1795NOTE:
With 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
DATE
7-2-93
LOCATION OF CONSTRUCTION 52-090 Montezuma
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Widen Approach 2' Sketch (attach construction plans if appropriate)
per Riverside Co Std No 207
DESCRIPTION OF CONSTRUCTION attached
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN July 2, 1993
APPROXIMATE TIME OF COMPLETION July 6 1993
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
J
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 petmit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result/f this workie�
Majestic Homes
Name of Applicant (please print)
Stuart Podell
ure
P.O. Box 76 La Quints, CA, 9;
Business Address
or Age
5
Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
590684 2537
City Business License No.
Contractor's License No.
Applicant's Insurance Company
FEES: Subdivision Improvement Permit — Class II 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
Permit Fee 10 II
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 30
Received by Date
Recorded by
Policy Number
a
P A i 3:)JUL 021993
PERMIT VALIDATION
PERMIT NO. 1795
DATE APPROVED 7-2-93
7-6-93
EXPIRATION DATE
DATE ISSDED 7 2-93
Administrative Authority
TELEPHONE: (619) 564-2246
.l 1d - - - -- - - --- - _ J
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.
DATE: ja 23 19 9�3 Subdivision Improvement Permit —Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 5'o? - 0 `/ 0 A) gc _ rn A f re CR /Iw; I5]`Ig 9 oZ I )-0
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION i l ile.9 9Y9 o A s%,% Y Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL 94Y--4'-'
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN a
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTS SD
(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 an all applicable rules and regulations of the City of
La Quints and to pay for any additional replacement necessary as the result of th• rk.
�
ture of Applicant oC<A gent /
S- L
Name of Applicant (please print) Business Address Telephone No.
C u c,.7 f30Ci 213
Name of Contractor and Job Foreman Business Address elephone No.
S20 6841 X537
Contractor's License No. City Business License No.
•11,109 11% a UyYlOI1W wmpdny Policy Number -
FEES: Subolvision 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.
Received by Date
Recorded by
12;86
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246