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1942
t NOTE: VAh 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 October 25, 1993 LOCATION OF CONSTRUCTION 52-725 Alvarado Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV (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 October 26, 1993 D' OCT 11 1993 APPROXIMATE TIME OF COMPLETION October 30, 1993 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 agrees to: Iridemnify,•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 Wes Development 77-885 Montezuma Drive, La Quinta, CA 92253 564-5154 Name of Applicant (please print) Business Address Telephone No. Stockman Homes Same Name of Contractor and Job Foreman Business Address Telephone No. 642348 2534 Contractor's License No. City Business License No. 1 w©rn,,4 t4 ra --T,— fl S a mL - 44 a I 110 °t! a31 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 $ f 20.00 Permit Fee 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ ` 30.00 Receipt No. Received by Recorded by Date 1'942 PERMIT VALIDATION PERMIT NO. 1942 DATE APPROVED 10/25/93 EXPIRATION DATE 10/30/93 DATE ISSUED—r— IG/25/93 Administrative Authority TELEPHONE: (619) 564-2246 A NOTE: With proper validation this form constitutes ih encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT -PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction of OUblic or private curbs, driveways. pavements, sidewalks, parking lou, sewer{, wets mains and other like public world improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS DATE: CJIl7!��'t Subdivision Improvemeht Permit — Class III - I _ , LOCATION OF CONSMinor Improvi!r6rit Permit Class N TRUCTION I (ttrest addreis Or Oeferipbon of LbGtioill PURPOSE OF CONSThUCTION Sketch (attach construction plans it appropriate) DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEECEO APPROXIMATE TIME WHEN WOOK WILL BEGIN6 _Z APPROXIMATE TIME OF COMPLETION___ ESTIMATED CONSTRUCTION COST S ' (Including removal of ill dbstructioh, materials, and debrit, backfilling, wm• piction and placing permanent resurfacing and/or replacing improvements) In consideration of thi grintiho bf this 040hit; the i6plieiitt hereby aor,6" to: I Indemnify, defend i nd Cavi the 6liv. iti buthori:ee ; a0irltf, OffkiH, rtlptefbntatives and amployeis, harrrllast from and aglinit in* and NI panaltiet. Iiabilitieljoi Ion resulting from elitirrli or tourt letioh and lrisinb out of any aceidin"t. lots or happanriq or oeturiin4 is a broxinrte riiult of my wort undertakeh under the �^' Jo persoei or property Pat granted pursuini to this application. Noti>v the Adminit�tr"•itivi Authority at Btwnt att eY•four 1241 hourt in advance of the tin* when wort will be etarnd. COmpIY with all ipplicab i City Ordinamm. the termt and conditions of the parmrt and all 400 icable ruies and regiulatiom of the City of LA Quints and to 148Y for any idditkmw reWscOlneM nary to the result of this wort. f) " ` /� v Signature of Applicant or Agent IN -3 a�,rZ ,;�%�, C,, -4—Co "M S`Ol rl�L,,vl. Z. ,. _ _ . -I- Name I-Name of Applicant print) G So Name of Contractor and 16b Foreman C99 z � Contractor's License No. Business Address tl _�- dliv �-6 Telephone Nb. &, Business Address Telephone No. Dom0:71 1(-, City Business License No. _ - Applicant'! Insurance Company a-1 07, Policy Number FEES: Subdivision Im6Vemertt Permit — Class III Public imprJvertlents: 3% of estimated construction costs Private imprbvemenis: 396 of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Intp4ctlon Fee $ Permit Fee Penalty Cash Deposit -Surety florid if required TOTAL: S Receipt No. Received by Oats Recorded by PERMIT VALIDATION PERMIT NO. DATE APPROVED . EXPIRATION DATE DATE ISSUED By Administrative Authority ' TELEPHONE: (6191564-2240 1 m m