2114_j.6,
iVOTE:
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 II I
DATE: 3-29-94 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54-825 Obregon
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Driveway approach
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 1-29=9&
Sketch (attach construction plans if appropriate)
per Rive;side Co. Std No. 207
(attached)
APPROXIMATE TIME OF COMPLETION 3-30-94
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 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 pplicant or Agent
Sunrose Properties 72-850 Boasts 8d. Palm Desert, CA 346-2840
Name,of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
533670
Contractor's License No.
1137
City Business License No.
on file
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class II I 1
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
10
$ 30
A
Received by ..Date
211
V
PERMIT VALIDATION
PERMIT NO. 2114
DATE APPROVED
3-29-94
EXPIRATION DATE 4-01-94
DATE ISS D 29-94
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA. QUINTA ._.
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION '(ENCROACHMENTt
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, watei rr�ifet
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
DATE: �Z.7 A" y Subdivision Improvement Permit — Class 111
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION - E '/ — l's"�4y� f513 gF��p�cJ Qk� f�
(Straac address or Oesenption of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL - " x ago
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
S 7� � Zor7 �77v,�t-/at Ii>
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTS
(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:
m
Indamfv. defend and save the City. Its authorized 8". , officers, representativaand employe". harmless from and
venues. liabilities or loss resulting from claims a against arty and all
court action and arising out of any accident. loss or damage to persons W pnOpaity
haMening or occumn g as a proximate result of any work undertaken under the permit granted oursuant to this epouation.
Notify the Administrative Authority at hest twenty-four 1241 hours in advance of the time when work will be stared.
ComgWy with all applicbNO City Ordinwices, the tams and conditions of the permit and all appliame rules and regulations of the City of
La Guinea and to pay for any additional revacenant neoesmy as the result of this worn.
FRO
Nance of Applicant (please prim)
of Applicant or
Business Address AG /-,-,
PMW_4- YJ
kil
Name of Contractor and Job Foreman J �rvr _ 0 �� '
Business Address -,'j-Telephone No.
h 3�,A 7D
Contractor's License No.
City Business License No.
Nh o
Applicant's Insurance Company 7q 7—
Policy Number
FEES: Subdivision Improvement Permit —Class II 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 $ 2�
Permit Fee f d
3enalty
ash Deposit -Surety Bond
J required
TOTAL:.
Receipt No.
Received by Data
4ecorded by
PERMIT VALIDATION
PERMIT NO. / ��� `I
DATE APPRED — o Z9/9
EXPIRAT ON DATE
4116
�'
9
DATj UED
By_1
Administrative Authority
TELEPHONE: (619) 564-2246
1
7
r