1513•NOTE: '
_With proper validation
w=.. 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
DATE: August 12, 1992
LOCATION OF CONSTRUCTION 53-805 Cortez
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway annroaeh
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
Subdivision Improvement Permit — Class l II
Minor Improvement Permit Class IV
and 54-085 Alvarado
SIZE -OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 9112/92
Sketch (attach construction plans if appropriate)
PER RIVERSIDE COUNTY STD. NO. 207,
ATTACHED.
APPROXIMATE TIME OF COMPLETION A/13192
ESTIMATED CONSTRUCTION COST $ 600.00
(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 re u t of this work.
rt.. �'- •
Signature of Applicant or Agent
Suncrown Corporation 52-740 Alvarado 564-5231
Name of Applicant (please print) Business Address 'Telephone No.
Larry Donoho 52-740 Alvarado 321-3569
Name of Contractor and Job Foreman Business Address Telephone No.
627265 2154
Contractor's License No. City Business License No.
State Fund ' 1270495 Exp. 11/92
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
?$5w• 1a * ,�. :fit' Sf lSll't�LB-12;,..�w� ,�
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
$ 40.00
20.00
$ 60.00
Date
PERMIT VALIDATION
PERMIT NO.
1513
DATE APPROVED
8/12/92
8/14/92
EXPIRATION DATE-,
DATE ISSUED
8/12/92
By
Administrative Authority,
TELEPHONE: (619) 564-2246