1476----------------------------. .: ------ -------------------
L y
NOTE:
With proper validation
I
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR 'PERMIT
PUBLIC WORKS'CONSTRUCTION (ENCROACHMENT)
the,<construction""of" ' lic � or ' _rivate-curbs; drivewa s "•"wg fo ` �^�
4;,,.-, P _ ,p _ ,,,, __ i w , �' ,*p_ave,ments; sidevValks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class I I I
DATE: June 26, 1992 Minor Improvement Permit�Class IV
LOCATION OF CONSTRUCTION 53255 Avenida Herrrera r ^
(Street address or Description of Location) ,
PUR OS OF CONSTRUCTION Replace driveway with concrete
anc� ad walkway
DESCRIPTION OF CONSTRUCTION Remove asphalt and replace
with concrete
DIMENSION OF INSTALLATION OR REMOVAL '
SIZE OF EXCAVATION, IF NEEDED '
APPROXIMATE TIME ARK WILL BEGIN 1/26/92t)
Sketch (attach construction plans if appropriate)
SIDEWALK SHALI<'BE CONSTRUCTED
`'PER RIVERSIDE CO; STD. 401 s,
ATTACHED.
r /^
OWNER UNDERSTANDS THAT IMPROVE TS e.,/'
IN 1HE PUBLIC RIG QPI,�} W Y MAY NEED
/� T V I_ i� I 'C'i 1V %S THE
OTHER PURPOSE.
APPROXIMATE TIME OF.SCOMPLETI'ON 7F3792—
.ESTIMATED
3 92ESTIMATED CONSTRUCTION COST $
(Including removal ofall obstruction, materials, and debris, backfiil'I ng; 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 authorizedagents, 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�offany 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 w n work will be started.
Comply with'all applicable City Ordinances, the terms and conditions of the permitand 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.
SIg tur of Applicant or Agent
John Bell. 564-2816
Name of Applicant (please print) Business Address ' _ Telephone No.
Owner/Builder
*� Name of Contractor and Job Foreman Business Address Y Telephone No.
Contractor's License No. City Business License No:.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III I ?"18FJA �7TAiALr-P-•92 X0.0010
Public improvements: 3% of estimated construction costs. 1 �
Private improvements: 3/0 of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule r .
Inspection Fee $ 20.00* PERMIT VALIDATION '
Permit Fee 10.00 1476
PERMIT N0.
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 30.00
Receipt No.
Received by
Date
DATE APPROVED 6/26/92
EXPIRATION DATE 7/3/92
DATE ISSUE 6/26/92
By AL A^44-411
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an
encroachment permit
t
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:_ c uOe� 2(0 ) q Z Subdivision Improvement Permit -Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION ro�2E6 AaA Ida 14e Ile-oa �,4 n , CA
(Street address or Description of Location)
DESCR I
DIMENSION OF INSTALLATION OR REMOVAL
Sketch (attach construction plans if appropriate)
CV,J S"C2u.�CGU
Pi&42 e2r Vat IrP.--3 / 0Tr C:,�' ST 0 f 0 I
0wj,JLAN
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN �17.�v� Zo t?,� (L�w1°�/Zi� I r 7tw-. /-4,
APPROXIMATE TIME OF COMPLETION
►.is�D S �,'t ;nam P� „1 a � Ae�st'(� �,n,�-�ri S �
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 andsave 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 p rmit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the reiult of his work.
Signatu ` f.A licant or Agent
0 DELA_
Name of Applicant (please print)
Irn (A IV HIR- U (L. Ef .
Name of Contra
ana joD roreman
Contractor's License No.
Business Address
Business Address
Shy- ZIF-/(
Telephone No.
Telephone No.
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit - Class If I
Public improvements: 3% of estimated construction costs U
Private improvements: 3% of estimated construction costs 13 8
Minor Improvement Permit - Class IV: See attached schedule
Inspection Fee $ ~L0 II PERMIT VALIDATION
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ �O
Receipt No.
Received by
Date
PERMIT NO. I !_1-7�v
DATE APPROVED ( 7 CQ -�
EXPIRATION DATE 7 `✓ - 9� z'
DATE ISSUED 6 -ZU--C,2
By
Recorded by I TELEPHONE: (619) 564-2246
Administrative Authority
HARDWOOD
SOFTWOOD
LUMBER
PLYWOOD
FLOORING
MOULDINGS
PARTICLE
BOARD