2038NOTE:,
�
1ith 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 I II
DATE:_I_11/10.1Q4 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 52-195 Avenida Obregon
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Concrete Driveway Approach Sketch (attach construction plans if appropriate)
For S.F.R.
DESCRIPTION OF CONSTRUCTION Concrete Driveway
Approach
DIMENSION OF INSTALLATION OR REMOVAL
17FT X 5'6" X 6'
SIZE OF EXCAVATION, IF NEEDED
17'X 5'6" X 6' -
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION 1/11/94
ESTIMATEDWN-"RUCTION COST $ 300.00
(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:
pQ �
D JAN 111994D
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 ap licab rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of 'K work.
Signatur f&plic or Agent
OFFBRY P. SCHLEY 41590 Maroon Town Drive #B (619) 345-3620
Name of Applicant (please print) Business Address Telephone No.
JEFFERY SCHLEY BERMp'DA DUNES (619) 564-1799
Name of Contractor and Job Foreman Business Address Telephone.No.
B-346836 CA 92201 2697
Contractor's License No. City Business License No.
Y
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 $ �tt�, Q
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
Date
2438
PERMIT VALIDATION
PERMIT NO. - - 0
DATE APPROVED —' + - 9 L)
EXPIRATION DATE a - 99
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246
.�
�' t
NOTE:
With proper validate OF LA QUWTA
this form constitutes an
encroachment permit JAN 1 11994
CITY OF LA QUINTA
APPLICATION FOR PERMIT
pUBLICIMV,SWORKS 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
��/6• �'y Subdivision Improvement Permit - Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION /��
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
A 0 19C, h/ y0=0h
DESCRIpTJ��� �TROCTION CO/`�� AP --L / !/C COrs? Y
DIMEN IPN OF INSTALLATION OR REMOVAL 17 �� X
- 6 ° X
SIZE QF EXCAVTION I.F NEEDED ���• 77
(- 6 � �
APPROXIMATE TIME WHEN WORK WILL BEGIN
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 this wo k
Signa ure of A161 icant or Agent ;be
y/ S` i o �� A o o,-- :.j Pte.. !J?
Name of Applicant (please print) Business Address Telephone No. 6/ci
7ev�_/2 e- le 511 Y �en A -T o e v 40, �f .S` 6 V - / 7 9 5�
Name of Contractor and Job'Foreman Business Addre;s� Telephone No.
26'97
Contractor's License No. City Business License No.
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 _
TOTAL:
Receipt No.
Received by
Date
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Recorded by 11 TELEPHONE: (619) 564-2246
Administrative Authority
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STATE FARM
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INSURANCE
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RMI:::S ( REV )
AGENT COPY
JANUARY 1.0 , 1994 OF x'7961.
POLI : 55--._76--4886-6 F H0MEOWI�IE_R EXTRA
SCHLEP, JE Y �YLVIA
41590 MAR00PJ 'TOWN DR F:
BERMUDA DUNES, CA 92201-1194
PHONE# : (H) 619--345-3620
***** REVISED REC!UEST -****
Eff date: 0)1/05/94) C ur i ent date: (01/05/94) Time: 0i0:42 AM"
(REV)
RO REMARK::S : ( PROPERTY IS COMPLETED AND READY TO BE MOVED I N . MAIL BOX IS GOING )
(UP TODAY AND YOU CAN CHANGE M., A'i I_ I iZ ADDRESS TO THE LOCAT I' i IN . 'THAI'Jf;: Yfi(.j , GREG. )
( )
( FOLLOW UP, HERE ARE THE. PHOTOS AND THE I NS UREDS CHECK:: FOR THE RENEWAL $42r r . {:rr? . )
(THANK*. YOU, GREG NORR I . )
RE11AF'1'F`:S APPLY TO : F i r -e
JERRY J. NORRIS, AGENT
619-347--4506 1 N I T I ALS (Gl-N )