1977OTE:
ith 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
11/16/93
LOCATION OF CONSTRUCTION 53-330 VILLA
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DRIVEWAY APPROACH
\.
DIMENSION OF"INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 11 16 93
APPROXIMATE TIME OF COMPLETION 11/19/93
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
PER RIVBRSIDE CO. STD NO 207
(ATTACMD)
�4 --J
r
pQ°D
V 16 1993 D
'BY
I
paction and placing permanent resurfacing and/or rep acing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to: w*
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.
Signatx of Applicant or Agent
DESERT SLIT CONCRETE CO. 81-789 SUMA,IND10, CA 347-8335
Name of Applicant (please print) Business Address Telephone No.
JS PAZ SAME
Name of Contractor and Job Foreman Business Address Telephone No.
645522 C-8
Contractor's License No. City Business License No.
STATE F= 12-976693
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
rN
Inspection Fee J$ �0'� ` PERMIT VALIDATION
Permit Fee , 10.00 t PERMIT NO. ' 1977
Penalty DATE APPROVED 11/16/93
Cash Deposit -Surety Bond t
if required EXPIRATION DATE 11/19/93
TOTAL: $ 30.001/16/93
. � •, DATE IS UE '
Receipt No. B
Y f. 96
Received by Date 0 Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
tNOTE:
jWith proper validation
`this form constitutes an CITY OF LA OUINTA
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: ��' S" 93 ' Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Locat.lr_11�iL)Id.44-40
PURPOSE OF CONSTRUCTION Sketch(attach construction plans if appropriate)
Cr F
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN X \ .'_\F—c13
APPROXIMATE TIME OF COMPLETION
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:
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
iia co ock�/� �t ? 91 9 3
yd`y q� d33S'
Name of Applicant (please print) Business Address Telephone No.
�AAAVE 81��8� sly ��- 3q > 1 35�
Name of Contractor and Job Foreman Business Address Telephone No:
Contractor's License No. City Business License No.
X 5MIX 01�wV -E:2 C-26 f,__5
Applicant's Insurance Company Policy Number
FEES:--,$ubdivision Improvement Permit — Class III
improvements: 3% of estimated construction costs
Private impsvements: 3% of estimated construction costs
Minor Improvement Perrnit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by Date
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED��n77 c 3
`
EXPIRATION DATE k q3
DASE ISSUED
By
Recorded by 11 TELEPHONE: (619
Administrative Authority
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