1955NOTE:`
With prdper validation
this forts 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: 11/4/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION MONTEZUMA AND OBRMN
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION HAUL TREES
DESCRIPTION OF CONSTRUCTION CLEAR RI(Br OF WAY
DIMENSION OF INSTALLATION OR REMOVAL 10116"W z 10%
CAT 980 LOADER WITH RATE
SIZE OF EXCAVATION, IF NEEDED NONE
APPROXIMATE TIME WHEN WORK WILL BEGIN MMEM 11/4/93
APPROXIMATE TIME OF COMPLETION 11/4/93
ESTIMATED CONSTRUCTION COST $ 100.00
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
Sketch (attach construction plans if appropriate)
HAUL ROUTE: HAST CITY LIMTS ON
AVENUE 52 TO AVENUE 52 AND
MONTEZUMA ,
HAUL DATE: It 93q
NOTO 4 1993
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f
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 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
F.J. STOWELLS, JR. P.O. BOR 1059, INDIO, CA 774-1359
Name of Applicant (please print) Business Address Telephone No. j
JAMS EMM 345-4746
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
City Business License No.
CAI. FARM SA 0715193
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 $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
10.00
TOTAL: $ 10.00
Receipt No
ived by
by
Date
PERMIT NO.
{9515
PERMIT VALIDATION
1955
DATE APPROVED 11/4/93
EXPIRATION DATE 11/4/93
DATE ISSUED . .11/4/93
By N i r* —
Administrative Authority
TELEPHONE: (619) 564-2246
.�'
r
NOTE:
With orrfiper validation
this form constitutes an CITY OF LA QUINTA
engroa ► ment 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: / iZ3 ?3
LOCATION OF CONSTRUCTION _1.1C11LL1
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL t/% 4241 -4- L
GA -7 q6 e., L0,4 -D i_2- wI-I-Ar 4ZA-yr-
SIZE OF EXCAVATION, IF NEEDED.
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plansifappropriate)
7-(
rj
ok
APPROXIMATE TIME OF COMPLETION t UCJ V1
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:
5Z �. %z7,. -r
A��L_ ; t//y/q3
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 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 allapplicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this io ,y
Sig'rre of/Applicant or "en
O , O D VV - ,�Si
Name"Of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
4--:i7 AaM 07l 51 q 3
Applicant's Insurance Company olicy 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
Penalty
Cash Deposit -Surety Bond
if required
. TOTAL:
Receipt No.
Received by
$
Date
1936
PERMIT VALIDATION
PERMIT NO. y ��
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Recorded by 11 TELEPHONE: (619) 564-2246
Administrative Authority
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