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2166NOTE: With prover validation tAis 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 DATE 5-9-94 LOCATION OF CONSTRUCTION Moving equipment Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV (Street address or Description of Location) PURPOSE OF CONSTRUCTION 235 Backhoe Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION HAUL ROUTE: AVE 58 to JEFFERSON ST. DIMENSION OF INSTALLATION OR REMOVAL 141H 12 W TO HWY.111 89'L SIZE OF EXCAVATION, IF NEEDED HAUL DATE: 5-10-94 APPROXIMATE TIME WHEN WORK WILL BEGIN �' APPROXIMATE TIME OF COMPLETION - / j ESTIMATED CONSTRUCTION COST $ Dr �f (Including removal of all obstruction, materials, and debris, backfilling, com- �%A paction and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to:�Qy y Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and gainst an -and, penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or prope 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 Applicant or Agent Jones Bro. Construction 85-989 Ave. 52 347-2291 Name of Applicant (please print) Business Address Telephone No. Mike Jones Name of Contractor and Job Foreman Business Address Telephone No. 406921 153 Contractor's License No. City Business License No. Sfingi & Hannon 86 FJ 954610 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 $ 10.00 Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date PERMIT NO. 2166 PERMIT VALIDATION 2166 DATE APPROVED 5-9-94 EXPIRATION DATE 5-10-94 DATE ISS ED 5-9-94 By O Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 MAY 09 '94 14:36 6193982012 JONES BROS. P.1i2 JUNES BROS. CONSTRUCTION CO. GRADING, PAVING, UNDERGROUND AND EQUIPMENT RENTALS 65-989 AVENUE 52 a- F;O. BOX 905 COACHELLA, CALIFORNIA 92236 TELEPHONE (619) 347.2281. FAX (619) 398.2012 LIC, NO, 172092 FAX TRANSMITTAL DATE.: �t ��i� TIME: NO. OF PAGES: COMPANY: FAX #: ATTENTION: SENT BY: IF YOU DO NOT RECEIVE THE TOTAL NUMBER OF PAGES LISTED ABOVE, PLEASE CALL IMMEDIATELY. OUR PHONE NUMBER IS (619) 347 - 2291. OUR;: FAX NUMBER IS (619) 399 - 2012 "h1AY O9 '94 14:36 6193'382012 JONES BROS. J.. ; . NOTE:.LL_ _ With prgper.,validation this 1 (fo constitutes -an 'CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT P40..LIG WORKS CONSTRUCTION (ENCROACHMENT) P. Foi flit, construction of public or private curbs, driveways, pavements, sidewalks, parking tots, sewers, water , mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit - Class Hi PATE; Minor Improvement Permit Class IV LOCATIQN.OF CONSTRUCTION Moving _ Equ-ipement - - — - -- i (Suess address or Ooscription•of Location) PURPOSE OF CONSTRUCTION. 235 Backhoe Sketch (attach construction plans If appropriate) DESCRIPTION.OF CONSTRUCTION Haul, Route: Ave 5:8 to Jefferson St to Hwy 111 SOIMF.N$ION OF INSTALLATION OR REMOVAL M � �a `a Haul Date: 5-10-94 SIZE.OF,EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST S (Including r4moval of all obstruction, materials, and debris, backfidling,.com• paction and placing permanent resurfacing and/or replacing improvements) ! In consideration of the granting of this .parmit, the applicant hereby agrees to: 4ndimnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from and tpinst any and all penalties, liabilities or loge resulting from claims or court action and arising out of any accident, loss or damage to persons or property happening or occurring as•a proximate result of any work undertaken under the permit granted pursuant to this application. Notify, the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started, comply with, all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of Le tauinta and -to pay for any ariditiorial replacement necessary as the result of this work. I Name of 'Appliconi (please' print) Name of Conua.ctor and Job Foreman 406921 Contractor's License• No. Sfinai ..& Bannon Applicant's In$urance Company FEE$: Subdivision Improvement Permit - Class III Signature of Applicant or Agent 85-989 Ave 52 3'47-2291 Business Address Business Address Tetep#ione No. Telephone No. City Business License No, 86 FJ 95461.0 Policy Number 9 • .aAVer'Nste� . mow.+. VM•/V��.�VI� �.I�/V.V.IV.� 1 41.111► - %.6000 111 Public improvements: 3% of estimated construction costs ~' Private improvements: Wof estimated construction costs Minor ,Improvement Permit — Class IV: See attached schedule Inspection Fee 10.00 Permit Fat Penaity : Cash• DepositSuraty Bond if. required Receipt No. Received byDate Recorded. by Extended Page. 2.1 PERMIT VALIDATION PERMIT NO. ,2 tce (o DATE APPROVED 9 EXPIRATION DATE v,9/ DATE ISSUED S �9 ^ 2 Y, By TELEPHONE: 16191 664-2246 f UMM15Trallve