1351--�,------------------------ ---- -- ---- - -----------------------i
NOTE
i
With proper validation
thisrform constitutes an
`-----_ CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
I• „n
PUBLIC WORKS CONSTRUCTION. (ENCROACHMENT)
SOF
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 IMPROVEMENTSand APPROVED SUBDIVISIONS
DATE: January 28,1992
LOCATION OF CONSTRUCTION 54-680
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway Approach
DESCRIPTION OF CONSTRUCTION Driveway Approach
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1/29/92
Subdivision ImprovementPe;mit — Class I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION 1/30/92
ESTIMATED CONSTRUCTION COST $ 180.00
(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:
Per Riverside County Std No. 207
(Attached)
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 regulationsof the City of
La Quinta and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
i
Mike Whitley 54-520 Ramirez La Quints, CA 92253 564-4690
Name of Applicant (please print) Business Address Telephone No.
Sun Country Construction Same �amQ
Name of Contractor and Job Foreman Business Address Telephone No.
358739. 1797
Contractor's License No. City Business License No.
State Fund
Applicant's Insurance Company Policy Number
FEES: .Subdivision Improvement Permit — Class III 0051132 10 7314 01-28-92
10 .~ .'CASH i TOTAL 1 3p, 00
' 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
Recorded by `
$ 20.00
10.00
$ 30.00
Date
PERMIT VALIDATION
PERMIT NO. 1351
DATE APPROVED 1/28/92
EXPIRATION DATE 1/30/92 q.
DATE IS ED 1/ 8/92
By
dministrative Authority
TELEPHONE: (619) 564-2246
t
NOTE:
r With proper validation
this form constitutes an CITY OF LA QUINTA U
encroachment permit
APPLICATION FOR. PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) '
0F 7 ft89ws
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: January 28, 1992 Minor Improvement Permit Class IV
LOCATION OF'CONSTRUCTION 54-680 Obregon
(Street address or Description of Location) '
PURPOSE OF CONSTRUCTION Driveway Approach Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Driveway -Approach Per Riverside County Std No. 207
(Attached)
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1/29/92
APPROXIMATE TIME OF COMPLETION 1/30/92
ESTIMATED CONSTRUCTION COST $ 180.00
(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
La Quinta and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
Mike Whitley 54-520 Ramirez La Quinta, CA 92253 564-4690
Name of Applicant (please print) Business Address Telephone No.
Sun Country Construction Same Cama
Name of Contractor and Job Foreman - Business Address Telephone No.
358739 -1787
Contractor's License No. City Business License No.
State Fund
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 $ 20.00
Permit Fee 10.00
Penalty'
Cash Deposit -Surety Bond
if required
TOTAL: $ 'An -nn
Receipt No.
Received by Date
Recorded by
00I82&SH7 Sl TOTAL 8-92 3
0.00
. 131
PERMIT VALIDATION
PERMIT NO. 1351
DATE APPROVED1/28/92
EXPIRATION DATE 1/30/92
DATE IS ED
By. �—
dministrative Authority
TELEPHONE: (619) 564.2246
PROPERTY LINE
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REVISIONS
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8-10-77 STANDARD " N0.,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
Subdivision Improvement Permit — Class III
DATE: l �� Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 5 L 2 90/1
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION rAaheol_4 Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION rr
�2. J
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGINyL�
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ / 26 , u
(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:
S-r-z;� J v
z-0-1 aTT-^C,4 -
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. /% .,7
— j Signature of Applicant Qr Agen
Name of Applicant (please print)
L�. _AZy leA
. Business Address
Telephone No.
Name of Contractor and Job Foreman Business Address . Telephone No.
Contractor's License No. City Business License No.
J ;G'f
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimpted 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
DATE ISSUED
By
TELEPHONE: (619) 564-2246
1350
Administrative Authority