1167♦��.. NOTE: � i_ '•-- - + .' '
,-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
�f
F
Subdivision Improvement Permit —Class III
DATE:JMY' 31. 1991' Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION ARRRCM
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION DXM )SACH Sketch (attach construction plans if appropriate)
' DESCRIPTION OF CONSTRUCTION DRIVEWAY APPROACH SHALL' BE CONSTRUCTED PI
.RIVERSIDE COUNTY STD #207 (AT'T'ACHED)
DIMENSION OF INSTALLATION OR REMOVAL 5n.0
SIZE OF EXCAVATION, IF NEEDED
z
APPROXIMATE TIME WHEN WORK WILL BEGIN -8-1-91: i
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ '100.00
(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:
e a
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
III happening or -occurring as a proximate result'of�any work.undertaken under th"e 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. l
/tAl/
Signature of Applicant or Agent ,
RT1�O-ARfl MMM —IC T.T
Name of Applicant (please print) Business Address ` Telephone No.
SAMA CARLSAAD CA
Name of Contractor and Job Foreman Business Address Telephone No.
I Contractor's License No. Y City Business License No.'
Applicant's Insurance Company ` 'Policy Number. - IP
14 005 '' 0 07-31-9t '` 10
FEES: Subdivision Improvement Permit —Class III 10 ,�CIAL 1 30.00
Public improvements: 3% of estimated, construction,costs
Private improvements: 3% of estimated construction costs 11,67
Minor Improvement Permit — Class IV: See attached schedule
• Inspection Fee $ 20•00 PERMIT VALIDATION
Permit Fee , 10.00 '1167 '
PERMIT NO.
Penalty7-31-91
Cash Deposit -Surety Bond DATE APPROVED
if. required EXPIRATION DATE 8-2-91.
00 '
TOTAL: $ 30. 3 D E I.. _ 7-31-91
Receip
1—
Receipt No. B '
Received by Date Administrative Authority'
Recorded by TF1 FPHONF- IRM 9';fi4-9241;
t
r — NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit v
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
• C�OP'17�9�5
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 I I I
DATE: JDLY 31, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 53-7711 Sg7ft11 OnBEC4N
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION DRIVE APPROACH Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION DRIVEWAY APPROACH SHALL BE CONSTRDCTED Pl
RIVERSIDE COUNTY STD 1207 (ATTACHED)
DIMENSION OF INSTALLATION OR REMOVAL 5%20
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 8-1-91
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 100.00
(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 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
Le Quints and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
RTrAAAn rrntmn apt ,t SAI I H MADRZD 6327638 ,
Name of Applicant (please print) Business Address Telephone No.
SAME • CARLSBAD CA
Name of Contractor and Job Foreman Business Address Telephone No.
nraraan RTT nuo
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit _ Class III i0005rNs, 01 3TQ�AL �1 31-9L30.00 10
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
$ 30.00
Date
•1167
PERMIT VALIDATION
PERMIT NO. 1167
DATE APPROVED 7-31-91
EXPIRATION TE 8-2-91 '
D EI
B
Administrative Authority
Recorded by 11
TELEPHONE: (619) 564.2246
i
J .
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 `3` 4? /
LOCATION OF CONSTRUCTION 5-3 - 7 7/
4 P
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 10el yl 0M01e6%1C1/
DESC IPTIO�y OF CONSTRUC ION
DIMENS ON OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit - Class III
Minor Improvement Permit Class IV
3 713'/ C_) 6Gn450yL,1
Sketch (attach construction plans if appropriate) - �.�+ a E3 � c� •,.� �"Lru�-�Z ry�-
(�lpi 2v✓ F�,lL S 7 to
-7 (^-T 7-A
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
L.a Quinta and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
,el c �,,#/epre e Name of Applicant (please print) Business Address Telephone No.
5� /P7 cA421_S 44D C4
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
City Business License No.
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 $ - ZO , Oy
Permit Fee /o , 00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
1 U 1
DATE APPROVED
-7 - 3 ( —q It
EXPIRATION DATE
-CIL �
DATE ISSUED
'7- 3 t -ttl I
By
Administrative Authority
TELEPHONE: (619) 5642246