1133NOTE:
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
DATE: 6/24/91
LOCATION OF CONSTRUCTION 52-905 Ave. BERMUDAS
(Street address or Description of Location)
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
PURPOSE OF CONSTRUCTION SAW CUT APPROACH TO Sketch (attach construction plans if appropriate)
DRIVEWAY
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 8/24/91 10 AM
APPROXIMATE TIME OF COMPLETION 6/24/91 11 AM
ESTIMATED CONSTRUCTION COST $ $200.00
(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:
CONSTRUCT PER RIVERSIDE CO.
4207. '.
i '5WSHOi '7193A06i 24 -9fi -0_QO 14
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 propeerty
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 app.)icable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this
Signature of NppIicant or Agent
DARYL SILVERSTEIN 78 650 AVE. 42 411104 BERMUDA DUNES 619-774-5173 r
Name of Applicant (please print) Business Address Telephone No.'
rr DTT*T rnXTQTDTVtTT/VQ TTADVT 0TT1TVD0frVTAT 70 LCA AVL+ /.o 'GTn nen nnno
Name of Contractor and Job Foreman Business Address Telephone
424386 1901 dr
Contractor's License No. City Business License No.
STATE FARM {`
1
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 111
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee 30.00
Penalty'
Cash Deposit -Surety Bond
if required
TOTAL: $ 30.00
Receipt No.
Received by Date
Recorded by
11331
b�
t�
PERMIT VALIDATION
PERMIT NO. //3-3
DATE APPROVED 6/24/91
EXPIRATION DATE i s
DATE ISSUED 6/24/91.
By k.
Administrative'
I J f
TELEPHONE: (619) 564-2246 i
� s
Authority
C 0
a
NOTE:
With proper validation
this form constitutes an
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: 6/24/91 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
52-905 Ave. BERMUDAS
(Street address or Description of Location)
"+. PURPOSE OF CONSTRUCTION SAW CUT APPROACH TO Sketch .'(attach. constructionlans if appropriate)
ppropriate)
DRIVEWAY
1
DESCRIPTION OF CONSTRUCTION
CONSTRUCT PER RIVERSIDE CO.:
#207. r
. DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
j
APPROXIMATE TIME,WHEN WORK WILL BEGIN 3/24/91 10 AM 05 22 0 2721 06-24. 9 14
i LfiS iAL 1 0.400. 1
APPROXIMATE TIME OF COMPLETION 6/24/91 11 AM
ESTIMATED CONSTRUCTION COST $ $200.00
(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 al,l
r
penalties, liabilities or loss resulting from claims or court action and airising 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 iules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this work
I
Signature of Applicant or Agent,
DARYL SILVERSTEIN, 78 650 AVE. 42 #1104 BERMUDA DUNES' 619-774-5173
Name of Applicant (please print) Business Address Telephone No.
TEREN-CONSTRUCTION DARYL SILVERSTEIN " 78 650 AVE .42 619-360-2928.
Name of Contractor and Job Foreman Business Address 'Telephone No..'
424386 1901
Contractor's License No. City Business License No.
STATE FARM. ;
Applicant's insurance Company Policy Number
• r r,
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs
Private -improvements: '3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ #
30.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if -required
TOTAL: $ 30..00
Receipt No.
Received by Date
Recorded by
1133
PERMIT VALIDATION
PERMIT NO. 33
DATE APPROVED ` 6/24/91
EXPIRATION DATE
DATE ISSUED 6/24/91
By
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE: • ,
With proper validation
this form constitutes an CITY OF. LA aUINTA
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: `, y 1V "I G Minor Improvement Permit Class IV
' LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE• 0 CONSTRUCTION C, �„ 'Sketch (attach construction plans if appropriate)
• DESCRIPTION OF CONSTRUCTION -
DIMENSION OF INSTALLATION OR'REMOVAL
SIZE OF EXCAVATION; IF NEEDED
APPROI ATF TIME WHEN14 �WI�LL BEGIN IMDN�II'9�''I
APPROXIMATE TIME OF COMPLETION A 2y rD / LD
ESTIMATED CONSTRUCTION COST 200 `o.
(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:
L. + Indemnify,defend and save the;City, its authorized agents, offices, representatives and employees, harmless.frorn 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.
t 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 is w
Signatur Applicant or Agent
5� -6 a rA �� �z 1 101f � �V V E5 �� 7 ' 7 7 Y 51 ..
Name of Applicant (please print) Business Address Telephone No..
w
Sruynu 79�6(;,n ° v(- L2
Name of Contractor and Job Foreman Business Address Telephone No.
X2�f�
X.
Contractor's License No. City Business License No'
15T�-�-�
Applicant's Insurance Company Policy Number
FEES:. Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction "costs
Minor Improvement Permit — Class IV: See attached schedule ,.
Inspection Fee $ PERMIT VALIDATION
Permit Fee All
PERMIT NO.
Penalty
Cash. Deposit -Surety, Bond DATE APPROVED
if required EXPIRATION DATE
s x
TOTAL: $ DATE ISSUED
Receipt No.
Received by Date Administrative Authority
Recorded by TELEPHONE:. (618) 5642246 ,