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1938NOTE' With proper validation thi'f orm 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 Subdivision Improvement Permit — Class I I I DATE: October 20, 1993 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 77-400 Calle Sonora.. '"- (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 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 10/20/93 APPROXIMATE TIME OF COMPLETION 10/23/93 ESTIMATED CONSTRUCTION COST $ 135.00 (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 Per Riverside County Std. 207 (attached) 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 t Sterling Homes P.O. Bax 450, La Quinta, CA 92253 564-1866 Name of Applicant (please print) Business Address Telephone No. L>endel Ventures/Daaiel Cravfdrd P.O. Boz 450 La Quinta, CA 564-1866 Name of Contractor and Job Foreman Business Address Telephone No. B 638535 �1 859 Contractor's License No. City Business License No. Golden Eagle Insurance Co. CCP=203971-00 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class 111 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 Recorded ,by 20.00 10.00 $ 30.00 Date 0 2 3 lJ { LBY, PERMIT VALIDATION PERMIT NO. ' 1938 -.., DATE APPROVED 10/20/93 EXPIRATION DATE 10/23/93 DATE ISSUED 10/20/93 By AQ4:!n4 -&&- biz�� — lrigjnistrative Authority TELEPHONE: (619) 564-2246 s iii 4 NOTE: With proper validation this form constitutes an encroachment permit CIN 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:— LOCATION ATE: LOCATION OF CONSTRUCTION Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV (Street address or Description of Location) PURPOSE OF CONSTRUCTION ,40—IL964• L/(i�1v6�) Sketch (attach constructionlaps if appropriate) ppropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION _ /D Q /93 ESTIMATED CONSTRUCTION COST $ 13S` (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: I ndemnifv,. defend and saw 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 anV work undertaken under the permit granted pursuant to this application. Notify the Administrative Authority at least twenty-four IN) hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditions of the perm and all applicable rules and regulations of the City of Le Quina and to pay for any additional replacement necessary as the result of is wo Si ature of Applicant or/Agerd �Gl s - v" s-0-- 6� U/,Vw Name of Applicant (please print) BuZ ess A dress Telephone No. Ot7L �7rrTr/ /v/� a x 4�J/AI Name of Contractor and Job Foreman A p Business Address Telephone No. A 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 J Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule N �,.Lnspeccion Fee $ PERMIT VALIDATION Permit Fee Penalty PERMIT NO. Cash Deposit -Surety Bond DATE APPROVED if required TOTAL: $ EXPIRATION DATE Receipt No. DATE ISSUED Received by Date BY Recorded by Administrative Authority TELEPHONE: (619) 564-2246 yt�