Loading...
1465------- ---- ------ ------ - )OTE• 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 DATE:' June 17, 1992 LOCATION OF CONSTRUCTION 52-865 Avenida Navatro Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV (Street address or Description of Location) PURPOSE OF CONSTRUCTION Driveway Aoproach Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION Concrete installation of approach Per Riverside County Std. #207 (attached) r DIMENSION OF INSTALLATION OR REMOVAL 161 x 5'611 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 6/18/92 t APPROXIMATE TIME OF COMPLETION 6/25/92 ESTIMATED CONSTRUCTION COST $ 300.00 (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. 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 iff Applicant or Agen� R.B. Marchi Concrete P.O. Box 2229 Palm Desert, CA 568-6982 Name of Applicant (please print) Business Address Telephone No. Same Name of Contractor and Job Foreman Business Address Telephone No. L126938 2505 Contractor's License No. City Business License No. State Fund 046-000-3323 Ext). 1/1/93 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class 111 Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs .1465 Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ Previnual-y PaAd 0 PERMIT VALIDATION Permit Fee Building Dept. w/ 1465 PERMIT NO. Penalty Building hermit - ' Cash Deposit -Surety Bond 10497 DATE APPROVED 6/17/92 if required EXPIRATION DATE 6/25/92 TOTAL: $' DATE ISSUED 7/17/92 Receipt No. , BY Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 —__--- ----------- --------.-------------- 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 /: — /7 _ / 2 Subdivision Improvement Permit — Class I I I D&TE: (!� �, Minor Improvement Permit Class IV '1 LOCATION OF CONSTRUCTION a ° y °4✓;1%✓Lr?- 0 (Street address or Description of Location) PURPOSE OF CONSTRUCTION 2[1/FvJy � UPZPJ' 4-W Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION /° - Ca -r� DIMENSION OF NSTALLATION OR REMOVAL )b GeV&, SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 7i a e) �s►J �-r� �9Z APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ 30b'�o (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 Applicant or gent jZI 3- n/1u1•zcdt� ewc�� j��r, r3� a.P.29 2, i • �G �9b�2 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Z-1.1 le 13 8' -2- So !�;— Contractor's License No. City Business License No. �'►4�('F_ l 0 `/% ¢10`Q G 3 3 a 3 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III �F 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 Date PERMIT NO. 1236 PERMIT VALIDATION DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE:,. (619) 564-2246..... C.