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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: d 9A� 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 - -- 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. J l 41 t N }: •