1390y!
it 'i•�'
If -
--------------- -------------------------------------------
------------------------ - - - - - - - - - -
NOTE: i
With -proper validation Q�
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)C�+.
w ;
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
DATE:- March 20, 1992 Minor Improvement Permit Class M1
LOCATION OF CONSTRUCTION 54-880. Avenida Juarez
.s
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _Driveway Approach Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Per Riverside County Std. No. 207
(attached).
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED '
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/20/92
" 005182 10 85i'f �3-20-92 14
APPROXIMATE TIME OF COMPLETION 3/27/92 10 CASH 1 YO A!. 1 30.00
,ESTIMATED CONSTRUCTION COST $ 300.00 S
(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 AppJiL�t or Agent . ,
Alex: 0. Toreew 44-071 W. Sundown Creat L/ La Quints, CA 92253 360-3337
Name of Applicant (please print) Business Address Telephone No.
A.O. Torres Construction Same
Name of Contractor and Job Foreman i Business Address Telephone No.
550498 1451
Contractor's License No. City Business License No.
State Farm Insurance 10908 49
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 estimated construction costs 1 390'
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 26.00
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ An. an
Receipt No.
1
Received by
Recorded by
Date
PERMIT VALIDATION
PERMIT NO. ,1390
DATE APPROVED __3/20/92
EXPIRATION DATE 3/27/92
DATE ISS ED 3/20/22
By
dministrative 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:Tlgz Subdivision Improvement Permit— Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 5�����D I�//E .Z/I,q/1 E Z
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _71yiV1_wn,:j� 4&'/b^C.L
DESCRIPTION OF CONSTRUCTI N _ SAw cul Q--4
x Qd U r 1�
DIMENSION OF INSTALLATION OR REMOVAL Loi 6"V!5
l X 7-0 It jos rvm�1
Sketch (attach construction plans if appropriate)/
SIZE OF EXCAVATION, IF NEEDED - .4 2_,- ns 4.9--jr-
cvY
APPROXIMATE TIME WHEN WORK WILL BEGIN Z 12-2 A Y
APPROXIMATE TIME OF COMPLETION z
ESTIMATED CONSTRUCTION COST $ 3bo.tp--
(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.
Name of Applicant (please print)
Name of Contractor and Job Foreman
Contractor's License No.
Signature of Appl
Business Address
-
r7
ay 6r Agent
ilia./
Telephone No.
Business Address Telephone 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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ ;�56
Received by Date
Recorded by
1309
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED 2, 2
EXPIRATION DATE - _z�,'P- 9
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246