1682NOTE:
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 II
DATE: 3/4/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 51895 AVS DIAZ
J
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION DRIVEWAY APPROACH Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
SEB RIVERS211IE CO # 207
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION 4/5/93
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 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 per gt and all ap licable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of his world
SWnature of App scant orAUen."
STERLING HOMES PO BOX 450 LA QUMNTAP CA 92253 (619) 564-1866
Name of Applicant (please print) Business Address Telephone No.
SALT & PEPPER CONCRETE (BOB) PALM l3PA7NGS (619) 567-2017
Name of Contractor and Job Foreman Business Address Telephone No.
B 638535
Contractor's License No.
859
City Business License No.
STATE FM 1101246-92
Applicant's Insurance 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 $ 20.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
10.00
$ 30.00
Received by Date
?051.8?AkA M&R i4-93 30,00i0
1682
PERMIT VALIDATION
PERMIT NO. 1682
DATE APPROVED 3/4/93
EXPIRATION DATE4/5/93
DATE ISSUED 3/4/93
By
Recorded by 11 TELEPHONE: (619) 564-2246
Administrative Authority