2782t.
z
NOTE:
With proper validation
this form constitutes an
encroachment permits CITY OF LA QUINTA
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 III
DATE: J1fiA 9A Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 43055 Dune PtIme R"A
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Stockpile eXGl1111 fill Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION ntarkaf1a dirt
DIMENSION OF INSTALLATION OR REMOVAL 2001 X 21161
SIZE OF EXCAVATION, IF NEEDED n112
APPROXIMATE TIME WHEN WORK WILL BEGIN 1/22/01111
APPROXIMATE TIME OF COMPLETION���
ESTIMATED CONSTRUCTION COST $ a/a
(Including removal of all obstruction, materials, and debris, backfilling, com-
see attached couditimmi.
see dust 6=trol plan
(IDCP 98-36).
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
I
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
CC4zG»-Crow* .1 Corimm tion 1535 R. "D" 1St.. Sari 1korx►arAirto„ rA, 924OR (90) 'A01.-6007
Name of Applicant (please print) ' Business Address Telephone No.
Nadriaal 1routal.. 'Inc. 7685 1.Akoxide Dr.. 1Riyaraid*. CA. 91509 (9091 6AI-6419
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Steadfast Insurance Ccmaany scn9108441
Applicant's Insurance Company ' Policy Number
FEES: Subdivision Improvement Permit — Class I I I {
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
$ 4QQ . nn
100.00
Receipt No.
Received by Date
(011Tn0 �-
V
Nhl1U
AUG 31 1998 2782
1% l i O LAHNTAALIDATION
PERMIT NO. 2782
. Y t
DATE APPROVED 7
EXPIRATION DATE 7/22/99
DATE ISSUED ..,
Administrative Authority
Recorded by 11 Telephone: (619) 777-7075
CENT0111Y CROWELL COMMUNITIES
Topaz Xss,,cialcs, L.P.
1515Smll "I)"Sued. Suitt ."X)
Sm;.13, Mudi,% CA 4.^.,,,g
DETACH �*A ENT BEFORE DEPOSITING
(90908 6fX)7-FAX(909)1','l-(X)41 jr. 106535
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eposi $500.00
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'EllITURY CROWELL COMMUNITIES ®BAbK
-Folwiz Assnci..Aes, L.P. 'FOOTHILLIV fa Exceedyour Evecrations 106'535
4��l )#11. :" , CHECK NO:
4012 GRAND AVE.
1535 South "D" Suco. Suile 200CFIINO,CA91710
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(909) 4',1 6007 •
FA Y (909) 381 -(X)41
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TO 'rHE
ORDER OF:
VOID AFTER 60 DAYS
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TOPAZ ASSOCIATES. L. r'.
CITY OF LA QUINTA
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110 106 S 3 Sul 1:1222324391: Ls S 2-s- LOO L69110
CENTURY CROWELL COMMUNITIES
Topaz Associates, I -P.
1515 Snmh `0- $Neel. Suile ?INI
San llrncn Jinn. CA 9 1118
14A1p tNl IdNl7 • VAN (90).481 IN141
Check No. - 106524
Check Date - 07/21/98
DETACH STATEMENT BEFORE DEPOSITING Stub I of I
106524
CENTURY CROWELL COMMUNITIES
Topaz Associates, L..P;
�P. �Aar.0 Af �#N lXlil
1535 South "I)" Shect, Suite 200
Sao Bernardino. CA 92408
(909) 3�41-6007 • FA)( (909) 381-00,11
PAY
FIVE HUNDRED AND 00/100TO THE
ORDER OF: CITY OF LA QUINTA
P 0 BOX 1504
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LA QUINTA; CA 92253 #'
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112LOG, 5241e i:L2223A391: 452x11 100 169110
ILL INDEPENDENT
CHECK NO , 1 .9—A
( [o.Exceedyoul6yecfafions
4,012 GRAND AVE.
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( GHINO, CA 91710
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UMVERIFICATION: (9DO)804.2202
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,9398
07/21/98 $******* 500.00
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112LOG, 5241e i:L2223A391: 452x11 100 169110