18774,
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: 9/10/93
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54-010 Ave Ramirez La Ouinta
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway Approach and
front entry walk
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED "
APPROXIMATE TIME WHEN WORK WILL BEGIN 9/.10/93
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION 9/15/93
ESTIMATED CONSTRUCTION COST $ 750.00
(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:
Driveway approach &hall be
constructed per Riverside Co
Std No 207
Stairway to be constructed per
the approved drawing
pQ°D
SEP 13 1993 D
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 this work.
Signature of Applicant or Agent
*Wbfl Inc PO Dox 1355 La Quints (619) 564-1338
Name of Applicant (please print) Business Address Telephone No.
1iil,UM Howard
Name of Contractor and Job Foreman Business Address Telephone No.
$37333 2526
Contractor's License No. City Business License No.
Scottsdale GLS 499425
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 1 8T7
Inspection Fee $ 20.110 PERMIT VALIDATION
Permit Fee 10.00 PERMIT NO. 1877
Penalty/10/93
Cash Deposit -Surety Bond DATE APPROVED 9
if required EXPIRATION DATE 9/17/93
TOTAL: $ 30.00
DATE ISS E ,
Receipt No. By "
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
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NOTE:
VM proper validation
this form constitutes an
encroachment oermn 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 maims
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
I '
DATE- Subdivision Improvement Permit - Clea III
Minor Improvement Permit Class IV
LOCATION OF CON RUCTION -1- O �,i�e A -m 1 A Q 7 1 1
(SUM address or Oeseription of Locnion)
PURPOSE OF CONSTRUCTION
tel'
LA x
DESCRIPTION OF CONSTRUCTION
i_d t, cr 11s,�c wm Z A• 6v n �-tA1 L_ 6?A-►
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
f jD.av�way �1Pr�,w� �-
�v � 2s t �� co . s�r D. t� • Z� 7
1!:5_rR t n,W AY -[D 13fZ- -t"�--r� n
APPROXIMATE TIME OF COMPLETION_
ESTIMATED CONSTRUCTION COSTS -7
(Including removal of all obstruction, materials. and debris, backfilling, Com..
Paetion and plating permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indernnifv, defend and save the City, its authorized agents, off,
can, representatives and arnployap, harmless from and
panait�es, liabilities or lou resulting from damns or court agairut any and all
action and arising Out of any accidarK, toes or darnage to persons or property
happening or occurring es a proximes
atta result of any vrort undertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at Nast tvwnty.four 1241 hours in advance of the time when wort „rill be started.
Comply with all applicaba City Ordinances. the terms and Conditions of th Kara all appkiabla rules and repulatlorla Of the Clty of
La Quints and to pay for any addltlonal replaearrnnt nacnawy 4 the t this wort.
Z, �N CA Ai
-
t._Sio6Lure of Ap9licant or Agent
Name of Applicant (please print)
Name of Contractor and Job Foreman
33-3
Contractor's License No.
&119-ap
Business Address
Business Address
-133a
Telephone No.
Telephone No.
!�_� ("
City Business License No.
(3rLs kjqC? 4ae—
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 $
Permit Fee I
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 30
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 1977
DATE APPROVED - l� r 7 3
EXPIRATION DATE --
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564.2246
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