1823NOTE:
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: 8/3/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 52-660 1Ve Navarro X .. J
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driv�DVrojach Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
ORR RIVERSIDE COUNTY STD # 207
(ATTACIMD)
APPROXIMATE TIME OF COMPLETION
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 Igrrees 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 afising 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 ig advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions Iofithe permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the rI sult of this work.
r
f
I k
Signature of Applicant or Agent
Curb Sawing Inc 31255 Ave Maravilla`Cathedral Gity /321-9700
Name of Applicant (please print) Business Address 1 Telephone No.
Coronel Conetructian 77.836 Ave Montezuma Ste A Le Ouinta 564.4604
Name of Contractor and Job Foreman Business Address ' Telephone No.
694981
Contractor's License No.
On File
Applicant's Insurance Company
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 x
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 20.00
10.00
�r
$ 30.00
Received by Date
2261
City Business License No.
.1
On Pile
Policy Number lu
I
�V
PERMIT VALIDATION
PERMIT NO. 1823
DATE APPROVED 8/3/93
EXPIRATION DATE
8/6/93
DATE ISSU D 8/3/93
By �� 5tw I
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
C "--7
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: b• J 1 Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION — � '�V �°�i/a�,n1 C�A QtWCLA _0
(Street addreu or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
(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:
Sketch (attach construction plans if appropriate)
Indemnify, defend and saw the City, its authorized agents, officers. roprnentatiws and employees, harmlea from and against anti and all
Penalties. liabilities or loci resulting from claims Or court action and arising out of any accident, loci or
damage
happening or occurring as a proximate result Of any worn underspermit granted pursuant to this application.
Notify the Administrative Authority at least tvwntyfour 124) 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 ruin and regulations of the City of
La Ouinte and to pay for arty additional replacement neceswV u the result of this work,
Signature o pp Rant or Agent
Name of Applicant (please print)
U C.
Name of Contractor and Job Foreman
� 3 � CkO
Contractor's License No.
,�
Business Address
'Th 06 N4. hwv44,Z.vi,,,,u SNo;,
tk`, Busine Address 1��ki
PFJ• � K
/_11
Telephone No.
Telephone No.
- D-- (a
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subarvlslon 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 $ 7, 1*
Permit Fee / e2 B
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 30
Receipt No.
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED J' ? c_7f
EXPIRATION DATE 0 ^ q
DATE ISSUED — )� — S — q3
Received by Date BY
Administrative Authority
Recorded by
TELEPHONE: (619) 564-2246