1545NOTE:' Z
With proper validation '
this form constitutes an CITY OF LA QUINTA
,encroachment permit
APPLICATION FOR -PERMIT
PUBLIC WORKS CONSTRUCTION, (ENCROACHMENT)
• f
For the construction of public or private curbs, 'driveways, pavements, sidewalks, parking lots, sevvers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit— Class III
DATE: Septeidber 15. 1992,' Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 3+1�*465.Ag®. Alya�xado '
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION' DrAoriroaCh 1. Sketch (attach construction plans;if appropriate)
DESCRIPTION`OFCONSTRUCTION Curb cut it drIVOWaii )1�
apP roach. PIM RIVIR80N COMM STD, NO. 207,
DIMENSION OF INSTALLATION OR REMOVAL 16' Curb cut and
remtrobh,. q 4
116 1
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE. TIME WHEN WORK WILL BEGIN 9113/92
APPROXIMATE TIME OF COMPLETION 9123142 r
ESTIMATED CONSTRUCTION COST•$ 200•00"
(Including removal of all obstruction, materials; and debris, backfilling, com
paction and placing permarient 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 ofany accident, loss or damage to persons or property
happening or occurring as a proximate,result of any work u .dectake,n--IC "dee—r'?Mie%permit gLptecl pursuant to this application ., J
Notify the Administrative Authority at least twenty -f r (24) hours in adv ,aee of he time when work will a started.
Comply with all applicable City Ordinances, the terms�fid+�eond ionis of hie 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.
T
° Signature of Applicant or Agent
,Kolayon and Brad Jones 79.738 Arabld. PIL L Ouinta 771-=0311
Name of Applicant (please print) Busine`s`s Address Telephone No.
1 -at r r
Oita*r/Bul (der
Name of Contractor and Job Foreman Business Address Telephone No.
:Contractor's License No. City Business License No.
Allstate ' 02723476307/27
Applicant's Insurance Company Policy Number
r
FEES: Subdivision Improvemerit Permit — Class I I I
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 _
20.00
10.00 r
Penalty
Cash Deposit -Surety Bond
if required-
TOTAL: $ 30.00
Receipt No.
Received by
Date
T Op 10
545
PERMIT VALIDATION
PERMIT NO., 1345
DATE APPROVED 9/15/92
EXPIRATION DATE 9/25/92 t,
DATE ISSUED 915/92
ByAIA401
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
ff S Subdivision Improvement Permit —Class III
DATEr � Jid Igz Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION'— `I b 5 Avg-• A l vavaao
(Street address or Description of Location) r
PURPOSE OF CONSTRUCTION Sketch (attach.construction plans if appropriate)
D :,.,eel 6"
DESCRIPTION OF CONSTRUCTION Cv-b (. )4 Ilr�ve�wc../ fZ�VU'�` LD g�Cr7 �7
DIMENSION OF INSTALLATION OR REMOVAL 110 —b C,.4 +
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIM✓E WHEN WORK WILL BEGIN, WJedk c F q I-.ti142.
APPROXIMATE TIME OF COMPLETION WeAkk of ' q ILI' 9 L
ESTIMATED CONSTRUCTION COST $ 2.00. 4a
(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 permitand 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.
00 IIY Signature ofAAppli t or Agent
�PW�/Uw GwU �srz.,CA- TowPiy `14—l39 A, -*W /o• it" L.L..yewfR.. �%1�1) 71—OSi1
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
A•14SJu.fie, + ?2`12-34 -►b w,7 I z- .
ppllcant s Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class II I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ �1
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 el-- (S �C Z
By
TELEPHONE: (619) 564-2246
Administrative Authority