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2106
NOTE: Wiih proper validation this f04 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: 3/23/94 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 53-335 Ave. Bermudas (Street address or Description of Location) PURPOSE OF CONSTRUCTION Cut Curb for Approach Sketch (attach constructionlans if appropriate) ppropriate) DESCRIPTION OF CONSTRUCTION Driveway Ap-proach Per Riverside County Std. #207 See Attached DIMENSION OF INSTALLATION OR REMOVAL 20t SIZE OF EXCAVATION, IF NEEDED 61 x 201 APPROXIMATE TIME WHEN WORK WILL BEGIN 3/24/94 D � � APPROXIMATE TIME OF COMPLETION4/15/94 MA 3 1994 ESTIMATED CONSTRUCTION COST $300.00 (Including removal of all obstruction, materials, and debris, backfilling, com- By 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. Signat re of Appl fcant or Agent Victor Pinson 85-624 Calle Lim&n, Coachella 398-1490 Name of Applicant (please print) Business Address Telephone No. Same as above Name of Contractor and Job Foreman Business Address Telephone No. 675422 2934 Contractor's License No. City Business License No. Crusades Ins. Co. CICT17089 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 $ 20.00 Permit Fee 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 30.00 Receipt No. Received by Date 2106 PERMIT VALIDATION PERMIT NO. 2106 DATE APPROVED 3/23/94 EXPIRATION DATE 4/15/94 DATE ISS D 3/23/94 By Administrative Authority Recorded by TELEPHONE: (619) 564-2246 LOt '0N 0Nd0NVIS HOvodddd .(VAf3A/YO 3J380N0.0 opmAiy 16 Alunoo -0 .l .0 s 1 -I 0 l 0- -.l 1 -I 7I/JdL�R70 71'/1K�'SIY �O I �Bli� SN0/SN31Y�t'I,X .�C 376�t1 'y7r17d JML jO )r/7 )Ori 7r71Q�1/9AO7 J/J /It�1U 4 0 Mrxd )YGI JOW JOM 77►MS Arr)A/YO 0I JM77rrOr r)Yr 0jawrA 10 j/07S 7rwoni/91t77 '03*11U/O IYr Sl407S O/rS 71JAr7 r7rr3019 SLAWS , IY/77 JO)"/JM so )tnr-2m 13* )I IOM Mr7 S3I07S 9M/1/w/7 )AOI► JYjMI r7�A�3ois M n i , i0 -i ca -h-• Ot- i 09-5 /t -11-I SNO/SiA3d 9/LrA73N,7S ' L,116N) 177n 110M / 'y91tM0Y1 I/Yi/OYe !NC �wr M/M/iI t4rr)A/rA/ M))A1436P OJY/tWo "A) lM9/)M 77n, J0 Ol 7 p7 I. SSr77 M 77WAfS MOld-I JOV.7 77F 7 93WOM S/ yo sl six3 117 VAl301S ON N3NA1 rowrrw 00 w/w 0l 7►/7Yiww00 Ir or r/w ,11 7r/ld M)0/SAr—t-- r• w ri =i M S C% ~•: a �! A �e 'j —�-- N/ A1d]d06 d JV 7 VAI MIS rio�3irwoo JV r---- /� -rrw Or 'Aw•0l 7►ti7Y3wwl .7 —y w ` •. 1 i I t 4 3' Z j 1. Mi/► 9 �. N / u f • bt a • ♦ M lb - % i I �f NOTE: With proper validation this form constitutes an encroachment oermit CITY OF LA QUINTA APPLICATION FOR PERMIT -PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction of public or private curbs, driveways, Pavements, sidewalks, parking lou, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS DATE: — z `� �� Subdivision Improvement Permit — Class ill Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION — 5Asti,sv� (Street address or Oescription of Locetion) PURPOSE OFCONS7RUCTION GrAA—P_6 PP rcrz�n Sketch (attach construction plans if appropriate) DESCRIPTPN OF CONSTRUCTION 4 Ari DIMENSION OF INSTALLATION OR REMOVAL ?0 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 2 U `7 APPROXIMATE TIME OF COMPLETION /S Lt_ ESTIMATED CONSTRUCTION COST S --*- (Including removal of all obstruction, materials, and debris, backfilling, com. Paetion and placing permanent resurfacing and/or replacing improvements) _ In consideration of the granting of this permit, the applicant hereby agrees to: Indemnify. defend and saw the City, its authorized agents, officer,. represemstives and er+Olovees, harmless from and against any and MI Penalties. liabilities or loss resulting from claims or court action and arising out of any accident. loss or happening or occurring as a proximate result of a damage p persons or prtspsity any wort undertaken under the permit granted pursuant to this eDOlicetgn. Notify the Administrative Authority at least twenty-four 124) hours in advance of the time when wort will be starts& Comply with all applicebte City Ordinances, the terms and conditions of the permit and all applicfale rola and regulations of the Chy of V Quints and to pay for any additional replarerment necessary as the result of this work. r Signatu er of Applicant or Aaent I J r\s 6 r Name of Applicant (please print) –L Business Address L, l ephone No. u Name of Contractor and Job Foreman L l �% S�f Business Address Telephone No. r,z Contractor's License No. —r r u.Sr��- Applicant's Insurance Company 2-13 `f City Business License No. ( I_ T1 --? F\ c Ct Policy Number FEES: .i'ubGov lslon 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 $ Z© Permit Fee 'D Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. -------------- $ 36 Received by Date Recorded by T PERMIT VALIDATION PERMIT N0. Q [ O DATE APPROVED 3— z_3 ^ 5-q EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (619) 564-2246 N - I. r r x r t x x