1368NOTE:
With proper validations �
2.
this form constitutes an CITY OF LA QUINTA
encroachment permltr, �
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
i OF
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:. February 26, 1992. Subdivision Improvement Permit —Class I11
j _ -'•''.. Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 53-801 Avenida'Ramirez
(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 `
i a
SIZE OF EXCAVATION, IF'NEEDED
APPROXIMATE.TIME WHEN WORK WILL BEGIN 2/26/92
APPROXIMATE TIME OF COMPLETION 2129/92
ESTIMATED CONSTRUCTION COST $ '250.00 f
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and-placing- `
p g� 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 wo {
Signature of pplicant or Agent 1
P Silverstein 2177 E. Badillo Covina, CA (8.18) 332-4853
Name of Applicant.(please print) Business Address Telephone No.
Teren Construction. C/0,52-905 Ave. Bermudas La Quinta, CA (619) 434-9266
Name of Contractor and'Job Foreman Business Address _ Telephone No.
424386- 1901
Contractor's License No.. 'City Business License No.
State Fund 1154251-.92 .
Applicant's Insurance Company Policy Number'
FEES: Subdivision Improvement Permit —Class III 0 i$" 795q oma''-2 -a92 0
iQ. C SH 1 T0, L 3Q,o
Public improvement`s: 3% of estimated construction costs
Private improvement's: 3% of estimated construction costs 11
� 36,81
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
Recorded by
30.00
_ Date
PERMIT VALIDATION
PERMIT NO. 1368
DATE APPROVED 2/26/92
EXPIRATION DATE 2/29/92
DATE ISSUED - ?/26/92
By �..
Administrative Authority.
TELEPHONE: (619) 564-2246
t
r
I ------------__---__.------------------------ =----------------
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
DyTE: t-f,�y�2`1 i�y Subdivision Improvement Permit — Class I I I
n _ Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION —S 3��oI A��►lJti p� �MIR+EZ
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _DR)VE WA`'1 iA1 MQACN
DESCRIPTION OF CONSTRUCTION
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)
Sketch (attach construction plans if appropriate)
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 1icant or Agent
21-77 C , 8,-�0-/ Lo CD -0I A4 CA PM3*_>,Z— yQS__�
Name of Applicant (please print) Business Address Telephone No.
ij jc( IOIJ. �o Sz-gD��gV�, p,E tA_5 c.�4l,�i�G1��� Y3`�/ F2�6
Name of Contractor and Job Foreman Business Address 56y �Iepho e No.
LI ? L4 _�>o
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 $
Permit Fee j
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ ?
Receipt No.
Received by Date
Recorded by
1236
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE Z _q Z
DATE ISSUED Z - Uo —q
By
TELEPHONE: (619) 5642246
Administrative Authority