2262NOTE: �.
*ith 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
DATE: 11-7-94
LOCATION OF CONSTRUCTION La Quinta Community Park
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Art Show on 11-11,11-12,11-13
DESCRIPTION OF CONSTRUCTION 3 Day show from 9:00am
to 5:00pm each day
DIMENSION OF INSTALLATION OR REMOVAL close Avenida
Montezuma E/B from Eisenhower Dr. to Mendoza
Sketch (attach construction plans if appropriate)
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 9:00am D Q Q
APPROXIMATE TIME OF COMPLETION 5:00pm NOV 0 8 1 8
ESTIMATED CONSTRUCTION COST $ 141,
(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 thime when work w;U/�be'started.
Comply with all applicable City Ordinances, the terms and conditions of the pern
p4j4d all applicable r I and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of is work.
Signature of Applicatit or Agent
La Quinta Arts Foundation P.O. Box 777 La Quinta, CA 92253 564-1244
Name of Applicant (please print) Business Address Telephone No.
Susan Francis
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
1174
City Business License No.
Great American PAC 2-1619-03-01
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I 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 $
Permit Fee 10
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
$ 10
Date
2262
PERMIT VALIDATION
PERMIT NO. 2262
DATE APPROVED
EXPIRATION DATE
11-7-94
11-13-94
DATE fSSUSD 4 11-7-94
By
&4496�=
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
N O V- 4-194 FRI 16:05
COMPANY
FAX
FROM
NO. OF PAGES cr
(including cover sheet)
MORE INFO. <r
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PU
to qu1*nta arts f oundat"10
facsimile no. 619 56y 6881 A! telephone no.619 56111,
NCetil-- 4-134 FR I 1 6: 016 P 0L
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tl1h form oontaa N 4n CITY OF 1.A QUINTA
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APPLICATION F4R PERMIT
-PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For 06 commyc ". of 0*14 or DOWN cu t, drivll"Yq. Wvafrarn. Udoanikil. Parting lots. MOP , wstV f aleft
and other lite pubile Montt ImproeemenS In confwa:on wiM MINOR IMPROVEMekT$ a4 APPROVED SUBDIVISIONS
$ubdivwoa Improvoww" Permit- Cteas 14.»..
OATS: 11-4-94Mttnw Improvement PUMA Ctaos IV -
LOCATION OF C0N$TitVCn0N t,. QL�ommunity Park
Ittreet eo$" of O&OW 14" Or Lama.")
PURPOSE OF CONSTRUCTION art show %olds I.toa+ com* ctleo Punt H 41POV fr14ts1
OESCRIPTtON OF CONSTt N c �5 t -kb -`o
:0 ., om a "' a ,
IMEP},Sl N Of INSTAL 110 OR QV'""'tom
on ezuma
SIZE OF EXCAVATION, IFNEED(D
APPROXIMATE TIME V1MEN *OAK WILL BEQIN n • 00 A - m -
APPRO?LIMATE TIM$ QFCCwKrMOM. ST -011 �m.-.� 7 day
ESTIMATEDCCNS'TRUCTIONCOBT.i .� , -
(Ineludlrq rvoow I of 411 obnvuaion, "Weis. seal deals, bedcfllllnp, o wre,
p*~ &w ploelM wlivlartent nfnv%dnq mWor nt0gdn0 imomvfs o"I
Ih oonswerwov bf tN fropUng of #hit &"it, the lowiant hereby ww to;
t-dtrtnnrry. deeeed eed ow fM Ckv. w evuaorleell eoaw. ottio n, 'w"soaeeuw and woluvose, hetrroeee frodl eM N"t my 04 fl
per ba. lWitin a f4M n OfJrq trent 4144" a court tenon 4nd ar" etre of env teciam. lea or aeenep 0 owMU Or froeenv
neoe4n44 w e ww" N 4 pr+►iee ..sine of f4w w.e vp4w%vnl Vallee ow owmit rmvw owe "f 0 wo cowlaetfao.
NoovV tfle A"4Kmon Avdoft vt Meg t o ft4our 1241 hems M 90"411" of 014 16•tv %Men voww'vAl W etivea
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)4La Quinta 564
oundatiot� P.O. I3ox 777 •-1.244
N4nt4 of Apoiksnt (oleseu prilet) Busman Advo Tetepl+wtt? NA
X Susan Francis Same samo _
Nome of Convactw end Job Fa«naft Bwirnu Aodrm TelopAorw No.
Conp4aete Litarraw
Mg. City Bvsire.rs Licam No.
Great kmcrican Parr 2-1619-03--01
APplk"t't In4vroto Cofvwy OIC4. 10A811.,1'ry Potky Numgw
FEW b'arbewleton Imploveront PKmit - (is" III
PublIC IMWVvW wro:.O% df .eewatad oa,ebvcTlon oven
Privet. improvatxrtow 3% of ofrtinntsci 4onetrwdon cow
132E
Mime[ fntprowmatt PerlMt « Ctsn IV: $ee set4t*ed e41e4tu14
Ineoeet+on Fee — �' at,IOAT10N
Permit fat Post r brsnd fax transmittal memo len "1'606 —
Ce4n 0epoelt•swel
it naulred .1 LA —.
TOTAL. • Phone #-7 %. O%
fteeelat Fax
N o• / ,,� � -ox P
Received by u /ldminicCattW AMWr7riry
Aecyrded by 4 TELEPHONE! [0110} 5642244
No. -` s