1844A
NOTE:
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: 8-18-93
LOCATION OF CONSTRUCTION
51-220 Paloma
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway Approach
DESCRIPTION OF CONSTRUCTION 2 20 Curb cute
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 8-19-93
APPROXIMATE TIME OF COMPLETION 5-27-93
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
per Riverside Co. Std. 207
(attached)
AUG••
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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 per i and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the resul this work.
SI ure of Applicant or Agent
Samuel Castro P.O. Box 1513 Indio, Ca 399-5646
Name of Applicant (please print) Business Address Telephone No.
Candelario Felix 54--125 Madero La Quints 564-5070
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
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
Permit Fee 10
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 30
Receipt No.
Received by Date
1$44
PERMIT VALIDATION
PERMIT NO. 1844
DATE APPROVED 8-18-93
EXPIRATION DATE 8-27-93
DATE 15S Sap 8-N8-93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
1� �a,,
. 'fit -
NOTE:
With proper validation
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION FOR PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENTI
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewefs, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE 1-11 �� 3 Subdivision Improvement Permit - Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION - �' a �-O /,\,-j(i' 0.&4 na A
(Street addreu or Oesenption of Location)
PURPOSE OF CONSTRUCTION Z21 Q rz-- W k A era �h
P- Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION r r , r7 Fz,
r__ r? � — , - - - - .
DJMENSION OF, INSTALLATION OR REMOVAL
Qo
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN _-5-7- ok r43
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:
TrM& r l ur&R-S 6O F, Co S"T"`D
Indemnify, defend and saw the City, its authorized agents, officers, representatives and employees, harmless from and against env and all
Penalties, liabilities or lose resulting from dairte or court action and arising out of any accident, los or
happening or occurring as a proximate result of any work undergranted pursuant to this taken under the permit damns to persons Or property
appliotion.
Notify the Administrative Authority at least twOnty-four 124) hours in advance of the time when work will be started.
Comply with all appliable City Ordinance, the terms and conditions of the permit and all applicable rules and regulations of the City of
La Quints and to pay for any additional reptaeettem necessary as the result of this work.
5 AM u6c_
Name of Applicant (please print)
(�, A ly Q 6A,� 0 r
Name of Contractor ani:14-o6Tore
Contractor's License No.
Signature of Applicant or Agent
0% 13ox(5
Business Address
) 2 5 '4,V ;
Business Address
5
Telephone No.
Telephone No.
t1ow'E,
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subolvlslon 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 $
7i0
Permit Fee
10
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $__
30
Receipt No.
Received by
Date
Recorded by
PERMIT VALIDATION
PERMIT NO. - /Q 7 V
DATE APPROVED —9 -19—q3
EXPIRATION DATE
DATE ISSUED
By
TELEPHONE: (619) 564-2246
-7o
Administrative Authority