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.
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FACSIMILE. COVER SHEET
TO:
DATE:
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FROM: 6 ! o /41
NUMBER OF PAGES INCLUDING THIS PAGE:
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FAX #*619-347-3680
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