2797 (2)m';, °�4�8l26/19981 09:23' r r7697T77�55« CIT`{.OF LQ QUINTA ';;'PAGE'
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fm form aenetitvttie on {� :CITY OF - LA Ql11NTl! • t
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` "t,:: - APPLICATION FOR -4111M1*
• `� ' ` , PUBLIC WARK3 CONST RUCTION, {ENCRpACMIMEl11T) `
For the oonmuaicri of, public. or prlveta curb&, drivenavf,' Pavements; sidewalks. Wining lots,•sawen, cater misfit
• .� and other like public works imorovements in connection with MINOR IMPROVEMENTS and APPAOV£O SUBDIVISIONS ' - •', ,,
,r..- _ , *�� •! -• • . " tAlbdlvifien improysnte»I Permlf — Ciaat III ����: '
DATE: i Minor Improvement Permit Gaal IV r
ncjsJF t�>� L i2.fi' f
* LOCATION OF CONBTR CTION 1L��i. �L
++ • w �- , _ liveet eddreee or oeiie'Iptlon of Lowilton
NS l
PURF E OF CMTRUOTION '- - = sketch ttvttsch cO4ttuRlon planes if appropriate) ' •_
�
4 DEdC elON 4 ION s � V' /f � taO` Gv�
{ ' OIMbNSION 0/ INO'I'ALLrAT10N OR REMOVAL ,1Y
' • � , , I � ''a 811<E OK ExCAVATI.ON, IF NEEOEO _ �` � � ` t`
* .• y r� APPROXIMATE TiME WHEN WORK WILL ®EGIN ` `r
APPROXIMATE TIMII QF COMPLETION _
ESTIMATED CONSTRUCTION CWT E
(Ineiud(rigi rsmovel of dl obstwotlon, MoterieI end dabrle; baahfiiliitg, aem- �' • .
l *OOA and placing gei"Iineri% resurtecing endlor raplaaing inharovements)
' = in cenSlderedofh of this grgn(ng of this�w►mlt, tM soplivent hereby eg" to:
• f '" IndMimrv, delerid ane eve me city. its ow"riaed soMit, ofikors, reorernteee end nnployen, h•rmreet en
Irem one ep.irnr enr
`penildu, tirappfer of, too ro4viCof iron cleipta or Dean anion end eti.iny out of enY eurdeM, lou or Ae»MW t0 Derremr or pfeipirlN:. ;
4 , r �, • halo""" or aeeerriva n e proximolit tetiA of enp %on% VflQe"Amn under rbe permit dfsntfd ov scent to this sopiltatiom.
Nett% the Adfatnletretive Abtnefity at leen toosty-four (241 hour• in a&d.- to of the time whet. t.a+r :fill be derma
• - Comply 'p th all epptryalo, CItv.Ordinencet, tflo tome cid eotedltiom of the permlt aid NI OMlioiaie mir oto frdelNeeti of V,e City Of
IIA gulose and to ply ra env tddklond nwoo"w" neeeeaafy ee the rf,uli of Nb WArk. �
4 t ' �' •� :r.s
SlgnaNro of Apglksnt or Agent
` - 1 x _ • -,1 - ,; Nath' i lsns•{plw=.IntWInc. 3f1ry ��'rte�4eCapit
CNT AM----u10n �at.pnSo.nvC. , .
Ca. .
f r
Nana3t trsetar;attd Job Foreman • 6vu.•ae Addnn Tate • No.
i. ?1698 5221 (949)
� gullcit Li
_ tl
r - AppllaanNf insuram OLmW%, Y,. Policy Number
t' r
Pont! Svtadivislon Imttrevalneht Permit — Claes 1!l
Public Imofevsfll w 3% of estimeted otutstruatbnaoate' ` e
PrtvM Ynpovoitk!itei 3% of.artimated PmnetNation�cotts
MiT
4 ,. ..2774 ,.
na hfhtpruvsmont Petites — ClassIV :fist « eehvd ttAadula ,
InepatNQr$i" aD. "k,' . PtRMIT VALIDATION,' '
{> .,• t,".. P.rmit Ile , PERMIT NO. f A 1 /x, t" `
Penalty
Gets Deposit•Surivty sendDATE APPAOV,60
' t :`• ' - it naWned r ' _ .,» ,r `. ` ; ...
t..r , IWIF49ATION GATE
TOTAL• s f OATS ISSUED'
N Y Y 6 RomiAt No. r -
By
t , • 'Raabedby ` Oat; _ Administrative Authority
•a .` y R+wrmed by T@&Wh Ao: (619)777 -MS
y i.. ^, ,+-` `• .. +r
A.
ENDIO
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Fax number 1 t IC5
PA �tlrtrber
Ali
Urgent 0 Reply ASAP � P/ease comment �lwvse review w your In' f0 matlon
Total papa, Inqudinp cover.
COMMENTS
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31831 Camino Capisti ano, Suite 150 ► San Juan Capistrano, CA92675 • Tel (7I4) 443-3786 Fax (714) 443-3844
' � wsuw.Ontl.COm
California Statc Contractor's.11cense No. 8 716396