1976NOTE:
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
Subdivision Improvement Permit — Class III
DATE: 11/16/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 52-780 CARSANZA / 53-725 MARTINEZ /
.53-810 VII.LA / 53-683 ALVARADO
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION DRIVEWAY APPROACH Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
PER RIVERSIDE CO. STD #207
(ATTACHED)
DIMENSION OF INSTALLATION OR REMOVAL
SIZE.OF EXCAVATION, IF NEEDED
' L
APPROXIMATE TIME WHEN WORK WILL BEGIN 11/18/93
APPROXIMATE TIME OF COMPLETION 11/18/93
ESTIMATED CONSTRUCTION COST $ 1,200
(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:
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 IS& q , SS y O
LQC, INC 310'WASHINGTON, P214o MARINA DEL REY, CA (310) 827-0171
Name of Applicant (please print) Business Address Telephone No.
r
SMW
Name of Contractor and Job Foreman Business Address Telephone No.
457700
Contractor's License No.
2976
City Business License No.
CONSTRUCTION SERVICE INSURANCE AGENCY 589461
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
Penalty
Cash Deposit -Surety Bond
if required
r
TOTAL
Receipt No.
80
10
Received by Date
Recorded by
D
NOV 17 1993
PERMIT'VALIDAN.Ion
PERMIT NO. 1976
DATE APPROVED 11/16/93
EXPIRATION DATE 11/24/93
DATE ISS ED 1 / 6/93
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form 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
11(0 J�3 Subdivision Improvement Permit — Class III
DATE: f Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION �✓Z_7�� L z 2> 7Zs IVIAr _Tw,4CCz
E2 3 -51 S:;) ll l �4 C✓ fo �j 3 t—�/oP�4O i '
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _12��" A ww� _P' Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL t --t q�)
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN ll/I�la3
APPROXIMATE TIME OF COMPLETION l I 4, 1 4 3
ESTIMATED CONSTRUCTION COST $ -tom 1rL4—_1'SR
(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:
!Ei,� t� 207
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 o0sulof
t and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the work.
Sign re of Applicant or Agent---
Rj PZ 0 NtA&I.J _ Div vLo% z.-7 - o 171
Name of Applicant (please print) Business Address Tele hone No.
Name of Contractor and Job Foreman Business Address Telephone No.
4-1?Zc2t&_-, 297
Contractor's License No. _0^1 x/504 /t/wc City Business License No.
— �' Ns7���T'.�� v���'��•��� ---�� 5-89 �� l
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 $� 49/49 PERMIT VALIDATION
.Permit Fee it
PERMIT NO.
Penalty
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE
TOTAL: $ DATE ISSUED
Receipt No.
By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564.2246
e