1199F•
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
V
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
8/28/91 Subdivision Improvement Permit —Class III
DATE: Minor. Improvement Permit Class IV
LOCATION OF CONSTRUCTION y Avenida Bermudas W/S S/W Calle Sonora
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION City Street Improvements Sketch (attach construction plans if appropriate).
Assessment District 91-1
DESCRIPTION OF CONSTRUCTION Move conduit due to
conflict new catch basin 0
DIMENSION OF INSTALLATION OR REMOVAL None
SIZE OF EXCAVATION, IF NEEDED Approximately 80' of
trench @ 5t Deed
APPROXIMATE TIME WHEN WORK WILL BEGIN 8/30/91
APPROXIMATE TIME OF COMPLETION 9/15/91
.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. !
' r•
Signature of Applicant or Agent
Hood Communications Grand Terrace, CA (714) 274-0577
Name of Applicant (please print) Business Address Telephone No.
Rick Sorbel 61-726 Hilltop Drive Joshua Tree, CA 92252 (714) 274-0577
Name of Contractor and Job Foreman Business Address Telephone No.
580721
Contractor's License No. City Business License No.
Lloyds of London I0-30434
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 PERMIT NO. 1199
Penalty DATE APPROVED 8/28/91
Cash Deposit -Surety Bond
if required EXPIRATION DATE 9/15/91
TOTAL: $ —0 RAT UED 8/28/91
Receipt No. By l
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an CITY OF LA OUINTA
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
�_2
9
`?/Subdivision
Improvement Permit —Class III
DATE:.r
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description. of Location)
PURPOSE OF CONSTRUCTION
IPTION OFCONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
Slj8VXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN ?5--<942
Sketch (attach construction plans if appropriate)
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 per d all a licable rules and regulations of the City of
La Ouinta and to pay for any additional replacement necessary as the resul f t ork.
SilnatureefApplicant or Agent
i Avi r wiL ' < LJ/cTi{(/ - // y —<— `Y- ZU /
Name of Applicant (please print) Business Add ss Telephone No.
ZCILs� as��
Name of Contractor and Job Foreman Business Address Telephone No.
goo
Contractor's License No. City Business LicenseNo. /
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III
Public improvements: .3% of estimated construction costs
NOTE:
With prc alidation 04
this forn stitutes an CITY OF LA QUINTA
encroacl- t permit S
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
CEtIOF Tf69wS
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
8/28/91 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Avenida Bermudas.W/S S/W Calle Sonora
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION City Street Improvements
_ Assessment District 91-1
OF CRIPTION OF CONSTRUCTION Move conduit due to
cc 'lic new catch basin
DI' =NSIOf -OF INSTALLATION OR REMOVAL None
SI, OF EXCAVATION, IF NEEDED Approximately 80' of
trc ch @ 5' Deed
API tOXIMATE TIME WHEN WORK WILL BEGIN 8/30/91
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION 9/15/91
ESTIMATED CONSTRUCTION COSTS
(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.
No the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
Co with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La ,ta and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
Hood Communications Grand Terrace, CA (714) 274-0577
Name of Applicant (please print) Business Address Telephone No.
Rick Sorbel 61-726 Hilltop Drive Joshua Tree, CA 92252 (714) 274-0577
Name of Contractor and Job Foreman Business Address Telephone No.
580721
Contractor's License No. City Business License No.
Lloyds of London I0-30434
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 Fee
Penalty
Cash De; '--Surety Bond
if requin
—0—
J rAL: $ —0
Receipt No.
Received by
F. rder b,
Date
PERMIT VALIDATION
PERMIT NO. 1199
DATE APPROVED 8/28/91
EXPIRATION DATE 9/15/91
q�CfE1b LED 8/28/91
By
Administrative Authority
TELEPHONE: (619) 564.2246