2334. . M;T-%
NOYE%
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
w 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 II
DATE: 4`3-95 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Tract 26152 Lake La Quints.
Calvo Bay 6 Via Florence
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Construct slough Nall Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Construct slough wall in Bldg 6 Safety to provide inspection
City R/W
DIMENSION OF INSTALLATION OR REMOVAL Plant material in the planter shall
not exceed 30" in height at any time
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN —4-95
APPROXIMATE TIME OF COMPLETION
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:
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L 03
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless from aAd agar y a d all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage A persons /ad
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
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
Century Homes 1535 South "A" Street San Bernardino, CA 92408 (909) 381-6007
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
314473
Contractor's License No. City Business License No.
Certificate on file
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 20
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 20
Receipt No.
Received by Date
2334
PERMIT VALIDATION
PERMIT NO. 2334
DATE APPROVED
4-3-95
EXPIRATION DATE 4-28-95
DAT IS ED 4-3-95
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
I
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NOTE:
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 lou, sawel water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
GATE: -
4, .q� Subdivision Improvement Permit - Clan III
,Minor Improve Permit Permit Class IV
LOCATION OF CONSTRUCTION 1 r �P S !� (�G,ID -$�� < via �CC,
iStfm Kmmu or Oetcnption of L.eationl I
PURPOSE OF CONSTRUCTION T� W — - Sketch (attack construction plans if appropsim)
DESCRIPTIQN OF CON RU ON
AAA ]IN L
DIMENSION OF INSTALLATION OR R'EhAOVAL
SIZE OF EXCAVATION, IF NEEDED .
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
(Including removal of all obstruction, materials, and debris, backfilling, com-
Paetion and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant. hereby agrees to:
Ihdammfy, defend aro lave On City, its outhorized Spans. office". representatives and smplavow harmless tram ane MUM Soft end all
penUaes, liabilities Or los "lusting from claims or court action and arising out Of " accident. los or
happenuvr « occurring es w
a proximate nmit of any ork undertaken under the pammR granted pursuant to tmb spplbtidamepe to jol, M. « propeity
o
NotIN Me Administrative Authority at lees twentyn n
-four 1241 hour in advance of the tarwhen vowis trill be stad
Con Illy M^th all .applicable City Ordisunas. the tams and conditions of the pamnit and e11 + kabte rules ecce nqutations of the Gly of
V Quints and t0 pay f« any Additional replaeernem me as es the vault Of lois/word / f
X Name
X
Name of Contractor and Jl
Contractors Geensi No.
X
e Spnature of Applicant or Agust
15 3 �_ - 1 15T. (q�&gl or
Business Address Telephone No.
Business Addrass Telephone No.
✓ City Business License No.
Applicant's Insurance Company ClICU. LIABILITY Policy Number
FEES: Subalvlslon 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 S
Permit Fee
Penalty
Cash Oeposit•Surety Bond
if required
TOTAL: S
Receipt No.
Received by Date I
Recorded by
13086
PERMIT VALIDA
PERMIT NO. •�
DATE APPROVED
EXPIRATION DATE IVOWC
DATE ISSUED
By
Administrative Authority
777- 7075
TELEPHONE: (619) Se8449W.
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