1709NOTE`:
'Withi'l3ro'per.,validatior
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 I I I
DATE:. 3/31/93 Minor Improvement Permit Class.IV �.
s'• LOCATION OF CONSTRUCTION 52-440 Ave Obregon
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _Driveway Approach Sketch (attach construction plans if appropriate)
'M
DESCRIPTION OF CONSTRUCTION `.
Per Riverside�County STD.#, 207
(Attached)
DIMENSION OF INSTALLATION OR REMOVAL '
SIZE ,OF EXCAVATION, IF NEEDED30.00
h`: +
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/31/93
>: APPROXIMATE TIME OF COMPLETION '3/31/93 .
ESTIMATED CONSTRUCTION COST $ 600.00
(Including remova l• of all obstruction, materials; and debris, backfilling, com
paction;and placing permanent resurfacingJand/or replacing improvements) 4
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 against any and all
penalties, liabilities or loss resulting froml 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 :tunder 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 `
WE.S Development Company 77-885 Montezuma 564-5154
Name of Applicant (please print) Business Address Telephone No:
De®ert.Concret Palm.Desert
Name of Contractor and Job Foreman Business Address Telephone No. .
81642348 2534
Cont'ractor's License No. City Business License No.
:Reliance SP1953315
Applicant's Insurance Company Policy Number
FEES:'`Subd'ivision Improvement Permit = Class•111
Public improvements`. 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
{yMinor.lmprovement Permit — Class IV: See attached.schedule: �,'
u
Inspection Fee' . .-s 20.00 PERMIT VALIDATION ;
•�
Permit Fee. 10.00
� � PERMIT NO. 1709: 1.
7.
Penal
Deposit Surety Bond' DATE APPROVE
ty
CashD 3/31/93""
if required'
EXPIRATION DATE -4/9.1/93
r TOTAL: $ 30.00 DATE SSUED 3131/93
Receipt No.
Received by Date
Recorded by
B '
Y `
Administrative Authority
TELEPHONE: (619) 564-2246