2063NOTE:
1 th`p per 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: 2/14/94 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54-275 Ave. Mendoza
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Widen Approach 2' Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 2/18/94
Per Riverside County Standard #207
See Attached
APPROXIMATE TIME OF COMPLETION 2/18/94
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 perrriit and all applicable -rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result gf,this work,/''/; )
nature of Appri nt or
t
Staart Podell P.O. Box 76
568-6014
Name of Applicant (please print) Business Address Telephone No.
JMK Development 11684 Ventura Blvd. *818 656-3153
Name of Contractor and Job Foreman Business Address Telephone No.
590684
2537
Contractor's License No. City Business License No.
cagy ;IleIHQ-6 rr1S01-k14L1 WC- 1202&92 6,161_ 4
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 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.
20.00
10.00
$ 30.00
Received by Date
D
20
PERMIT VALIDA'1'I
la D
F E 8 1 1 1994
PERMIT NO. 2063 v
DATE APPROVED 2/14/94
EXPIRATION DATE 2/19/84
DATE ISSUED 2/14/94
By
1119— Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
:%_OTE?
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.III
DATE:,6 y y Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION S Y- a ? S 1 Me.vd o z a ef'a 9,2.2 s 3
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION W, aaN 12 gao W cVm 2/ Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 07
/��Achc�1
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION Feb
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'end.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 pe and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result is work._,-_�
of AdbKcant or
O /So
Name of Applicant (please print) Business Address Telephone No.
�mo�moeaT //�8 11enJ't'ulZn gI.J �/3
d5-6-
Name
S6Name of Contractor and Job Foreman Business Address Telephone No.
9oG8y S 3 7
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
Recorded by
......+TION -
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619)564-2246
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