2482 (2)r
)er� validation
nstitutes,an
men pCITY OF LA QUI NTA
neermit•
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
Subdivision Improvement Permit — Class 111
E:'=« T�•�'�i 't'-''° -Z-I Minor Improvement Permit Class IV
QNSTRUCTION`' Rancho- La,-,(
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Na f Coritratto� end Jgb Fore Tian,
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�E 11sta'll' cur:& gutters
,CONSTRUCTION � b
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•" Sketch (attach construction plans if appropriate)
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JOFCONSTRUCTION See approved plans
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Seer attached conditions ,
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)F�INSTALLATIOIV-OR>REMOVALy Install
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&=gutter �� �
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See approved street improvement
plans prepared --.
AV�ATIC{N; IFANEEDEDf - ,See: plans'.
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rEtIME'WHEN WOR Ka1NILL,6EGINa i
9g77
'OF'COMPLETION 2 8
UCTION COST $ �-
ill�obstriiction;cmaterials; and debris; backf Ming, com-
'rmanent•'resurfacing and/or replacing improvements)
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rantin of'this permit, the applicant hereby agrees to:
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and"sav+:e he'City, its; authorized, agents, officers, .rep resentatives•,and employees„harmless..from and against anyand�611
eor;aoss'.•resulting from>claims or: court: action and;arising.out oft any.accident;r=loss or damage.to,persons or=property„
Ming.as ap;proximateIresult''oflany'.work-undertaken under the permit granted pursuant to this application.
ftrativeAuthoflty atsaeast.twenty-four-,(24),hours'in� advance of the time when, work will be started.
iplicable City Ordinances; the terms and conditions of- the permit and.all applicab ules'and,regulations of the City of
myAor,lanyfadditionalLreplacement'necessary as`the`result'of"this"work:
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4 1 went P.O. Box 1716 La Quinta, CA- 92253 771-1941,•
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�' ? "�d� `5 7 Business Address�tthe ��*ve� rc : •.4=�) ra&vtTelephone No. ift.�>� t:, F, ;
a at s
Southwests-Const :�s,(citrb .&
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9 tte'r) 2909 �Ra nbbw�Vly:�+Rdr t+k••Fal•1bro�o3b20 :.�
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',Contrticto�'suLicense�Not w;v sa:
>r3rtw;:6 �. City Business License No.
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APplicantstns'1r raniq)Company
^ icy�u ber
iemen�3P,efmltl:—tC18SS;1 I.I �.,ic��', • f �C %tb;�d !<S Caw t �� �% �� r:a`.: . +raM„� .s,,a
vents:; 3% of,estimated construction costs,
m ntsc;396 of estimated construction costs
r,
it4Permit'— Class IV: See attached schedule .
Date
PERMIT V#}4DATION
PERMITNO. ,
DATE APPROVE
EXPIRATION DATE
DATI TIUED
-
By
WA
Authority
TELEPHONE: (619) 777-7075
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