1751NOTEf'_
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 III
DATE: 6/4/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 78-590 Singing Palms
(Street address or Description of Location)
Driveway Approach °
PURPOSE OF CONSTRUCTION Sketch (attach construction plans`if appropriate) +t�;
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL *�`y
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Per Riverside -County STD # ?07
(Attached)
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 800.00
(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:
' 85' FAM ?3HT2614_.93 30.0013
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.
Wilford Hurta 79-541 Ave 42 Bermuda Dune
Name of Applicant (please print)
Business Address
licant or
Telephone No.
_BKR Builders 78-883 Ave 42 Bermuda Dunes 92201 (619) 345-7517
Name of Contractor and Job Foreman Business Address Telephone No.
616161E
Contractor's License No.
Burlington Ins
2918
City Business License No.
051516437
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
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$ 20.00
10.00
$ 30.00
Date
11511
PERMIT VALIDATION
PERMIT N0. 1751
DATE APPROVED 6/4/93 '
EXPIRATION DATE 6/11/93
DATESUED 6/4/93
By
Administrative Authority
TELEPHONE: (619) 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
Y' T -
45;7
/ irk•^
GATE: Subdivision Improvement Permit — Class III
0 Minor Improvement Permit Class IV
LOCATION dF CO STRUCTION S� 6 !� I1,�1�� —IYD
WO0
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 22 ' 19e l
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATI,QN OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED A/0-.✓
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if app vWaW)
l �� lv0,eslpc Cow✓� l
5 7D Alo Z - 7
(A-7-7,fc `V
I 3 O'
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTS Fi71
=4 .
(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 env and all
Penalties, liabilities or loss resulting from claims or court anion and arising out of any accident, loss or '
happening or occurring es a proximate remit of a dam+�a p persons or property
any work undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four 124) 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 Quints and to pay for any additional replacement necessary as the result JV.
this work.
Signature of pplicant or Agent
Na Applicant (p)#ase print)
x n _ Business Address Telephone No
�,
Name of Contractor and Job Foreman
Contractor's License No.
Applicant's Insurance Company
Business Address Telephone No.
City Business License No.
olicy Number
FEES: Subolvision 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 $ 7,0
Permit Fee 1 v
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$__._,L.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO
DATE APPROVED
EXPIRATION DATE
DATE ISSUED G - LI 73
By
TELEPHONE: (619) 564.2246
Administrative Authority
9
a