1578NOTE:
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
Subdivision Improvement Permit — Class I I I
' DATE: October. 19, 1992 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
MOtT@
PURPOSE OF CONSTRUCTION 004%ent Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION CAT 633. 8crapo .
'tom bona 'Pam and l ie s txard Ho
North on 11140 ; elms' -*,Wont on miles
00rth on lWashi ton to ive side County
- - n8 � � CY
loaded on 9 eal.es
DIMENSION OF INSTALLATION OR REMOVAL Li:S1e and xOttlk^il unladen.
14-9 hifth, ,13-9 vides. 99-10 overall, strolsswt*.
218,581 I. 4
SIZE OF EXCAVATION, IF NEEDED-
APPROXIMATE
EEDED '
.APPROXIMATE TIME WHEN WORK'WILL BEGIN 10/20/92, ;p .
APPROXIMATE TIME OF COMPLETION ,
ESTIMATED CONSTRUCTION COST•$
(Including'removal of a►I obstruction, materials, and debris; backfilling, com-
paction and .placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the,applicanthereby 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 o� 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
S,L. 'Xeagax Cont`. Co. Inc. T.b, 8ox 87 Riyeraiii •CA (800) 222-5360
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.
Amerj6n '- TutemationAl 897702162
y Applicant's Insurance'Company Policy Number
FEES: . Subdivision Improvement Permit — Class I I I • ;
' Public improvements: 3% of estimated construction costs ,
� "rA.010.92 to .00 to;
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.
$
10.00
$ 10.00
Received by Date
PERMIT NO
1578 i
PERMIT VALIDATION
1578
DATE APPROVED 10/19/92
EXPIRATION DATE 10/20/92
DATE ISSUED 10/19/92
By 11f,14devi rev"
Administrative Authority
Recorded by 111 11 TELEPHONE: (619) 564-2246
OCT -19—'92 -MON 09:50 IP: F. L. YEAGER TRANSP. TEL NO: 800-281-3101
res r,t r„r.•
AIOTIIS '
With proper valld$tien
thll form eenititutn an
enaroachm9rd ermit CITY OF LA QUINTA
APPLICATION FOR P011MIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
00E `-mtP 0\JZXSI'Z9— IJAo PERMIT -
#316 P01
Por the oonttruetlen of public or privets curbs, orlveways, pavements, sidewalks, parking lata, sewers, water Maine
and 6dW Ilk$ public works Intprovemants In Connection wleh MINOR IMPROVEMaNT3 and APPROVED SUNDIVIAIGNS
CATII:� - 101 i i t
Suhdivleron ImprOvamsnt P$nnit CIaa1 III —
Mlnar Improvement Pamn Clau IV
LOCATION OF CONSTRUCTION
ititrast 196MW-01 o wrlptlar Al t.owilonl
PURPOSE OF CONSTRUCTION -..Mfi-At v i pmro4 T
ONCRIPTION OF CONSTRUCTION
A
2ftigN OF INSTA TI 12�Ri V
Ina pop
r ,
SIZE#I OF EXCAVAY10ii, IF NellosD ,
APPROXIIMATI TIME WHEN WONX WILL BEGIN
APPROXIMATE TIMI OP COMPLETION
Sft�h (attach oonttructlon plans if appropriate)
tSect�a e>�t �U�g Prates • ^�1es� o►J
M1t.,VIS 0R''t'1a 0 U 1��sN1w�To.�
ft,r uz.w 0W LOb W—s4.
lSTIhtAT@D CpNST'RLhCT'iON DOST! �� 1.11 R�
410141904 n1R•oval of ell bbatruogon, ffsnta..ld1, and debris, bec"llImp, Com• �1„Vb� 1tL
peatlon Intl placing permanent relurfsotn/ senior rapIWAg ImprovVMnisl
In consideratl0n of the yrantln0 of this psrmlt, the aPPlicent hereby $gran to:
IWgfflhOV,.Mand and aw the City, in auanerieed I$vnU, officers, "Preso mlwl Ina Imaloysta, hltinl2n front any galeot Inv Ina fll
Is"twh, lybllmlel or low fasulthla ream alalnd or ca.et sellen Ind stitlrp Owe of Inv Ialeent, lou or daedaa to Idna" or orwerty
ANMIF4 et onunha a a OrOslegte mutt Of any Iwortt undlrgk/n under Ina perolt pentad pursuant to thle appllaven.
NOeIM the AdMInlsoittivl Authorhy at $aW twenN•fsur (241 VA Its adwna of the elft whsa work will be etamd.
oamaly with all tnp/IMODII City 9rdinanae. 1114 fi/rnft Ind oondltlofle Of IM AsnMlt and all 40011at a ruiat and ryulatletd of the City of
La CMIR $ Ind 01 pay far any IddltImal r1Al$0lewnt Flea lty a1 thers wla
two
SIgAture of Applicant o ret s
CID. �>aL �,0. Box Sic . Rlv��ts�oc cc, � ob
Name of Appilant (Olean print] BusinessAddntsl Tflephone No,,,,,
Nemo of COM14110r And Job Foremen Business Address Telephone No.
Contractor's Lioanse No. City •usin$11 Leann No.
AM��.�,c_ow -"f L►�eec.�a cart a 14 Its, 16--
Appllcantes Insurance Company RP -013-0-91 67.
,,,
Polloy Number
Poll., JILbdivision Impmvernan= Parmit — else,III
Pubila Imprtivel W1tl; 3% of estimated censtruotlon Coats
Private Improv.Mentl; 3% of 1111 atad construatlon oohs
Minor Ire vem$nt Parmit - CIM IV: 8a attached schedule
Immotlan Fee ! :l PERMIT VALIDATION
Permit Fee b i 15?8
PSAMIT NO,
�
Penalty �.�........._ 10 - I 9-q7
oath 0$00llt3urety send OAT% APPROVED _
if t4oulr4d, n r '1
_ A
EXPIRATION DATE -
TOTAL: j ��. e q _ - 0 2
11140410t No. DATE !casino
R4celved by Data i 6y
Adminbtrative Authority
Recorded by �' TELEPHONE: (6101564-2240
ZOLOZ-53`0