115 '(619) 34772470
1 -c. EXPLANATION .'AMOUNT
t r..
90-4144:..
1222
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OLLARS
CHECK<
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DESCRIPTION
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' r PINSON.BROS:'&.ARROYO`' • "
GENERAL CONTRACTORS
r+ r LIC.4547897.
45-250 ,SMURR ST.'. SUITE 12 • , + . y
INDIO, CA 92201 •
� (619) 347-3115 '(619) 34772470
1 -c. EXPLANATION .'AMOUNT
t r..
90-4144:..
1222
• - y ��. � - � 2 81.1,,:. '
OLLARS
CHECK<
n * 'i,TO THE ORDER OF <.y - }�
DESCRIPTION
-
CHECK'
NUMBER
=:AMOUNT•'"." --�
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—" BANK Of THE DESERT 'NAT IONAL'ASSOCIATION
89-790 HIGHWAY 111 INDIO,`CALIFORNIA. 92201`,
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