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1754y .NOTE: ..eith.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: 6/8/93 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Hwy 111 & Washington St (Street address or Description of Location) Survey 10�s t fl SIA IN%i ,06 -09-:93 13 PURPOSE OF CONSTRUCTION Sketch (attach Qnstr t�qn p ans zf3a,ppropriate) 90.00 DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED See Attached Traffice Control Plan Work Hrs. Shall Be Limited To 9am & 2pm No Work On Friday's shall be E Permitted APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION 2 days 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 permit and all applicable rules and regulations of the City of f La Quinta and to pay for any additional replacement necessary as the result of this work. Signature of Applicant or Agent JF Davidson Assoc 77-564 Country Club Dr Palm Desert 360-3780 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. RCE17550 119• Contractor's License No. City Business License No. Milam & Munaretto 086ACM22413090 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class Ill 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. $ 80.00 10.00 $ 90.00 Received by Date PERMIT VALIDATION 1754 PERMIT NO DATE APPROVED 6/8/93 EXPIRATION DATE 6/10/93 DATE ISSUED 6/8/93 By Ah AA �p6 OAN dministrative Authority Recorded by 11 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 . Subdivision Improvement Permit — Class III DATE: — Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION -4�3 u A 0S ✓ ` DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction plans if appropriate) �`�_ >«tTT►9-tea Tris-�! c_ \Ajo 2K Hrc-5 TI7 C1 '. 0 U A4- IIAt7 APPROXIMATE TIME OF COMPLETION &� ESTIMATED CONSTRUCTION COST $ 0 k-)91 (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: 1A) v a t--- o ►J Deis Tj{1-sq-1� 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 11241 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 Ouinte and to pay for any additional replacement necessary as the result of this work. J F Signature of Applicant or Agent A�Ji i� Som sSoc'. Zile . Name of Applicant (please print) Business Address -� Telephone No. Z 00 Name of Contractor and Job Foreman Business Address Telephone No. c A- A L 17S -S-0 1 1 61 Contractor's License No. City Business License No. y4 4 IVA.,.)ADE777) ��� 14 �113o9d Applicants Insurance Company Policy Number FEES: Suborvision 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 0 I Inspection Fee $ R 69 - � Permit Fee /0 Penalty Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Date Recorded by 13a61 PERMIT VALIDATION PERMIT NO. DATE APPROVED `P 93 EXPIRATION DATE DATE ISSUED 6? -6 -17-3 By Administrative Authority TELEPHONE: (619) 564-2246 IJP S N BGRRICADE TEL No . 1619 473b80 Jun 8,93 9:53 No .001 P.01 TOPS N+ C B R �`,AD ES 44.631 JACKSON STREET . INDIO, CALIFORNIA 92201 (619)347-2111 INC. a FACSIMILE. COVER SHEET TO: DATE: r ATTN : FROM: 6 ! o /41 NUMBER OF PAGES INCLUDING THIS PAGE: MEMO: FAX #*619-347-3680 1 ON :H r:�o i r�-�� L! L 'Z 86ed pepue4x3 a 0 ?O'd TOO'ON iS:6 16'8 unf o r �� '20 089j�.VS'6T9T*ON -131 6IIU--*"Id��69 N -SJC�i Fil X,