2001NOTE:
Nith proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
4r 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: 12/2/93
LOCATION OF CONSTRUCTION 33-845 AVENIDA CORTEZ
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION CURB COT FOR DRIMAY Sketch (attach construction plans if appropriate)
APPROACH
DESCRIPTION OF CONSTRUCTION
PER RIVERSIDE CO. STD. #207
(ATTACHED)
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED '(
APPROXIMATE TIME WHEN WORK WILL BEGIN 12/3/93 Q
D
APPROXIMATE TIME OF COMPLETION 12/7/93 EC � 1 93
ESTIMATED CONSTRUCTION COST $ 300.00 Dc
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) RV,
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, -defend and save the City, its authorized ageits, 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.
ryMN
Signatureof S4pplicant or Agent
CURB SAMM, INC. 31255 AVE MARAVILLA. CATHKDRAL CITY. CA 321-9710
Name of Applicant (please print) Business Address Telephone No.
COROM CONSTRUCTION P.O. BOX 1238, LA QUDM, CA 92253 5164—:604
Name of Contractor and Job Foreman Business Address Telephone No.
634981
2261
Contractor's License No. City Business License No.
ON FILE OR FILE
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
PERMIT NO
2001
PERMIT VALIDATION
2001
DATE APPROVED 12/2/93
EXPIRATION DATE 32Pj% %
DATE ISSUED 2/2/93
IV
Administrative Authority
TELEPHONE: (619) 564-2246
� i0TE:
°Ath proper validation
this form constitutes an CITY OF LA QUINTA
eperoachment 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: 12-02-93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 53-845 Avenida Cortez..
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR J3EMOVAL .
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN �a 3 3
Sketch (attach construction plans if appropriate)
6� _
APPROXIMATE TIME OF COMPLETION 1, 1 - 9 3
ESTIMATED CONSTRUCTION COST $ -3-0ep
(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:
� �t ✓ i� /ISS I � � �� S.��
/I r L C
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 f Applicant or Agent
s`:�' AIX-
Name of Applicant (please print)
Coronel Construction
Name ofontractor a d Job Foreman
Business Address Telephone No.
P.O. Box 1238, La Quinta, Ca. 92253 (619)
Business Address Telephone No.
-4604
Applicant's I
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 $ a D
Permit Fee I '
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ _30
Receipt No.
Received by Date
1936
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED /
EXPIRATION DATE J 7 J 3
DATE ISSUED
By
Recorded by 11 TELEPHONE: (619) 564-2246
Administrative Authority
a
L