1812NOTE:
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 III
DATE: 7/26/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 51-725 Ave Villa
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway Approach Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
PER RIVERSIDE COUNTY STB # 207
(ATTACHED)
i
SIZE OF EXCAVATION, IF NEEDED %Q�
APPROXIMATE TIME WHEN WORK WILL BEGIN 7/28/93 D
APPROXIMATE TIME OF COMPLETION 1 JUL 2 6 . ? 1993 I
ESTIMATED CONSTRUCTION COST $ 300.00
(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
4
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 an)d conditions of the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this work.
51
tgnatu,fe of Applicant or Agent ,
Cornerstone 31-835 El Toro Cathedral City 345-0113
Name of Applicant (please print) Business Address Telephone No.
John Reise
Name of Contractor and Job Foreman Business Address Telephone No.
501804 22 Z8
Contractor's License No. City Business License No.
golden Eagla
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 II
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
10.00
$ 30.00
Date
PERMIT NO.
1812
PERMIT VALIDATION
1812
DATE APPROVED 7/26/93
EXPIRATION DATE
7/30/93
DATE ISSU D /26/93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
NO
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 lou, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE:- ; A x/93 Subdivision Improvement Permit — Clan III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION S-/ ' 72 S— d>zr/�,•y/CG/,7
(Street addreu or Description of Location)
PURPOSE OF CONSTRUCTION /4Paf117c�:prp CA.-
DESCRIPTION
rLDESCRIPTION OF CONSTRUCTION Apalloor
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 7%0
APPROXIMATE TIME OF COMPLETION olo�
ESTIMATED CONSTRUCTION COST S
(Including removal of all obstruction, materials, and debris, backfilling, com-
Paetion and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Sketch (attach construction plans if appropriate)
Cv(AAJ f`1
Ir>dernnifv, defend and saw the City, its authorized agents, officers. rePtaserttetives and employees, harmless from and against env and all
penalties. liabilities or lou resulting from claims Or court action and arising out of any accident, loss or
happening or occurring u a Proximate result of env work undertaken under the permit granted pursuant d tlt�application.tce or D��
Notify the Administrative Authority at least twenty-four 124) hours in advance of the time when worst will be started.
Comply with alt applicable City Ordinances, the terms and conditioru of the permit and all applicable rules and regulations of the City of
La Quints and to pay for arty additlonal replaceMem necessary as the result of this work.
���/l/i✓l2_S7Z2 A,
Name of Applicant (please print)
Business Address
or Agent
e, C. 92Z 3
Telephone No.
< w // i
Name of Contractor and Job Foreman Business Address Telephone No.
.5DISoy 2
Contractor's //License No. City Business License No.
Applicant's Insurance dompany Policy Number
FEES: Subolvislon 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 �U
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ �% 0
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED — 7- Zle g
EXPIRATION DATE 7-3a �93
DATE ISSUED -7 —Z-&
S=o //
By
Administrative Authority
TELEPHONE: (619) 564-2246