2816 (2),.' 10rOGT.l 2 998l: 412 caF o07,777155 CITY OF LA QIJSNTA• r NO.985 `-hP.2G • 02�, �
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With Prover validation - K '
this farm consti Wtfs 9n CITY OF to dU1NTA
encroachment purph APPLICATION FOR PERMIT•
' PUBLIC WORKS CONSTRUCTION,(ENCROACHMENT)
x For the construction of Public or private curbs, driveways, ov:emenu, lidsftllts, parking loci. sewers, wetel malnt
end other like public works improvements in connection with MINOR IMPROVEMENTS snd APPROVED SUBDIVISIONS
SubdivisitsA Ih,prevanwitt Permit — Clals III
OATS. r What Intpforgnlflrit Penrtlt CNIi IV
`. LocA�lo a ION
16trMt sddrersee Osrerlptfen of Lf "Wisttl'
KJARPSE OF NSTVOTION Sktso fottach construaibfl ofans It approvrigtol F
RIPT1 NOfC NSTRuCT1 a /iT�ifCt►�'!! GO"f�1T0�1(S
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF. EXCAVATION, IF NEEDED
APPR ATE T E RK WILL BEGIN r -
N
APPROXIMATE TIMf OF COMPLETION r ;
- ESTIMATED CONSTRUCTION COST 9 "
" Ilnsli dirio romorel'of all oburuction, materials, en debris, b6fi1linia, col
•' Pactlon and placing vatmanant rewrf leinf,-' and/or replacing improvementol
r In fionsideratlorl of thr granting of this permit, the applicant hereby agrees is;
- - In""Pitrr, darlrrd Ind te+t the C*. ke avthorlted 82,11 . a ieerR reoreesmstvee and funolwur, hsrfnlesr from end egeenet also snd ell n
" aamlries, liablihhts or tots resutulte Irate ela11r11 er **UK anleP end •ruing out 01 Iny oeeident. Ion or danWa to pawn or oroselnw
+ t - riapoonfna or set-1 lry a I prosim►w _fault or env eeork undartaten uhdor the pirmh gronsed ourlu"I to dtb appliraven,
fYeNh the A4n11nIIGMtM AutfidriN at peas ttftlrtry-four fZal Roues in adwitte er trio time whim wore vNu Do atartod.
Cenfply W" III Opal Mut G1ty ordlnenoa•, the rams and cendltlone of the oemtlt'and oil Iapiirablt rule and no:unlo■o or trio City of
6a Ovlrtw end to Pay ter snf• oddhtarial realaeaflint ngogmry rt the rvsu r chit wink. `
i6JL— -
��� SignQtvr'e of Aullcant or Agent
Name of -
Appiioant Iolaaoe prirstl Burinesa Add s .7elophot» No.
Natal of Conollotor, and Job Fvramart Bu isess Address TaI ph e a No.
• f I �-
Contrsao�a Llcent. No, ►� �,Aa G.rj I CA ` City
rr''•r'p1e S,NS 9tulnags License Ne,
r pi ir%
It
FEE$: Subtdirlden lri+p►ovemerit Permit —C1aw (11
Public Irnp►0eetltartta: 3% of ortlnlated eonruumlon delta • -
Private imtsrvWe Nnu,' 3% of astimeted ennatrlutlan Cone
Wool, IfrtproWmint Permit — Class IV: See strbehad schedule
Inmetion Fee i - 3? l Z'
r . PERMIT VAL114ATION
a PER Z�
C•M Depeait•S4rItY Solid, DATE APPROVED
itrunuired - b b0 4 141 XS)'
TOTAL: ti i•1 g1 L . %0 EXPIRATION DATE
DATE ISSUED r7l S
Aowipt No- � a •
Rewhrw by . OVA r Br -
AdminlrtretWe AUtrtonty
• RacoMed by � . ' .
lilephom: (Big) 7"-7076
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Rr INCO HOMES & AFFILIATES `
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` 1282 W: ARROW AM 909 961 8989 ' .
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P 0" BOX- 970 -'
qe zo Foou m t>na ? C r `90 7049 3 .
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UPLAND; CA 91785 0970
i ^� " UpeM�G8+788 '^ , ,-
BAAf!{&TFIUST tset 342.57ai 1 3222
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D'ATE.. Sept 24-, 199.8 t +
our'.
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`RAY **Four .Th'ousand:Eight Hundred
Twelve 'and 6,0/100.*** DgLLARS,. 4,812.60***
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TOE„ Cityy, of'- La Qiinta .
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t+,' " -VOID IF.'.NOT CASHED;WITHIN .6 MONT THISCHEC HS
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ORDER.
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uo00-3015 2n'' 1112:2.2,-70'.49 5�;- µ ' u� 3980 3-5
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