1582Q
N9TE
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
October 26o'1992 µ Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION�$qujq�l►nt Sketch (attach construction plans if appropriate)
DESCRIPTION -OF CONSTRUCTION UAW 03;
• - tractor and Sorapaa� ,
DIMENSION OF 4NSj�4LLATION OR RE IOVALLo8ded on 9 axless,,"
9 high, 13.10ry �}txide s f s9' ,10 oyo>ral2 length -
gross
!
Prom Wes Nard-g0 northbound on
Dun CLEm m
- West on Miles, north b
on Washdngton, to Riverside Cnty.
line, and ratsra unl'adan. r,
0.00 14
SIZE OF EXCAVATION, IF NEEDED
v1 '.APPROXIMATE TIME WHEN WORK WILL BEGIN'
APPROXIMATE TIME OF -COMPLETION + '
ESTIMATED CONSTRUCTION COST $ +'
(Including removal ofall 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.
A Comply.with'•all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Quirta and to pay for any additional replacement necessary as the result of this work.
t Signature of Applicant or Agent
'g.L•-Yeager Construction Co., F.O.�Box 87 RiVoirside CA, (800) 222-5360
Y 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.
Applicant's Insurance'Company Policy Number
FEES:, Subdivision Improvement Permit— Class 111
Public improvements: 3% of estimated construction costs`
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class,IV: See attached schedule, 1582.
,
Inspection Fee $ PERMIT VALIDATION
1040
Permit•Fee PERMIT NO.
Penalty
Cash Deposit -Surety Bond
if. required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
DATE.APPROVEDLo' 92
EXPIRATION DATE �� ` 7,7- 9Z
DATE ISSUED (�/O' Z_ 7 4Z
By >1 dr
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE; '
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private Curbs, driveways, pavements, sidewalks, parking Iota, sewers, water mains
and other like public works Improvements in connection with MINOR IMPROVEMENTS and APPROVLD SUBDIVISIONS.
16 2 V laz Subdivision Improvement Parntlt — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Loaatlon)
PURPOSE OF CONSTRUCTION 11eyIS 'Eku %P MW-w1Tr Sketch (attach construction plans If appropriate)
DESCRIPTION OF CONSTRUCTION C'r VS
pa
Dq p,IMt1XlONOFI iTAL ATtON01_ OV 10�A g �`� �,/t,`�Ss ff�l6ttTN b1.1 �AS�tII�f t'O�I
e •
R,OL tFat T 2
SIZE OF EXCAVATION, IF NEEDED To �tvE�cs�o� Gou>Jr� `„1�.1
APPROXIMATE TIME WHEN WORK WILL BEGINDE^i-
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTS
(including removal of all obstruction, materials, and debris, backfilling, corn•
pactlon and placing permanent resurfacing and%or replacing Improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnity, -defend aid'seve the City. Its authorised agents, effloen, rspreIVITNIves and employNe, harmless from and against any and all
penalties, liabilities or ion resulting from claims or court aotlon and arising out of any accident, los, or damage to persona or prop:rty
happening or occurring as a preximete result of any work undertskon under the permit granted pursuant to this application.
Notlfy the Adminlitrative Authority at least twenty-four (24) hours In advents of the time when work will be started..
Comoly with ■II applicable City Ordlnant:ea, the terms and conditions of the a ---
s It and ail sppliaeDla les and regulations of the City of
La Oulnts and to pay for any additional replsoement neceaary me the resul of a rk,
Signature of Applicant or A ret
E.1.. Coas-r. Co 87 Rwsms I vtr Co , (2, Do zu-531.0
Name of Applicant (please print) - Business Address Tdlephone No,
Nome of Contractor and Job Foremen Business Address Telephone No,
Contractor's License No. City Business License No.
AHroc.>taA.e� t�l-t^EYt-tJATleaat>,>L %o 9 St T707,jCa2
Applicant's Insurance Company Policy Number
'EES: Subdivision Improvement Permit —Class III s
Public Improvements: 3% of estimated construction Costa
Private Improvements: 3% of eatimalod construction costa
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee S i PERMIT VALIDATION
Permit Fee _ �� •0 O 11
Penalty
i� PERMIT NO,
Cash Deposit -Surety Bond it DATE APPROVED
if required
EXPIRATION DATE
TOTAL: $ I D • CI
ReoelDt Na. �I
DATE ISSUED
Received by Date---_ �I By Administrative Authority
Recorded by I TELEPHONE: (819) 664-2240
i
I