2821With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
_ APPLICATION FOR PERMIT
r PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
f� --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
DATE: 10-6- 94
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION £Kuthenst carnor of Tsmnirn ot4 FAno.nhooAr. VA hlntgn Stroiott
r
300' BoUth of Tampico a►o.4 soutbeast corner of WaahiuXunu Sheet and Bottlebrush.
(Street address or Description of Location) '
PURPOSE OF CONSTRUCTION Work on Alinodoo. Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Install now multorinak
wires.
DIMENSION OF INSTALLATION OR REMOVAL NIA SEB ATTACH0 CONDITIONS.
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 10~-8--98
APPROXIMATE TIME OF COMPLETION 1(3-31-SiB _
ESTIMATED CONSTRUCTION COST $ 5.000.
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) 4
In consideration of the granting of this permit, the applicant hereby agrees "to: '
Indemnify, �defend'=and hsave 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)"o-Qf this work.n �]
Signature of Applicant or Agent
ARB Inc. 7A00 Vista Chino, Thousand Palm. CA (760) 343--1180
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
194079 566
Contractor's License No. City Business License No. 4 '
St. Paul. Fire and Marine 9KOB308596
Applicant's Insurance Company Policy Number IDA I n
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs OCT 2 1998
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule A7�1,0f LA QUINTA
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
$ 0
100. on
$ ion.00
Receipt No.
Received by Date
PERMIT,,VALIDATION 6'
PERMIT NO. . 2821
DATE APPROVED In-7-48
EXPIRATION DATE 10" 7-99
DATE ISSUED 10--7--9888
Administrative Authority
Recorded by
Telephone: (619) 777-7075