2320NOTE:
With proper validation
this form constitutes an', CITY OF LA QUINTA �o
encroachment permit
APPLICATION FOR PERMIT S?
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
I.
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
3-10-95
LOCATION OF CONSTRUCTION
La Quinta Community Park
Subdivision Improvement Permit —Class II I
Minor Improvement Permit Class IV
Montex4ma between Eisenhower and Navarro
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 4 day art show Sketch (attach construction plans if appropriate)
DESCRIP ON OF CONSTRUCTION Close Montezuma 92 U am
to 4 pm daily between B senhower & Navarro
March 16 t ru March 19, 1995
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
r I
APPROXIjVIATE TIME WHEN WORK WILL BEGIN 8:3 am eac
. =0=2ng
APPROXIMATE TIME OF COMPLETION 6:00 pm each day
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 tte" time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the per'cn"it�d all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result/off tts work.
Signature of Applicant or Agent
La Quinta Arts Foundation P.O. Box 777 La Quints, CA 92253 564-1244
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
1 o
Contractor's License No. City Business License No.
Great American Ins. Co. PAC2161903
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
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: $ 10
Receipt No.
Received by Date
Recorded by
MAR 13 1995
230
PERMIT VALIDATION-
PERMIT NO. 2320
DATE APPROVED 3-10-95
EXPIRATION DATE 3-19-95
DATE SU D 3-10-95
911
By
Administrative Authority
TELEPHONE: (619) 564-2246
'NOTE:
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
l�l_t�q
3-10-95
LOCATION OF CONSTRUCTION La Quints, Community Park
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
Montez4ma between Eisenhower and Navarro
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 4 day art show
DESCRIPTION OF CONSTRUCTION Close Montezuma 9:00 am
to 6:00 pm daily between Eisenhower & Navarro
March 16 thru March 19, 1995
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 8:30 am each
APPROXIMATE TIME OF COMPLETION b:uu pm each aay
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:
Sketch (attach construction plans if appropriate)
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 t ime when work will be st ted.
Comply with all applicable City Ordinances, the terms and conditions of the per i nd all applicable rules a d regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result is work.
Signature of Applicant or Agent
La Quints, Arts Foundation P.O. Box 777 La Quinta, CA 92253 564-1244
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No.
I of
City Business License No.
Great American ins. Co. PAC2161903
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 $
Permit Fee 10
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10
Receipt No.
Received by Date
Recorded by
232
PERMIT VALID
PERMIT NO. 2320
DATE APPROVED
EXPIRATION DATE
3-10-95
3-19-95
MAR 13 1995
0*
DATE I SU D 3-10-95
By
Administrative Authority
TELEPHONE: (619) 564-2246
i�FtZ ID -23-95 THU 1 1 4Z
011/23/1995 12:23 6197777155 CITY OF LA OUINTA
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APPLICATION FOR PERMIT
.PUBLIC .WORKS CONVRUCTION (ENCROACHMENT)
P ® 1
PAGE 0'�
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