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1142�e:.. �'`'i: `i �,aa.J4Y�i'i''y^�i:�' "+"'?�l7•�F.� ,,,~„fi'�'�X�•i�+ "1�'"�3i •'�}�..•5JY^ '"_"�,•.;"Q"`+Sst•^'sNri+�J-y:-�.":"W:-^v�.j�r�+'i.Y'dii+�'�'�"��:����'�i"i'TI ..ftr� � y NOTE _ 4 With proper validation this form constitutes an 'encroachment permit I CITY OF LA QUINTA APPLICATION FOR PERMIT r PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)' . OF THEA 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: S! 9 !1 r Minor Improvement Permit Class IV ' LOCATION OF CONSTRUCTION (Street address or Description of Location) MOUS. MUI�, P., ppropriate) PURPOSE OF CONSTRUCTION Sketch (attach construction lans if a DESCRIPTION'OF CONSTRUCTION CITY LIMITS ON" WA 514 `318 -TO 7AMPICO d? LJASHIky6r1T&'.' .,,DIMENSION OF `INSTALLATION OR REMOVAL 13'H 1"397W g7r000" Q5 -' -• s SIZE OF EXCAVATION; IF NEEDED y ., HAVL UATL APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ' ESTIMATED CONSTRUCTION COST $G1L3 7 CA' R 1'Z EQU LR IVP (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, liarmless 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)yhours,in advance of the time when work will be started: , Complywith 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. F L' Signature of AW licant. r Agent 'ICOi\111��RUCk II�ICa { $Iglo A Name of Applicant (please print) Business Address -Telephone No. AJUEVC' ENL-Jk)EER IAl& '-1 --1774 °Name of Contractor and Job Foreman Business Address -Telephone No. AJ4 Contractor's License No. - City Business License No. 6N AJ4 Z 0111 -F/L E. ` Applicant's Insurance Company Policy Number , FEES: •Subdivision improvement Permit — Class I I • P 005i � SOi 010 07--013-9i i0 :Public improvements: 3% of estimated construction costs _. iQ ASH TOTAL i 0.00 Private. improvements: 3% of estimated construction costs -1 T Minor Improvement Permit — Class IV: See attached schedule- ` Inspection Fee $ PERMIT VALIDATION Permit Fee /0.00 O-0 PERMIT NO 1 I y 2 Penalty Cash Deposit -Surety Bond if,.required TOTAL: $ )0.00 Receipt No. Received by Date DATE APPROVED ` % _ 8 ^ q I EXPIRATION DATE 7— _q DATE ISSUED By 7 dministrative Authority Recorded by II TELEPHONE: (619) 564-2246 ;7- NOTE - With 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. DATE -7-S"Cl! Subdivision Improvement Permit — Class I II Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION MOVE. F -0 1)I P. Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 8 -Ty' ' C. IT Y L I M IT S ON k)A5H 11V&iatii �fPS 10 TAM FICO 0 LcJA5H 1kZl DIMENSION OF INSTALLATION OR REMOVAL 1 6f,W 97r 000 L55 SIZE OF EXCAVATION, IF NEEDED HAVL VATL 7.6 -q i APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ w EI LQT , AY _ EQU I P E12 (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. . Signature. of A/ licanVor Agent P'IC0�16 UC.k IIL.IG-, 714- &T7 - SI q& Name of Applicant (please print) Business Address Telephone No. svuEvo nuc-,�w INS, X545- »76 Name of Contractor and Job Foreman Business Address Telephone No. 62/U FILL'.:D AJ F'1 LL K Contractor's License No. City Business License No. } 6AI • AlL..E 61U F!L F. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit = Class III 005182 10 3010 07-08-91 4 10 Public improvements: 3% of estimated construction costs 10 CASH 1 TOTAL 1 10.00 Private improvements: 3% of estimated construction costs 1-142 Minor' Improvement Permit — Class IV: See attached schedule Inspection Fee $ PERMIT VALIDATION Permit Fee �O "©0 I i q f , Penalty Cash Deposit -Surety Bond if,.required TOTAL: Receipt No. Received by Recorded by Date PERMIT NO. DATE APPROVED 7 ^ 8— 9 J 6i I EXPIRATION DATE 7— w DATE ISSUED T_ 8^ q By 7(" r Administrative Authority III, TELEPHONE: (619) 504-2246 NOTE: Nith proper validation • : • ' s. orm constitutes an :ncroadiment 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 1Subdivisionn Improvement Permit - Class 111 tP `I DATE:' Minor Improvement Permit Class IV .LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION I ' SZ0141: 11144411 Sketch (attach construction plans if appropriate► DESCRIPTION OF CONSTRUCTION�t�-C akLA D EN 1 NOF' INSTALLATION OR REMOVAL / t I,�,c `.� SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN l APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and deb: -is, 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 autheriied 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, lost 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 (241 hours in advance of the time when work will be started. Comply with all appliceble,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 •additlonel replacement necessary as the result of this work. TOM Name of Applicant (please pr Name of Contractor and Job F On File Contractor's License No..;s B Applicant's I ■ FEES: e:Company Signature of A,&licaty or Agent 6223n1d C:arri.aaa Rrl. ___M t- r_i•r'I z� CA Q2 67 !(71?)1 n -L1.)6 Business Address Telephone No. Tric . 7()-1311 Count:rry .0 ih Dr,_ R(-rimida Dt ncis . ''111i-1778 lan Business Address Telephone No. On File City Business License No. nn. F1 l,a 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 nspection Fee $ ermit Fee Penalty :ash Deposit -Surety Bond ` required TOTAL: $ lecelpt No. leceived by Date lecorded by Policy Number N? li yZ PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (6191564.2246