2134 (2),ith.per validation 7
tFllsy #orm constitutes an
�y /� r
f. h p C CI Y OF LA' tlUINTA t
�nCroachment ermit
APPLICATION4i�l;' pi>MIT
w ,
ti PUBLIC WORKS ICONSTRUOTIC N' MMOROACHMENT)
e " ,Por the construction of public or private curb§, idrhVeWays,. payg lterlts, 914dWalks,, parking (lots, sealers, Wafer Trains
.and other like public works improvements in cohn96Uon mth MINOR IMPROVIrMEN111 andr,A0P.FIOVEq'SU!8DIIONS
Subckvision ItnoroveMant Permit - Clast III. � t
a r6ATE:__ 4/1-319-4-,' N)it►orlmprovementPehnitClaa9IV !�
r
t
'LOCATION OF CONSTRUCTION Corner of Milop aLd DUhe- gAlmg
Istre'at address or Description of Location)
I
ire a C• f F ,
-PURPOSE OF CONSTRUCTION _Move Equipment: SKateh attach Coni Usti
- 1 tr ori plarn If dppropfjatA)
'6 SLRIP,TION OF CONSTRUCTION Low Bed* 14WBjAdOa
{ ' H.W. lbs all legal I - HAUL ROUTE: Jefferson to Hiles Vel,;.
to Dune ;Palms f l
a ;;.', • : DIMENSION OF INSTALLATION OR REMOVAL T['
j Hui Dat'et 4/13/44 l
4 SIfi�OF EXCAVATION, IF NEEDED J `
ti.T "AP PROXIMATE TIME WHEN WORK WILL BEGIN I I�`—'� }_• ,F
APR 1
f 4PROXIMATE TIME OF COMPLETION -- e7 1994' ? I:
IWIMATED CONSTRUCTION COST $
;(I`1c6lUding.removal of all obstruction, materials, and'debris=-backflili� ,kom- +
r3actlon and placing permanent resurfacing and/or repladin§ I►Mprove
;In consideration of the granting of this permit, the ap04nt herdb�j °agtaes to; i i,•
Indemnify, -defend and save the City, its authorized agehts)-bffiCer�, )�resehtAtlkas and employees, harmlesf from R aiott afxy and ell
1 •ipenalties;•liabilities or loss resulting from clalin0tfr�rMf¢t tidal itn¢ u ff �iSjr Ct ertt, Ib'fa t l�A� ib IWr1! D �p pejty� �3 ,`
happening or occurring as a proximate result'of any work uhA$ liken ' "' •=
r l } h Alt. grunted pun Dani t6: thls appiioatinn. j
Notify the Ad
ministiative Authority at least twenty-four 11241, cU�s in advert J,at.the time whin walk wlh be Itarted: fit(
r i
t Comply with all applicable City Ordinances, the terms and c0gdItIo4 of-tho P ritrlt and gll iiCeble•ruieS and regUlatioN of the,Clty of I ',
( La Quinta and to pay for any additional
" replacement nce>nary a6 thg res jt o �.i4 rk.
l ` [
1
i f !t
5 ant
T6P Cat Equipment 2400 WtA_3 lie ir1 0 -6 '
' Wame of Applicant (please print) 'ss 3€llieAdd ss
i, 't el�phona Nha' .
Century Homes
r Name of Contractor and Job Foreman BGslh$s iAddh33s Telephone No.
Cbritractor's License No. city gUs)rtilft License N6.
Applicaht's Insurance Company i EoNcy Number !
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated con strUttltirl.,,gCOW
Private improvements: 3% of estimated construction costs
k
Minor Improvement Permit —Class IV: See attachediicthedule 2t34 I
'Inspection Fee $ I t
y { pniyll1' VALIt AXON j
IPermit,Fee /0
PtERMIT N8,
Penalty ` - t� - a
'Cash Deposit Surety Bond "" 5i
DATE APPROV�j� � a � ��` �
1
if required,'�fil'fO D+ +
N A E
TOTAL: $ IO--
I GATI, II >
Receipt No.
Received by Date (I r f dhtln)stt�t vlAufhor t}� '
y�
Recorded by ,. "' 6t�1 PHOW (0100 64- 248 5
1M
it