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2082NOTE: t -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: 2/24/94 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 64-670 Avenida Alvarado (Street address or Description of Location) PURPOSE OF CONSTRUCTION Driveway Annroa-rh Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION Per Riverside County Standard #20'3 DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 2/25/94 APPROXIMATE TIME OF COMPLETION 3/1194 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 ranted `� g 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 M L Construction P.O.Box 228, La Quinta 564-4447 Name of Applicant (please print) Business Address Telephone No. Marvin L. Jordan Name of Contractor and Job Foreman 343335 Contractor's License No. Scotsdale Ins. Co. Business Address Telephone No. 2051 City Business License No. GLS 502127 Applicant's Insurance Company Policy Number I FEES: Subdivision Improvement Permit — Class 111 Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs FEB 2 4 1994 Minor Improvement Permit — Class IV: See attached schedule 208 Inspection Fee $ 20.00 II PERMIT VALIDAL _�__L Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Recorded by 10.00 $ 30.00 Date PERMIT NO DATE APPROVED 2082 2/24/94 EXPIRATION DATE 3/1/94 DATE ISS►? D 2/,24/94 By ( Administrative Authority TELEPHONE: (619) 564-2246 NOTE: 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 I I I DATE: ��— L Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 21-6 70 AIEV Iy I / L l/�q,�,4 D O 44 Q 111A17 -A (Street address or Description of Location) PURPOSE OF CONSTRUCTION f)Dle l VC— W14 V A o 229P_©Ac-H 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 oZ 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:end employees, harmless from and against any and all penalties, liabilities or lou 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. Notifythe 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 Ouinta and to pay for any additional replacement necessary as the result of this work. Signa re of Applicant or Agent NamelicasV �nt (pl a pprDA /V , Business Address Telephone No. 1,4J PLO.- '60Y b+Q01A).SZY-4447 Name of Contractor and Job Foreman Business Address Telephone No. &-113336- C2015-1 Contractor's License No. City Business License No. 5��7�-sD,��� %NS . GD • �LS .� o� la7 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 ^TION PERMIT NO. DATE APPROVED EXPIRATION DATE -3 Z DATE ISSUED By Recorded by. 11 TELEPHONE: (619) 564-2246 Administrative Authority [ ' ,w � C`- 4 D � ���ft•I�IN�t/ REQUEST FOR INSPECTION 0F��24 HOUR ADVANCE NOTICE % I �/ DATE ./Z R / 9 `t PROJECT LOCATION PERMIT NUMBER , -Z6 12�4n'II_Z C;)oS`3, CONTRACTORS NAME PHONE NUMBER .399- 12CO COMPACTION TEST COMPACTION TEST Subgade.................. O Base ........................ O Grading ................... 0 Curb & Gutter .......... ❑ Drainage .................. 0 Formwork.................. ❑ Trenches ................ ❑ Striping .................... 0 Structural Steel ........ 0 Paving (Asphalt) ...... ❑ Signing .................... ❑ Backfill ...................... 0 Paving (Concrete) .. ❑ Landscaping ............ ❑ Excavation ................ ❑ Driveway Approach . V, MdNDAY TUESDAY WEDNESDAY THURSDAY FRIDAY 78-105 CALLE EST DO • LA OUINTA, CALIFORNIA 92253 • (619) 564-2246