1598NOTE: .�
With proper validation
this form constitutes an
encroachment permit
Vj l I-(- C,4v- arc- _r_t 61 o til
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
b7_r1111q
' r
November 10,•1992 ,
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 53--185 Avenida Bermua
F X11:$► 4 x2or la 92233
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 12-16 PT. Curb Cut Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Driveway Approach Per livereide County STD 207 3
attached
c DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION,'IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN Oa1A
APPROXIMATE TIME OF COMPLETION 8&SO dap
') 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, harmless from and agairist 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 granied 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.
$i nature of Applicant or ent
' John Guenther, Jr: 53255 Avenida $ermu0e 619564-»2577
Name of Applicant (please print) � Business Address Tel► (nphob1�1
Curb WaatnS 31-255 Avenida Maravilla Cathedra. City, •• FA 9223 9� 321-90fl0
Name of Contractor and Job Foreman `++ Business Address Telephone No.
y589084 2095
Contractor's License No. City Business Licese No.
Slate Farm 'Insurance Co. 55- V-0614-�
Applicant's Insurance Company Policy0pumb2�r`
a�' 4d "i� pert 30,00 i3
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 376 of estimated construction costs %
PERMIT VALIDATION
:1588
PERMIT NO:
r�
.DATE APPROVED 11-10-92
11.11 -92
EXPIRATION DATE
DATEISSUE
1-10-92.'. ,
' f '%%T Administrative Authority
TELEPHONE: (619) 564-2246
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ E 20
Permit Fee {
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 30
Receipt No. _
Received by Date
Recorded by
t
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
I�OATE: NAV �� ! 9 9 2 Subdivision Improvement Permit— Class III
�1 Minor Improvement Permit Class IV
')-LOCATION OF CONSTRUCTION f3 — �A�eNioA %3-0K httI Del S
LA 44,.-wrA, 42a41i 92.tS3
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION'—/ 2 — rr esf✓h9
DESCRIPTION OF CONSTRUCTION bKA' ttof+e-hf1 11
-
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
Sketch (attach construction plans if appropriate)
'_;`APPROXIMATE TIME WHEN WORK WILL BEGIN fe :A^%
Io.E sr /1
PPROXIMATE TIME OF COMPLETION SA*v%r- DAY
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:
_l V E. Rs f Df_ Co S"iD
Indemnity, • 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.
Sign ure of Applicant or Agent
v� Jo fig �/. Gyer'NTH�K, JK. 323$ Av4WiA4 /)011MvoAs Yzs'77
Name of Applicant (please print) Business Address Telephone No. �ZI _q boa
GyR 13 SA1AAi3O/G-
--Z-S-5' AvrwsoA yApq PP, vlI-I✓4 CqT)19-0f-c1"T4C4 d)?,Z3y
Name of Contractor and Job Foreman Business Address Telephone No.
, 56140gy - ZZ>9s
7tbntractor's License No. City Business License No.
_ ZATZ F-401)6- /Art . Co. `mss -,07 _ a 6/o/ 2 -
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III j
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
13F�
Minor Improvement Permit—Class IV: See attached schedule
Inspection Fee $ Com11
Permit Fee l
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ so
Received by Date
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE 1 1 " k3_ 5 2
DATE ISSUED
By
Recorded by 11 TELEPHONE: (619) 564-2246
Administrative Authority