2755Ir
'WOTE 70
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
Subdivision Improvement Permit — Class II I
DATE: may 28. 1998 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
Avenida Mendoza batwaan Calla Colima and Calla Arroba
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION black "arty
DESCRIPTION OF CONSTRUCTION Tom- ararcv street clo> uto
DIMENSION OF INSTALLATION OR REMOVAL 0" blootk
SIZE OF EXCAVATION, IF NEEDED I/A
APPROXIMATE TIME WHEN WORK WILL BEGIN 1100 D.i<it. 5/30/98
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION 1.000 A.rl. 5/30/98
ESTIMATED CONSTRUCTION COST $ N/A
(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:
$1S ATTACHUD CONDITIONS
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 the time when work will be started.
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`Aggnt
Row*tts Jensen P.O. Box 1255 La Ouinta. CA 92253 (760) 564-2004
Name of Applicant (please print) Business Address Telephone No.t
W/A
Name of Contractor and Job Foreman Business Address Telephone No.
N/A N/A
Contractor's License No. City Business License No.
N/A
Applicant's Insurance Company Policy Number
t
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 $
w0 -
Permit Fee 1.00.00
3FknaJty( Rental Fee 50.00
jCa's Deposit Surety Bon
cifr2fui._edr' Deposit 150.00
TOTAL: $ 300.00
Receipt No.
Received by Date
Recorded by
V55
PERMIT VALIDATION
PERMIT NO. 2755
DATE APPROVED 5/28/98
EXPIRATION DATE 5/31/98
DATE ISSUED
i r
By
Administrative Authority
Telephone: (619) 777-7075
SPECIAL CONDITIONS=- BLOCK':PARTY, PERMIT'NO., 2755
53-500 TO 53=750 AVENIDA MENDOZA'
• l :
Traffic control :equipment shall be provided to the designated party prior to the event. It shall be sets . ,..
e
'
`up as.shown,on:the,City! s traffic controlplAii for` street closures by'the•"event coordinators, and
'
monitored during the event. Crty;crews will'not'be re'sponsibl'e for setting -up or: for mairitaiiiing thea
.,
equipment. 'The equipment will be picked -up by City crews from the designated parry the following
=', • day. Damage to.the'equipment will be covered by the permit deposit. r .
..
y 2.
Ari eight feet (8'') wide`fire,lane on one'side of the street sliall.be.,provided`at all,tiines during the?
•
event. • � - = � �. 1
'3.
Provisions of the Quinta Municipal Code shall'be adhered to regarding -loud noises.and other -.
`
nuisanc' es.,Complaints received'by the sheriff; s' department from "surrounding residents willr be-'
addressed, and the'event shut down ifnecessary.
` ' 4.
The street shall be completely cleaned by 12: 00 Sunday, May' 31, to the satisfaction of the City+
crews. Any damage to public fac`ilities'shalf be the responsibility of the event coordinators:
• 5:
This`permit, authorizes a block party o' be .conducted`on, and the temporary'street closure of Avenida
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Mendoza, from Calle. Colima to Calle Arroba (53'500 to 53-750). `• 'w t ` A
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NOTE
With proper validation �{
this form constitutes an CITY OF LA QUINTA
encroachment •permit
APPLICATION .FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) '
0 1116
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 SUBDI'JISIONS
Subdivision Improvement Permit —.Class'(((
DATE:. �g v inor Improvement Pe mit Class IV
LOCATION F CONSTRUCTION A- -V'
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(Street address or Description of Locatlo •
PURPOSE OF CONSTRUCTION :rACH4 Sketch (attach construction plans if appropriate)
DESCflIPTION OF CONSTRUCTION �a c e4 cnt-���_
DIMENSION OF INSTALLATION OR REMOVAL ' y
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
• ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, coin{ ,•
paction,and placing permanent resurfacing and/or replacing improvements)
f
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 the time when work will be started:'
Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
LA Quina and to pay for any additional replacement necessary as the result of this work.
' Signature of Applicant or Agent
Rc'ne'r'L D . BOAC l 2Ss litn t L/�CA
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Name of pplicant (please print) Business Addresi telephone No.
Name o ntractor and Job Foreman Business Address Telephone No.
Contractq�} License No. - City Business License No.
Applicant's Insurance Company GEN. [,IAMILITY Policy Number
FEES:' Subdivision Improvement Permit —.Class I I I r
Public improvements: 3% of estimated construction costs. '
t Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule ..
ee $ IO/, PERMIT VALIDATION
Per
i�t �Fe`e - ` u 0 PERMIT NO.
I "erreetY-1 1 L° /�j "(�
DATE APPROVED 2� '
urety Bond
` EXPIRATION DATE 3 vI b r
1. TOTAL: $ } ' •
i DATE ISSUED
Receipt No.
By
Received by Date Administrative Authority
Recorded, by TELEPHONE:,(619)777-7075
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City of La Awnta, 78=495 Calle Tampico, P O.. Box 1504, La Oumta CA 92253 FXF
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NDUE - ORDER
AC No. 101-000-443-309 time^ Phone:
P.W.'Depaitment Signature: .1 �•- ,
Finance Department Signature:
Date:
Describe•Event. _•,' - ` V � � � � •
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tion: Street Name
Address From _ Address To {•
Date(s) of Activity: From, ! To,
Hours of Activity: 1 t ` 10 �j -
Set - up Date 1 Take - down Date
Maximum number of people working at site during activity at -any one time ! f.
,.Maximum number of people expected to attend the activity at any one time
~Total Attendance'per Day 4 Grand Total Attending
A . .APPROVALS:. (For•City Use).
Fees Paid Date Paid x �+
Deposits Taid• Date Paid
= Fire Department Approval Date =
Q_ Sheriffs. Office Approval' Date -
' y`. Public Works Approval. Date. '
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�_. City of La Quin
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r' 78495 Calle TanpicoT ; `•° ` r - .
La Quinta, Ca. 92253 �,., b r` •+r. }
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- (619) 777 - 7075
Block Party Permit Application ` MAY
-. (Residential Streets Only)
RESPONSIBLE PARTY: r )IT.Y OF:LA QL1►WA '-
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• - Name: Daytime Phone:"-7(h-35b rte. V"
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` Mailing Address:_ `MO
ature:
Describe Event:
Location: Street Name—���o P� Lend
Address From t'i Address To,
- .. �' Dates) of Activity: From To '+ r
Hours of Activity:�� '
Set - up Date �0 'q Take -down, Date
Maximum number- of people working at site during activity at any one time
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�.y f Maximum number of people expected to attend the activity at any one time ^ • r•� C�
Total Attendance-per Day Grand Total Attending
APPROVALS: (176r City Use) = ._
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Fees Paid ` Date-Paid l
De sits Paid at Paid
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Fire Department Approval1 " C�� - ✓°�,eeCte
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Sheriff's Office Approval S PLS-Date ✓� Zg
Public, Works Approval Date
CA41mtmosI m1941003a K•
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-City of La Quinta�.
78495 Calle Tampico
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La Quints, Cay. w 92253 '•
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(619)777' -
Block Tarty Permit -Block Patty Petition
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(Residential Streets Only) ; ;
We; :rhe undersigned, hereby
agree to have our street, blockedoff andagree to hold the City {
of La Quinta harmless from any,and,all. liability or damage or suits for.our families -or our
guests as .a result of the Bloc
Party ..to be held on IMO(J'3, 199 in the
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vicinity of3
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Tenants Name (Print)
Tenants'Address . Tenants Phone ' • ".Tenants ture
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. City of La Quinta r.
78495 Calle Tampico
La' Quinta, Ca. 92253
(619)777 - 707
.. Block Party Permit - Block Patty Petition
(Residential Streets Only)
We, the undersigned, hereby agree to have our street blocked off and agree to hold`the -City`:
of La Quinta harmless from any and all liability.or damage or suits our families or our
guests as a result of the Bloc Party to be held on 199 .in" the ;
vicinity of C
Tenants Name (Print) :Tenants Address Tenants Phone enants tore
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City. of La Quints
- 78495 Calle Tampico r _
La .Quinta, Ca. 92253
(619)777 -'7075
-
Block Party Permit x -Block Party' Petition `
(Residential Streets Only).. ' '•
:.
We, .the undersigned, hereby agree to have our street blocked' off and•agree tohold' the City
of,La Quinta harmless from any;and all liability or.damage or suiti for our families or our
guests as a result of the Block :Party to be held'on —� 199-7 in the.
vicinity of — Ici�l7 �CV A ��. r� ,�i �: k{-�
Tenants Name (Print) Tenants Address . '' Tenants Phone 'µ Tenants Signature''
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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
Subdivision Improvement Permit — Class II I
DATE: 113r 20t 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Ayonlda FLnndona botroon Calla Collen and Calla Arrobc,
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION D10c t. 1C1S'SZ Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION TC' -_20W( -2V
S3 lex x'AC D C@T7iiI'"c :i S
DIMENSION OF INSTALLATION OR REMOVAL 220 ;6100L�
SIZE OF EXCAVATION, IF NEEDED VIA.
APPROXIMATE TIME WHEN WORK WILL BEGIN 1100 P•13• 5/30/90
APPROXIMATE TIME OF COMPLETIONS 10100 ILL- 5/30/9R
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 the time when work will be started.
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
jo tcatl 2.0. a 1255 L,0 Qcsintn, CA 92253 (760) 564-2004
Name of Applicant (please print) Business Address Telephone No.
VA
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
N/A
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
17
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 0 .»
Permit Fee 100.00
{Renalt'y`� taCa3. Tien 50.00
'I ashzDeposivSuret —Bond
fzreq Iredl
TOTAL: $
Receipt No
Received by
Recorded by
Date
PERMIT NO
PERMIT VALIDATION
2755
DATE APPROVED 5/23/0
EXPIRATION DATE
DATE ISSUED
f Y
By
Telephone: (619) 777-7075
Administrative Authority
R L Ci. . • *F1' . , 'Y :'
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' ` `SPECIAL'CONDITIONS-= BLOCK PARTY; PERMIT,NO: 2'755
` "`,
• ' 53-500 TO 53-750 AVENIDA MENDOZA `•, i'' �-
�' , , ..
;Traffic`control equipment: shall -be provided -to the designated party prior to'the°event: Ifshall be set- I.
_
,
_ ``; q..
f .
up as shown o_ n the City's traffic control' plan fo'r street closures' by the event. coordinators, and ""
•�
monitored`diiririg the event. City crews will riot be responsible for setting -up or for maintaining the
'
r
equipment. The equipment will=be picked -ups by City'crews.from the designated party the following
day.. -Damage to the a ui equipment will be: covered b th'e permit de osit: •. _:
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An eight feet (8') wide fire lane on one side of the street shall be provided at`all,times durmg_the
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event. ' ° • ..�
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'P'rovisions of the La Quinta`Municipal.Code shall -be adhered to regarding loud!noises and"other •. y
nuisances. Complaints -received by ,the sheriff s -department from surrounding`'.residents will' be
addressed; aind'the event shut down if necessary. "'1- r • µ '
,.
,
4.
The street shall be completely cleaned by .12-:00 P.M. Simday, May,31,10 the satisfaction' ofthe City «'
"� `
•, crews. Any'darhage to public facilities shall be the responsibility of the event-coordinators.�:
„
5.
This permit autlorizes a block party to,be conducted on, and he temporary street closure of Avenida
<Mend'oza; from yCalle Colima to Calle Arroba (53-50.0 to 53-750).
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