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NOTE. • .r!(1]u..
With proper validation
this form constitutes an
encroachment permit
i�
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 ,
rt;`Subdivision-Improvement;Permit — CClas! ,III
DATE: March 19. 1992 Minor Improvement Permit Class IV � *10
LOCATION OF CONSTRUCTION 53-365 Avenida Carranza / 53-375 Avenida Carranza „ }
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway Approaches
DESCRIPTION OF CONSTRUCTION
Sketch (attach construction plans if appropriate) ,
Per Riverside County Std. No.,207'
(attached)
.DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILtL BEGIN 3/19/92.- 1
APPROXIMATE TIME OF COMPLETION 3/23/92 'k
ESTIMATED CONSTRUCTION COST $ • ` ''
(Including removal of all obstruction, materials, and debris; backfilling, com-
paction and placing permanent resurfacing and/or replacirig improvements) f
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 a4nd 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 .
Mark Katzman P.O. Box 1813 La duinta, CA 92233 564-6530
Name of Applicant (please print) Business Address Telephone No.
Werner Boettcher 82-365 HWVA11 No. 5 Indio, CA 342-2727
Name of Contractor and Job Foreman , Business Address Telephone No:
366385 On 'File`
Contractor's License NO. City Business License No.
a'
On File On File'
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class II I 0 1$2 848 ,49-•92 0
Public improvements: 3% of estimated construction costs CASH - L 1
Private improvements: 3% of estimated construction costs 38
Minor Improvement Permit — Class IV: See attached schedule If
Inspection Fee $ 40.00 II PERMIT VALIDATION
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ A0.00
Receipt No
Received by Date
rded by
PERMIT NO. 1386
DATE APPROVED 3/19/92
EXPIRATION DATE 3/27/92
DATE IS UED 3/19/92
By
Administrative Authority
TELEPHONE: (619) 564-2246
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:
6-I N -L -
LOCATION OF CONSTRUCTION S 3 3 &
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
Subdivision Improvement Permit- Class III
Minor Improvement Permit Class IV
�} v C`7v i b A C -A _r,4,v Z
S 3 3-7 f v �� W el -Az e,,q..,.., -2
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
Sketch (attach construction plans if appropriate)
°
��� i� o a
APPROXIMATE TIME WHEN WORK WILL BEGIN
3/31 Rz
APPROXIMATE TIME OF COMPLETION 1 �- 3 t 4 Z
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.
Co
Signature of Applicant or Agent
A,(z �� �d /?- Ili C .�,
�]`� l�•�i' Zd✓1 rs4'fl! o vX g c 2 L,4- q �• w*�a S G Y-6 i 3 0
Name of Applicant (please print) Business Address Telephone No.
LAN ice_ 9 o( 6 L__3 C r-
3 Y z -z--7 Z -t
Name of Contractor and Job Foreman Business Address Telephone No.
3 lP & 3 -r --S— o,J -E't (-,
Contractor's License No. City Business License No.
iF
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit - Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit - Class IV: See attached schedule
Inspection Fee $
go. 0o
Permit Fee
(b O
Penalty
Cash Deposit -Surety Bond
if required
5� C
TOTAL: $
Receipt No.
Received by
Date
Recorded by
1386
PERMIT VALIDATION
PERMIT NO. 1 '15E3
DATE APPROVED 3 19 - Z -
EXPIRATION DATE _ - 2-7 -q Z
DATE ISSUED 0\ .- Z
By
TELEPHONE: (619) 564-2246
Administrative Authority