1499S'
NtffE:
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 I I I
DATE: July 30, 1992 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54-820 Avenida Madero
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _ Dri'Veway 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 8/5/92
APPROXIMATE TIME OF COMPLETION 8/12/92
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:
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.
S ature ofp i ant or Age t
Majestic Homes P.O. Bos 76 La Quints, CA 92253 568-6014
Name of Applicant (please print) Business Address Telephone No.
Quest Construction 564-3580
Name of Contractor and Job Foreman, Business Address Telephone No.
461565 2463
Contractor's License No. City Business License No.
Parnmers Insurance 907790177
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 $ 20.00
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
it
$ 30.00
r
Date
185182ASH i IM -7-i 0 -92 30.00 10
TUTRI1499
PERMIT VALIDATION
PERMIT NO. 1499
DATE APPROVED 7/30/92
EXPIRATION DATE
8/14/92
DATE IS9(JED . A 7/30/92
By.v`"�"—
Administrative Authority
Recorded by 11 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
q Subdivision Improvement Permit — Class I I I
DATE: c �� J Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION ? ,:;lO Mjc— aLf)
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION%L
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 9Q.4,,57'
Sketch (attach construction plans if appropriate)
14
Nrty s -rd ad ?
APPROXIMATE TIME OF COMPLETION Q > >s T /9
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 Quinta and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent
-AV7 4a
o�y
Name of Applicant (please prri(nnt) Business Address Telephone No.
E7li]PS� �n►.IS nut Ii��1 O loo,* T,4'U 35,?Q
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
11-.7 12rnr rt r Zi C 90 77 1? 0 / 7 7
Applicants 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.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED.
By
TELEPHONE: (619)564-2246
Administrative Authority