2122NOTE:
With proper validation
this -form 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 I I I
DATE:4/7/94 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 54090 Villa
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Step/ Stairway in City R/W
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/8/94
Sketch (attach construction plans if appropriate)
The City reserves the right to
remove the stairway from the Right of Way
for any reason.
The City will not be responsible for
replacing the stairway if removed.
APPROXIMATE TIME OF COMPLETION 4/9/94
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 per and all applicably, rules a}d regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of th�i wor />�/ / / / A
If
of Arm ant or Afient
A.P.Lench P.O.Box 450, La Quinta, CA 5004-1866
Name of Applicant (please print) Business Address Telephone No.
Lendel Ventures Same
Name of Contractor and Job Foreman Business Address Telephone No.
3-638335
Contractor's License No.
Gold Eagle Insurance
Applicant's Insurance Company
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
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$ 20.00
10.00
$ 30.00
Date
859
City Business License No.
CCP -203971-00
Policy Nu
2122
PERMIT VALIDATION
PERMIT NO. 2122
DATE APPROVED A17/0A
EXPIRATION DATE 4/9/94
DATE IS UE 4/7 94
By
Administrative Authority
TELEPHONE: (619) 564-2246