1315r---------------- F--------------------------------•------------w-----------------
NOTE:
S 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:_- December 17, 1991 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 53-440 Herrera, 53-120 Alvarado, 53-320 Carrauza
(Street address or Description of Location)
PURPOSE OF CONSTRUDriveway ApproachonCTION Sketch (attach n tr t• 1 f )
DESCRIPTION.,.OF CONSTRUCTION
. cos uc ion p an. i appropriate
Driveway Approach shall be constructed
par Rivare;de County Std. 0207
(Att
DIMENSION OF INSTALLATION OR REMOVAL 16 .1
r
SIZE OF EXCAVATION, IF NEEDED i t'
APPROXIMATE TIME WHEN -WORK WILL"BEGIN -
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION,COST'$$180.00 cath
(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:
y
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 occur ring as a
proximate result of any work undertaken under the ,permit granted pursuant to this application. '
Notify the Adminisirative 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 ofthe 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 wor '
t the I - s
Signature of Applicant or ArMiIit
Mike Whitley 54-520 Avenida Ramirez La Quinta, CA 92253' -564-4690
Name of Applicant (please print) Business Address Telephone No.
i' Sams w .
Name of Contractor and Job Foreman Business Address Telephone No. '
'358739 - 1787
Contractor's License No. City Business License No., _ -
State Fund, 229-91 Unit 000-4205
Applicant's Insurance Company o Policy Number
FEES: _ Subdivision Improvement Permit — Class 111 , Oigg i0 bi Q 7"i7 -9i
90.100
Public improvements: 3% of estimated construction costs ' r�
Private improvements:'3%of estimated construction costs •' 1 #'31.5 '
Minor Improvement Permit— Class IV: See attached schedule
Inspection Fee $ 60.00
Permit Fee 30.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 90.00
Receipt No.
Received by Date
Recorded by
PERMIT NO
PERMIT VALIDATION
1315
DATE APPROVED '12/17/91
EXPIRATION DATE 12/20/91
DATE I S ED 12/.17/91
By
Administrative Authority
TELEPHONE: (619) 564-2246
10
f
x 20'
Cencro
l�SXT_D'
Gol►tE�R
. cos uc ion p an. i appropriate
Driveway Approach shall be constructed
par Rivare;de County Std. 0207
(Att
DIMENSION OF INSTALLATION OR REMOVAL 16 .1
r
SIZE OF EXCAVATION, IF NEEDED i t'
APPROXIMATE TIME WHEN -WORK WILL"BEGIN -
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION,COST'$$180.00 cath
(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:
y
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 occur ring as a
proximate result of any work undertaken under the ,permit granted pursuant to this application. '
Notify the Adminisirative 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 ofthe 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 wor '
t the I - s
Signature of Applicant or ArMiIit
Mike Whitley 54-520 Avenida Ramirez La Quinta, CA 92253' -564-4690
Name of Applicant (please print) Business Address Telephone No.
i' Sams w .
Name of Contractor and Job Foreman Business Address Telephone No. '
'358739 - 1787
Contractor's License No. City Business License No., _ -
State Fund, 229-91 Unit 000-4205
Applicant's Insurance Company o Policy Number
FEES: _ Subdivision Improvement Permit — Class 111 , Oigg i0 bi Q 7"i7 -9i
90.100
Public improvements: 3% of estimated construction costs ' r�
Private improvements:'3%of estimated construction costs •' 1 #'31.5 '
Minor Improvement Permit— Class IV: See attached schedule
Inspection Fee $ 60.00
Permit Fee 30.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 90.00
Receipt No.
Received by Date
Recorded by
PERMIT NO
PERMIT VALIDATION
1315
DATE APPROVED '12/17/91
EXPIRATION DATE 12/20/91
DATE I S ED 12/.17/91
By
Administrative Authority
TELEPHONE: (619) 564-2246
10
.y
PROPERTYit
L/NE
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u �•� I �. s •Wo '
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•
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COMMERCIAL 20'rw. 40 MAX.- -x MIM 4
AT COMA/ERC/AL
S/DEWA L X
PROPERTY L/NE
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u
—71
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-x' RfS/OEN7/IL n,
COMMERCIAL ?o'JO' MAX.MIK
r/N10' - m4r
.- '• NIN. 4
WHEN NO S/DEWAL9 SIDEWALK v
EX/STS OR /S REOVIRED
J. WNfRE ABOvE L/M/7/NG SLOPES CAN NOT
/ ALL ccwSTRUCTION SHALL of CLASS "B or MEr BECAvsE Of NE/G/[T or CUR& , DEA%rSS
CONCRETE SIDEWALK twrk SAID SLOPES ARE JSA/NED.
10' or <utt N(/6NT Cuss REOulmro LaWITUD/NAL 'SLOPE OE WARPO
BETWEEN /7F/v[ WAYS wl/N/N INK '
AojACEN7 TO OR/YEW, SNALLNof E jRr
ON! CROPfRTr RROMrAGf. MORE TNAN 61 FRAM TME LOyGIrMNAL GAOE
LINE A� rMfIDEWALK.
M& E Gig %Y'LYMENS/ONS
NOTE* MEET [HOB'S. I�"� WSOMrIAL CA LyAL
i;i;: EO GRADE
TRANSITION. ,:•' `POE Mt " 9 � 6.• t. O. 1. D..
Eft COYf11
Y of Riverside
A as. CONCRETE DRI VEWAY
A- E%%$ ' SCNEMAT/C APPROACH
- REV/BIONS
= e••-+�-• :-et --;STANDARD,- NO. -207.:
------'---- --
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
9 Subdivision Improvement Permit — Class III
D&TE:If Z Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION sn /C20 ��l1
S3 -30h 6;AAd,,. ,
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION �' o2d coa�c.Pe7�
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 the time when work will be started.
Comply with all applicable: City-fOrdinances,.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 r A
b
Name of Applicant (please p . nt) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
3-ff 73.9'
Contractor's License No. City Business License No.
qao.
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 Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by _ Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
PATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246