1814NOTE:
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: 7/23/93
LOCATION OF CONSTRUCTION 52-445 Bermudas
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
y
(Street address or Description of Location)
Driveway Approach
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
PER�R-IVERSIDE COUNTY STD # 207
i
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 7/26/93
APPROXIMATE TIME OF COMPLETION 7/28/93
ESTIMATED CONSTRUCTION COST $ Y'
D Q
JUL 2 6 1993
By
(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 and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of thhiis, work.
Signature of Applicant or Agent
Wes Development Co 77885 Montezuma La Quinta (619) 564-5154
Name of Applicant (please print) Business Address Telephone No.
Walter Stockman
Name of Contractor and Job Foreman
642348
Contractor's License No.
On Bile
Business Address
Telephone No.
2534
City Business License No.
On Pile
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.
Received by
$ 20.00
10.00
$ 30.00
Date
PERMIT NO.
1,814
PERMIT VALIDATION
1814
DATE APPROVED 7/26/93
EXPIRATION DATE 7/30/93
DATE ISSUED 7/,(26/93
By .l
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
s• 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 lou, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE:- 2Zl_L
p2 Subdivision Improvement Permit — Class III
Minor Improvement Permit past IV
LOCATION OF CONSTRUCTION — SZ ' �N.� I�►�r•. � �/li-�.
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION — �/'lvt,t"��`t ✓ rl/ Sketch (attach constructionlana if appropriate)
ppropriate)
DESCRIPTION OF CONSTRUCTION✓ ' FtV�2S ►:� �u _Ty
0
go ji
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION 4�
ESTIMATED CONSTRUCTION COSTS `QB-
(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:
Indemnifv, defend and saw the City, its authorized aunts, officers. representatives and employees. hartmlea from and against any end all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to thin applicto ation.
a p�
Notify the Administrative Authority at least twenty-four 124► hours in advance of the time when worts will be started,
Comply with all applicable City Ordinances, the terns and conditions of the permit and all applicable rules and regulation of the City of
La Quints and to pay for any additional replacement necessary as the result of this work.
Signature of Applicant or Agent c�
l"�Ls V t'iw �vY� �b�r.J'C � • ?% g�� %�'� d►�T f, :�✓wt /;~ �%L S �v � �,�1,� l
Name of Applicant (please print) T 2 5 z,_k .,oAl Business Address Telephone No.
40� of Contractor and Job F rem n Business Address Telephone No.
ry2��g C�c�-�
Contractor's License No. Z�
City Business License No.
C- 15 cq% ?I?
Applicants 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 $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 3b
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED - 7
EXPIRATION DATE 7-30-f3
DATE ISSUED - 5-'
By By
TELEPHONE: (619) 564-2246
Administrative Authority
t