1586NOTE:
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 III
DATE: October 30,1992 Minor Improvement Permit Class IV
'LOCATION OF CONSTRUCTION 51-925 Bonalas 52-848 , Velasco
53 -880 -Villa
(Street address or Description of Location)
,X RPOSEOFCONSTRUCTION Drlvevsp approaches
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
Sketch (attach construction plans if appropriate)
IP* r Riverside County STD #207
In consideration of the granting of this permit, the applicant hereby agrees to:
�r
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and a6ainst 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 su t of this work.
Signa ure of Applicant or Agent;
Stocimm Holes. 71885 MoutMsuala# La Quiata C492253 64-51514''
'Name of Applicant (please print) - Business Address Telephone No.
1
Name of Contractor and Job Foreman Business Address Telephone No.
642348 r 2534
Contractor's License.No. City Business License No.
Scottsdale Insurance Co. 018486817
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 64
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
10
$ 70
Date
51%2?9lAyA - 0-92 70.Qo W
JUT
1588
PERMIT VALIDATION
PERMIT NO. _
DATE APPROVED
1586
10-30-92
11-6-92
EXPIRATION DATE
DATE ISSUED 10J-30-92
By -I1 i I ,N
f Administrative Authority
TELEPHONE: (619) 564-2246
'6. 4
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
40ATE: f! 9 Z Subdivision Improvement Permit — Class III
----I Minor Improvement Permit Class IV
IYL'OCATION OF CONSTRUCTION ✓�� —� L 5' 6&►-'vl I-' C � e uL, Lq-:• L 0
31- VX0 G; l I r+
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
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:
IX
fF X F'Vr-u-su>E CO. STA tk�-7,07
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 tuwork.
/� Signare o Applicant or Agent
O C-11- V.-!rh ! / 'q A -C,
Name of Applicant (please print)
%%8'�S �»fie- �-►�. C4. Qu -
4 -Business Address
r&N -
Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Y. &913'[49 k SAN
Contra or's Lice se No. City Business License No. .
- Sd--`des. Co . x (r- S Lt 9(, &>,j 41
Applicant's Ins ante Com any C� 4B�uTy 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
j if required
TOTAL: $ —70
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 60
DATE APPROVED O 3O jq7-
EXPIRATION
DATE _ 10 — C1 Z
DATE ISSUED I o b-
'6 '? Z
By
TELEPHONE: (619) 564-2246
-/5-4
?GFS
Administrative Authority