1769•
NOTE:
With proper validation
this form cons'utes an CITY OF LA QUINTA
encroaAment permit
APPLICATION FOR RERMIT
PUBLIC WORKS CONSTRUCT ION�JENCROACH MENT)
For the construction of public or private curbs, driveways, pavemera' sidewalks,lpa`rkigg lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEM.ENTS� ndrAPPROVED SUBDIVISIONS
s
6/18/93 Subdivision Improvement Permit — Class II I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54-620 Avenida Ramlrtz
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway Approach Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Concrete
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/19/93
Per Riverside County Std. 207 (attached)
APPROXIMATE TIME OF COMPLETION 6/21/93
ESTIMATED CONSTRUCTION COST $ 500.00
(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:
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, t}he terms and conditions of the permit�a .pd.'a rI I applicable rules and regulations of_t ,e City of
La Quinta and to pay for any additional replacement necessary as the result of_ms work./ �j�
X atu of Applicant or P nt
DoDco Construction Services _'V, P.O. Bos 1012 La Quinta, CA 92253 564-6478
Name of Applicant (please print) Business Address Telephone No.
Dan Featheringill Same
Name of Contractor and Job Foreman Business Address Telephone No.
397 830 B-1 1375
Contractor's License No. City Business License No.
Golden Eagle CCP 178797
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 $ 20.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.
10.00
$ 30.00
Received by Date
PERMIT NO
1,789
PERMIT VALIDATION
1769
DATE APPROVED
EXPIRATION DATE
6/18/93
6/21/93
DATE ISSUED 6/18/93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
fit,
4
-.1f: - 1-7
NOTE: ' �'
With proper vaiidation
this form constitutes an
encroachment oermit 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: C—Ir— g 1 Subdivision Improvement Permit — Class III
LOCATION OF CONSTRUCTION Minor Improvement Permit Class IV
S'' - 62 0 Rvn
/4'Ier /Z2
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION —D/Li ✓r Sketch (attach constructionlans if appropriate)
Ppropriate)
DESCRIPTION OF CONSTRUCTION - at k -t-
DIMENSION
DIMENSION OF INSTALLATION OR REMOVAL /,6 , X 5 -
SIZE
SIZE OF EXCAVATION, IF NEEDED -- '
APPROXIMATE TIME WHEN WORK WILL BEGIN /'/' V 3
APPROXIMATE TIME OF COMPLETION—
ESTIMATED CONSTRUCTION COST S S'CXi `—
(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 saw the City, its authorized agents, officers, representatives and employees, harmless from and against any arty 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 11 applicable rules a reguletro ioof the Clty of
La Quints and to pay for any additional replacement necessary as the result o is
i
Si re of Applicant or Agent
O CO
Name of Applicant (please print)
l
Name of Contractor and Job Foreman
3 �7 t3o
Contractor's License No.
F_4yrcr's 120 10 /Z
Business Address
Telephone No.
Business Address Telephone No.
City Business License No.
Applicant's Insurance Company l
Policy Number
FEES: Subdivision Improvement Permit —ClassIII
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 Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
6Y7'r
By
Administrative Authority
TELEPHONE: (619) 564.2246