17664 ; :>
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
Subdivision Improvement Permit —Class I I I
DATE: 6/18/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54-210 Ave Bermudas
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway Approach
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF,NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/19/93
Sketch (attach construction plans if appropriate)
PER RIVERSIDE COUNTY STD # 207
(ATTACHED)
APPROXIMATE TIME OF COMPLETION
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 permitand all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result_of-t_h�is wo_rk!r
of Applicant 6 -Agent
DODCO CONST. P.O. Box 1012 LQ 564-6478
Name of Applicant (please print) Business Address Telephone No.
Dan Featheringill
Name of Contractor and Job Foreman Business Address Telephone No.
397830 B-1
Contractor's License No.
1375
City Business License No.
Golden Eagle CCP178797
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
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 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 30.00
Receipt No.
Received by Date
Recorded by
,66
PERMIT VALIDATION
PERMIT NO. 1766
DATE APPROVED 6/18/93
EXPIRATION DATE 6/23/93
DATE ISSUED 6/18/93
ay
dministrative Authority
TELEPHONE: (619) 564-2246
I
0
NOTE:
With proper validation
this form constitutes an
encroacnment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs, driveways, pavements, sidewalks,
parking
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISONS
w•
DATE:_ C—Ir— g Subdivision Improvement Permit — Class 111
LOCATION OF CONSTRUCTION Minor Improvement Permit Class IV
S 4 - Z /D 4.A i3 E2 pr j
(Sinn address or Oescrption of Locetior)
PURPOSE OF CONSTRUCTION DitI ✓r ie 1. �Q�en�„
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL /6 K S'
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN _(-
APPROXIMATE TIME OF COMPLETION _�,ys
ESTIMATED CONSTRUCTION COST S S -pp
(Including removal of all obstruction, materials, and debris, backfilling, com.
Paction and placing permanent resurfacing and/or replacing improvement
A s
Sketch (attach construction plans if appropriate)
s
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, defend and save the City. its authorized agents, officers. representative$ and emploVaes, harmless frau and against any and all
happening
n, liabilities or los resulting from calf or court action and arising out of any accident. Ion or dame" to arsons or propeity
happening or occurring e$ a prp;iry� reark of any work undertaken under the permit granted pursuant to this applicetion.
Notify the Administrative Authority at lean twenty-four I24) hour in advance of the time when work will be started.
Comply with all applicable City Ordinarmu, the terms and conditions of the pe
rttit II applicable rule a
La Quints and to pay for any additk"M replacement neoesfary a the result o is re9ulatioru of the City of
re of Applicant or Agent
0 CO
Name of Applicant (please print)
Name of Contractor and Job Foreman
3 el -I g,3, !3-/
Contractor's License No.
F/1 vier', /0 /Z 40 ,S�y 6Y7,r
Business Address Telephone No.
s l�
Business Address Telephone No.
City Business License No.
Applicant's Insurance Company f CC
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. ,
S
Received by Oats
Recorded by
131? �J
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564.2246