1596V-- ,
r,
NOTE: - --
Wjkh-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 '
t
Subdivision Improvement Permit— Class III
DATE: November 5, 1992 Minor Improvement Permit Class IV '
LOCATION OF CONSTRUCTION 33-140 Mendoza
i
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway -Approach Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 6 concrete approach Per Riverside County Std. #207
DIMENSION OF4NSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED I
APPROXIMATE TIME WHEN WORK WILL BEGIN 11/5/92 {�
` APPROXIMATE TIME OF COMPLETION 11/10/92 `
ESTIMATED CONSTRUCTION COST $ 350.00 '
(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 prope,rty
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.
'++ u
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 tocpay for any additional replacement necessary as the result of this work.
Receipt No.' ". 1 1
Received by Date``'
•,
Recorded by
y ,.. Administrative Authority
TELEPHONE:' j619) 564-2246 ' -
/�
{{
Signature ofApplicant or Agent '
Desert Cities,Concrete
347=8512
Name of Applicant (please print)
Business Address Telephone No.
Kew Stemmer 77-745 Delaware
Palm Desert, CA 92260 772-0046
Name of Contractor and Job Foreman
Business Address Telephone No.
-502964 , Exp. 10/31/93
1978--
978--Contractor's
Contractor'sLicense No.
City Business License No.
Slingi & Mannon
Applicant's Insurance Company
Policy Number 1
'FEES: Subdivision Improvement Permit — Class III
tA 45..92. io
..Public improvements: 3% of estimated construction
costs
a r ' Private improvements: 3% of estimated construction costs 1 -
Minor Improvement Permit — Class IV: See attached schedule
i' Inspection Fee r $ 20.00
PERMIT VALIDATION ;
" Permit Fee 10.00
�,
�.
-PERMIT NO.. 196 -
Penalty'`
•�' 11/S/92
' Cash Deposit-Surety.Bond
DATE APPROVED
if required. !
EXPIRATION DATE 11/10/92' `
TOTAL: $ 30:00
,,� ,
;,
_11 5/92
{DAT ISSUED
Receipt No.' ". 1 1
Received by Date``'
•,
Recorded by
y ,.. Administrative Authority
TELEPHONE:' j619) 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
DATE:_ �� % 7— Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION _ S� 3 ' —),kq
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION Of C-011USTRUCTION
a . At f-9,4. - AA
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 01
(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 result of this' work.
Signature of Applicant or Agent
+ C141 -es / Cf D /A( <_r .e.11 t o 3(J% g S -7
Name of Applicant (please print)
-1-1 _'?
Name of Contractor and Job Foreman
-65-02--26<4 '�4e 10/3119-L
Contractor's License No.
d
Business Address
Business Address
11
Telephone No.
-) -) a - c)(:_-�q
Telephone No.
l9?8
City Business License No.
Applicant's Msurance Company 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 $ C —
Permit Fee O
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 3 0
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED S — Ira
EXPIRATION DATE f ( c, — a
DATE ISSUED 12_C —9
By
Administrative Authority
TELEPHONE: (619) 564-2246
ry
7r" p
/•
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
DATE:
Z� Z Subdivision Improvement Permit —Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION - "-)6-
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Ty .� 't7 s . Sketch (attach constructionlans if
F
P appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVALS t
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:
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmlesi 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 e
en work will be started.
Comply with all applicable City Ordinances, the terms and conditions of thepe it and II plicable rules and regulations of the City of
La Quinta .and to pay for any additional replacement necessary as thei-res f is
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 1 v L
Minor Improvement Permit — Class IV: See attached schedule
'Inspection Fee $
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
By
TELEPHONE: (619) 564.2246.
Administrative Authority
er
4