2010iEIOTE:
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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 II I
DATE:. 12/14/93 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54-700 AVE ALVARADO
I
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION NEW RESIDLNCE Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION DRIVEWAY APPRIOACH PER RIVERSIDE CO. STD 207
(ATTACHED)
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED' Q a
APPROXIMATE TIME WHEN WORK WILL BEGIN 12/15/93 D
DEC 14 1993
APPROXIMATE TIME OF COMPLETION 12/17/93
ESTIMATED CONSTRUCTION COST $ 100.00 By ~
(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
EAST VALLEY CONSTRUCTION P.O. BOX 1281, LA QDINTA. CA 564-4844
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
296566
Contractor's License No.
1961
City Business License No.
PENN AiIERICA PAC1007343
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
20.00
10.00'
$ 30.00
Date
PERMIT NO
2010
PERMIT VALIDATION
2010
DATE APPROVED 12/14/93
EXPIRATION DATE 12/17/93
DATE IS SOE 12/14/93
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
J
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------------------------------------------------------------------------
i
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
G Subdivision Improvement Permit — Class II I
DATE: 1—/�— �—� Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION <LZl- 706) 19114 4 LVI—gX D0
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION ! VE/� ��-S/ �/��� Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION ve,12S/,4)Z-
�� z o � �-T7i4-:✓r�
DIMENSION OF INSTAI,LA/TION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN /L5 2z'i7
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTSS /00
(Including removal of a ll, 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
/-}—L �F �! �/►��-i�2 �a L� � /�.� / do9- �y��.�- Seo 5� 4���/�`
Name of Applicant (please int) Business Address Telephone No.
ozw
Name of Contractor and Job Foreman Business Address Telephone No.
2-9&S7P6e
Contractor's License No. City Business License- No.
"/ 0�* 3 Ll 3
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 '� h
TOTAL:
Receipt No.
Received by Date
r � f
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED �' I L4— I
EXPIRATION DATE Z ~ 7—q,5
DATE ISSUED % `15
By
Recorded by J1 TELEPHONE: (619) 564-2246
Administrative Authority
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