11307
•': NOTE:
With proper validation
this form constitutes an
'
encroachment permit CITYOF .LA QUINTA
APPLICATION FOR,PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OF
'For' the construction )of, public or private curbs, -driveways, pavements, sidewalks, parking lots, -sewers; water mains
and other like public works improvements inoctionwith M-INOR,`IMPROVEMENTS and APPROVED SUBDIVISIONS
connL
Subdivision Improvement Permit - Class III
DATE.: 6-19-91 Minor Improvement Permit Cl . ass IV
-LOcATION'OF.CONST&tTION 53-700 JUAREZ
(Sheet 'address or Description of Location)
p
iPURPOSE'OF CONSTRUCTION Sketch (attach construction plans if appropriate)
.,,-DESCR DRIVEWAY BE
DESCRIPTION OF CONSTRUCTION DRIVEWAY APPROACH MUST
..,:CONSTRUCTED PER RIVERSID4_.
COUNTY STANDARD 207 (ATTACHED)!_
DIMENSION OF INS 20FT
INSTALLATION REMOVAL -
r 'x SIZE
F. EXCAVATION, IF NEEDEDft.APPROX.
I MATE TIME WHEN WORK WILL BEGIN 6-18-91 0
1. 'N' . .". I . . I � . 1. 1 �S -2b J 067-0 91
805 �0
AL; 1 .60 00
APPROXIMATE TIME OF .COMPLETION. 6-21-91
STI MATED, CONSTRUCTION COST $
..*(Including'.'removal of all obstruction, materials, and debris, backfilling, com
'paction and 'placing permane ' nt'res.urfacing and/or replacing im provernents)
Iri'consideration of the' granting of this permit, the applicant hereby agrees to:
Inclemnify, -defend and save the City, -its authorized agents, officers, representatives and employees, harmless from and aga!instany and all",—,
penalties, liabilities or loss resulting' from claims or court action and . ,arisin6 out of any accident, loss Cor damage -to , n s. , ,or
r pr J
opeirty
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this a plicatiori-.1.rt
1
Notify the -Administrative Authority at least twenty-four (24) hours in advance of the time when workwill be started. - 4�
Comply,,with all. -applicable City Ordinances, the terms and conditions of the permit and'all applicable rules and regplationi 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"
1. PETER'SUAREZ 41910 1116ARWALK # A-4 (61411346-5100
Nam-eof.Applicint (please print) - Business Address Telephone No.
SAM
n
Name. of Contractor and Job Foreman Business Address
Telephone eNo.
FAMPP W;* -Aim
Contractor "-s'License Wo- City Business:1icense No.
;STATE PARK
. ..... ..
�Appl:c'ant's Insurance Compahy
Policy Number
!_
y' t
-.","FEES! Subdivision Improvement Perm it - C I ass, I I I
Public improvements: 3% of estimated construction costs_
Private t'e ii
riv� mprovements: 3% of estimated construction cost.s
Minor Improvement, Permit - Class IV.: See attached schedule
Inspection Fee$ 40.00
kRMIT,VALIDATION
- %
20.00
.Permit Fee,-
PERMIT NO. 1130
Penalty
DATE APPROVED. 6-19-91
Cash Deposit -Surety Bond
'A
if,required
TE
6-19-91
R AT I Oh A
TOTAL: 60. 00 6-19791.'
DATF I
y, Receipt No.
B,
Received by Date Administrative Authority
Recorded by -,,,'TELEPHONE: (619) 564-2246
i
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NOTE:.
With proper validation
this form constitutes an
encroachment permit
~a
� y
,v.;:� •�•.t-'.,.i,:'s'a,�.u�i).a�'�s f 4_...w`'��"";.Fa�..,�..+q�.ft.
-_ CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction lof public or ,private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and other like public Gvorks improvements in connection with MIN.0.13 ROVEMENTS and APPROVED SUBDIVISIONS
•��r"
Subdivision Improvement Permit — Class 1.11
DATE: 6=19-91 Minor Improvement Permit Class'IV,
LOCATION OF CONSTRICTION 54-700 53-700 JUAREZ . \
'.: (Street address or Description of Location)
PURPOSE OF CONSTRUCTION D R'M�iL_ Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION DRIVEWAY DRIVEWAY APPROACH MUST BE
CONSTBIICTED PER RIVERSIDE
COMM STANDARD 207 (AITACIM) F
DIMENSION OF INSTALLATION OR REMOVAL 201ff
s
` SIZE OF EXCAVATION, IF NEEDED i
:APPROXIMATE TIME WHEN.WORK WILL BEGIN 6-18-91. � -� . •' .
6-21-91 1805 T OTAL 1 . 00
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.
s Notify, the AdministrativeAuthority at least twenty-four (24) hours in advance ,of the time when work will be started. sw, w •
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,r
<' 'PBTER SIIAREZ' 41910 WARWALK # A-4 (619)346=5100'
Name of Applicant (please print) Business Address Telephone No.
SAM)
Name of Contractor and Job Foreman Business Address Telephone No:
Co'ntractor's License No. City Business License No. '
,i
y STATE FARK a
Applicant's Insurance Company Policy Number
r FEES: Subdivision Improvement Permit — Class I I I„
r Public imorovements: 3% of.estimated construction costs _
Minor Improvement Permit— Class 6V: See attached sche
' 40.00
Inspection Fee $.,
Permit Fee' 20.00
„Penalty
Cash Deposit -Surety Bond
r sf required
^"} TOTAL: $ 60.00
r Receipt No.
` 'Received by Date
st
Recorded by-
.'
le.: t
PERMIT VALIDATION
PERMIT NO. 1130
DATE APPROVED 6-19-91
�P RAl ON -DATE
.6-19-91
j.6-19-91
DATE I t,, • .
tYfa By
K. Administrative Authority
r
TELEPHONE: (619) 564-2246 n..'t
•
NOTE:
With proper validation
this form constitutes an
'encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
- PUBLIC' WORKS CONSTRUCTION ,(ENCROACHMENT)c *.• �g
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 — Ciass II
DATE: - �� '� Minor Improvement Permit Class IV
LOCATION OF.CONSTRUCTION•
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION ����r� wP�Y' A�R�o�u-t 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
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 a ime wh n work"will be started.
Comply with all .applicable City Ordinances, the terms and conditions of the pe it'a d all pli rules regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result this ock
i
Sign6tiure of Applicant or Agent
-Pr.-: TCZ 1Pr2E 4t9%c) .. 12>0 AX VjA`.K ��-4 �(0l5) 5'��-Sloo
Name of Applicant.(please print) Business Address Telephone No.
Name of Contractor -and Job Foreman. Business Address Telephone No.
Contractor's Li ense No.. -` City Business License No..
6,v pgnligg:
Applicant's Insurance Company Policy. Number
FEES: Subdivision Improvement Permit•— Class III
Public improvements: 3% of estimated construction costs r m
Private improvements: 3% of estimated construction costs
' Minor Improvement Permit —Class IV: See attached schedule '
Inspection Fee $ PERMIT VALIDATION
Permit Fee PERMIT NO.
Penalty
'•--Cash Deposit -Surety Bond' , DATE APPROVED
if required EXPIRATION DATE
TOTAL: $ DATE ISSUED
Receipt. No.
By
Received by Date Administrative Authority
Recorded by " w.. TELEPHONE -.(619) 564-2246' ,
' .. NOTE:
With proper validation
'r
this form constitutes an t
.=CITY'°OF LA •QUINTA'
.. V:
encroachment permit
r. '= APPLICATION;FOR
-• • PERMIT -'
i PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OF tflg9fy
{j
. 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
t DATE:' 6-19-91 Minor Improvement Permit Class IV
LOCATION OF 60NSTR'1JCTION' 94-700' 93-7n0-TDARF2 '
(Street address or Description of Location)
i
PURPOSE OF CONSTRUCTION-81111=iifiuB AprReAG3 :Sketch (attach construction+ plans if appropriate►•;_..
DESCRIPTION OF CONSTRUCTIONDRIVEWAY DRIVEWAY. APPROACH -NUST;BE.,,
s ` CONSTRUCTED' PER RIVERSIDES
1 .COUNTY STANDARD 20.7 (ATTACHED) i"
DIMENSION OF,,INSTALLATION OR'REMOVAL '' �20FT:`
' ��,
'SIZE OF EXCAVATION, IF NEEDED .•
' , '�
• APPROXIMATE TIME WHEN WORK WILL BEGIN 6-1A-91 g i 665 0 19 -91 i4
; • . • -
S `
j 1g05i CiSH012TOTALb
APPROXIMATE TIME OF COMPLETION
ESTIMATE_ D 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: • r
-the
r .
indemnify, -defend and save City, its authorized agents, officers, representatives and employees, harmless from and against any, and all
' ,y
penalties, liabilities or loss resulting from claims or court action and arising out of-any`accident, loss or damage topersons or property
n • t , ,' happening or occurring as a proximate result of any- work undertaken under the permit granted pursuant to this application.
• i '.Notify the Administrative Authority at least twenty-four(24) hours in advance of the time when work will be started.
.f Comply with all applicable City Ordinances, the terms_ and conditions ;of the permit and all applicable rules and regulations of the City of
A
- •"'Le,Quinta and ,to pay, for any additional replacement necessary as the result of this work. •- -
-
y
"Signature of Applicant or Agent ,
PETER SUAREZ - • 41910 BOARWALK # A-4 •` (619),946-S 100
'No.
Name of Applicant (please print) Business Address Telephone
;
?' 'Name of Contractor and Job Foreman Business_ Address.' Telephone No. `
A
r , Contractors License o: , City Business License No.
STATE FARM
'Applicants Insurance Company Policy Number
FEES:,: ,Subdivision Improvement Permit = Class III
Public improvements: 3%of,estimated construction costs' O
- Private improvements: 3%'of estimated construction.costs .�
Minor Improvement Permit? Class IV: See attachedschedule
f Inspection, Fee $^ 40.00 , PERMIT VALIDATION k,
.'
' Permit Fee `, 20.00' _.
. PERMIT NO. 1130
Penalty
i -Cash Deposit -Surety Bond c `#DATE APPROVED 6-19-91
l if required w •'RATI T.
,. ;.
•.:.
TOTAL: 1$ 60:00. 6=19-91
DAT
r .
Receipt No.
Received by Date- Administrative Authority
'
Recorded by - r - # . ' TELEPHONE: (619) 564.2246