1415------------------------------------------------------------------------------------------------------
NOTE:
With proper validation `
this form constitutes an CITY OF LA QUINTA
encroachment permit
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
April 10, 1992 Subdivision Improvement Permit — Class II I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54-260 Martinez
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _ Driveway approach .
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/10/92
APPROXIMATE TIME OF COMPLETION 4/13/92
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:
Sketch (attach construction plans if appropriate)
Per Riverside County Std. #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 an all applicable sand regulations of the City of
` ... La Quinta and to pay for any additional replacement necessary as the result of this/�k. � ���
S'.g:a/.
e of Applicant,vgent
L .�� 9
Majestic Homes P.O. Box 76 La Quin CA /568-6014
Name of Applicant (please print) Business Address Telephone No.
PGA Construction 45-250 Smurr St. Indio CA 92201
Name of Contractor and Job Foreman Business Address Telephone No.
627265
2154
Contractor's License No. City Business License No. _.
Farmers Insurance 470%%9 a/ 7
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
Minor Improvement Permit — Class IV: See attached schedule
Inspection Feb $ 20.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No
10.00
$ 30.00
Received by Date
Recorded by
i0 33 AA -t1415
00�5�8� TVAL019'
CAAT30.00
PERMIT VALIDATION
PERMIT NO. 1415
DATE APPROVED 4/10/92
EXPIRATION DATE 4/17/92
DATE ISSU D 4/ 0/92
By
Administrative Authority
TELEPHONE: (619) 564-2246
vr-....+..r.--+t.���r ��.eA.11,iiY'-ate— r��✓r. —. _. r—.--. ....._err—.r — _ _ _—.r — _ _ _ _ _ _ __ ___ _ _ __ _ _ _ _ _. _
NOTE:
With proper validation
this form constitutes an CITY OF LA aUINTA
encroachment permit
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
�— _ G% v Subdivision Improvement Permit — Class I.I1
DyTE:-- �✓ / Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION �`y = �� �"lK ��/I/7_
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION �� ��cyL�y' Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION C-L11C
aO_) le
A -
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 7-l0 - 2I7
APPROXIMATE TIME OF COMPLETION 7 3 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 Quints and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
Name of Applicant (please print) Business Address Telephone No.
X—TR13 fiUC-11hAt, els-,�50 5rr,ui ST Ili Jin 4;1
Name of Contractor and Job Foreman Business Address Telephone No.
e
Contractor's License No. City Business License No.
i .vary) C -Pr-). 1ilIJ u
Applicant's Insurance Company
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
Recorded by
$ rp
$
Date
Number
1236
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
y — 7r_
DATE ISSUED
By
Administrative Authority
TELEPHONE: -(619) 564-2246:
GENERAL ESCROW CO. DETACH AND RETAIN THIS STATEMENT
THE ATTACHED CHECK IS IN PAYMENT OF ITEMS DESCRIBED BELOW.
IF NOT CORRECT PLEASE NOTIFY US PROMPTLY. NO RECEIPT DESIRED.
i DELUXE FORM WVO-3 V-2
DATE DESCRIPTION AMOUNT
04/07/92 Job: THE SUNNY-BRITE TRUST 30.00*
10-17157 54-260 AVENIDA MARTINEZ LA QUINTA, CA 92254
Invoice Vchr Line Amount Invoice Vchr Line Amount
(CURB CUTTING) 68 3 30.00
w