1768NOTE. 'I
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
DATE: 6/18/93
LOCATION OF CONSTRUCTION 77-551 Calle Potitero
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
Driveway Approach
4.
t'
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV-V
Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Concrete Per Riverside County Ste. 207 (attached)
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/19/93
APPROXIMATE TIME OF COMPLETION 6/21/93
ESTIMATED CONSTRUCTION COST $ 500
(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
I
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 wheta..w/ork will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit ap all ap I'icable rules and regul tions of the City of
La Quinta and to pay for any additional replacement necessary as the result of 'is wor .
gnature of Applica or Agent +�
DoDco Construction Services P.O. Bou 1012 La Quints, CA 92253 564-6478
Name of Applicant (please print) Business Address Telephone No.
Dan Featheringill Bame
Name of Contractor and Job Foreman
397 830 B-1
Contractor's License No.
Business Address
Telephone No.
1375
City Business License No.
Golden Eagle CCP 178797
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
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 20.00
10.00
$ 30.00
Received by Date
W
PERMIT VALIDATION
PERMIT NO. 1768
DATE APPROVED 6/18/93
EXPIRATION DATE 6/21/93
DATE ISSUED 6/18/93
By — �S� �(_� -1'
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
■ •Y
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
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SU13DIVISONS
r-
DATE:Subdivision Improvement Permit — Class 111
LOCATION OF CONSTRUCTION Minor Improvement Permit Class IV
7 7 - SS`l CAi' rf o_,t2 no
(Sum address or Description of Location)
PURPOSE OF CONSTRUCTION � Li ✓R wAfldftoV
AIJ
Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION — Co,.. cK,r-OL
DIMENSION OF INSTALLATION OR REMOVAL— /f X Sn
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION .v9
ESTIMATED CONSTRUCTION COST S s'pd
(Including removal of all obstruction, materials, and debris, backfilling, cam-
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
Penalties, liabilities or loss resulting from clainq � ' officers r>sPresentativa and employees, harmless from and against any anti all
happening or ooeum cOUR action
and arising out of any accident, loss or
ng es • pro><irrhata result of any work wedertaken under the dame" to Der"" or property
Notify the Administrative Authority at leas tvwn f Permit granted pursuant to this application.
N• our 124) hours in advance of the time when work will be started.
Comply with all appliabla City Ordinartoes, the terms and conditio=of
La Quints and to pay for any additlasl recaa�t napplicable rules regulations of dha Ckv of
�Y as t
nt or Agent
Name of Applicant (please print)
F44 vies D 10 12 44 Q S'4/ 6Y7jr
Business Address Telephone No.
Name of Contractor and Job Foreman
Business Addressg, 3fg Telephone No.
Contractor's License No. -
1375
City Business License No.
a
1 CG
Applicant's Insurance Company
Policy Number
FEES: Subdivision Improvement Permit _ Class til
Public improvements: 3% of estimated construction cam
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
ash,Deposit•Suiety Bond
f required
TOTAL:
leceipt No.
a
9e0eived by Date
Recorded by
1%1.10 8 Fj
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246