2024NOTE: - r-
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
DATE: 12/28/93
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 53"360 AVE. VELASCO.
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DBIVMFAX APPROACH
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1141%
APPROXIMATE TIME OF COMPLETION 1/7/94
ESTIMATED CONSTRUCTION COST $ XT
(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:
Sketch (attach construction plans if appropriate)
PBB RIVMIDB CO. STD. #207
() f
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.
r
Signak r of Applicant or Agent
CURB SAIM, INC. 31235 AVE. NM //VILLA, CATHEDRAL CM, CA 321-9700
Name of,Applicant (please print) Business Address Telephone No.
CORONBL COB3T UM11M p.0. Dt1I 1238. LA QVMA, CA 92253 564-4604
Name of Contractor and Job Foreman Business Address Telephone No.
634981
Contractor's License No. .
2261
City Business License No.
(M FM OK FILE
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III t
Public improvements: 3% of estimated construction costs -
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 20.00
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 30.00
Receipt No.
Received by Date
Recorded by
PERMIT NO
2024
PERMIT VALIDATION
2024
DATE APPROVED 12/28/93
EXPIRATION DATE 4P/94-- 1
1 of
DATE ISSUED 12/28/93 �—
By
Administrative Authority
TELEPHONE: (619) 564-2246
,w
------'`-------------------------------------------------------------
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
Subdivision Improvement Permit — Class III
DATE: December 28, 1993 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 53-360 Ave. Velasco, La Quinta, Ca. 92253
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Curb cut for driveway
approac
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION L
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction; materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
k
In consideration of the granting of this permit, the applicant hereby agrees to:
Sketch (attach construction plans if appropriate)
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
Curb Sawing, Inc. 31255 Ave. Maravilla, Cathedral City, Ca. 321-9700
Name of Applicant (please print) Business Address Telephone No.
Coronel Construction P.O. Box 1233, La Quinta, Ca. 92253 564-4604,
Name of Contractor and Job Foreman Business Address Telephone No.
634981
Contractor's License No.
2261
City Business License No.
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
TOTAL: $
Receipt No.
Received by Date
Recorded by
2®®6
PERMIT VALIDATION
PERMIT NO
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE:. (619) 564-2246
GEORGE H. CHANEY CO.
Inspection Services
TO: / L) l
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LOCATION
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COPIES TO:
FIEiLTa REPORT
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WHITE -CLIENT, YELLOW- FIELD FILE, PINK - OFFICE FILE
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