14161 .M+
-- -- - - - - - - --- - - - - - - - - - - --- - - - - - - - - - - - ------- �!": -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
NOTE: _
With proper validation
this form constitutes an
encroi chment 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: April 10, 1992
LOCATION OF CONSTRUCTION Calle Tacate
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
DESCRIPTION OF CONSTRUCTION Tn rpmn-irp drivpwav and tn.
conntrll^t "Am rtri�soraa�r ar= rnarh
DIMENSION OF I %r, LLATION OR REMOVAL 7-aTe- out
New approach .
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/14/99
Sketch (attach construction plans if appropriate)
See Attached Sketch.
Driveway approach construction per
Riverside County Std. No. 207.
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 05,000.00
(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.
1
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 o this work.
Signature oYApplicant or Agent
Coachella Valley Water District P.O. Box 1058'Coachella, CA 398-2651
Name of Applicant (please print) Business Address Telephone No.
Alan Mensonides Same
Name of Contractor. and Job Foreman Business Address Telephone No.
M
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 14,16
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee —0
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
-0—
$•
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 1416
DATE APPROVED 4/10/92
EXPIRATION DATE 4/30/92
DATE ISSU D 4/10/92
By
Administrative Authority
TELEPHONE: (619) 564-2246
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
Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION -J0 RG~c e, ofel e -
J/44 AVD e'/ o Cm.ysTRtccT A-Af,. Oei C. GUI c
DIMENSION OF INSTALLATION OR REMOVAL Oce
—30_ Vew 49 - -- 0 e f
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
fl p f1U/,< Cc;>/Uls
17� ,to.! ✓�l�� Cv k,v � S��
/Vv 7, c7-7.
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ X04
(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 res It of this work.
C
Signatur of Applicant or Agent (/ l vfi TPS f��Si R �c�- o 600 /-0 5-d) 39 d9 26 s
Name of Applicant (please print) Business Address Telephone No.
L;,�nl /416/V S ory I'D s S,v /" r(=
Name of Contractor and Job Foreman Business Address Telephone No.
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
452
$ L,5;1
Received by Date
Recorded by w• . -1
1c� 6
PERMIT VALIDATION
PERMIT NO. 14114 -
DATE
4114 -
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246