2823 (2)----------
,
--'----------------t----i
------i----------------` .''`�-4•-r -t "�.0 -,.
•
NOTE:
With proper validation r '
•
this formm-constitutes an
,. CITY OF LA QUINTA.
a
r�•
�' _
encroachment permit _
'PERMIT
•< '-
APPLICATION FOR
PUBLIC WORKS CONSTRUCTION, (ENCROACHMENT),
For the construction of public 'or. private `curbs, driveways, pavements, sidewalks, lots, sewers, mains •,
parking .water
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
41
` }
•
_ Subdivision Improvement Permit -+Class I I I
9
1; 0 % 8 % 8
DATE: L' `. Minor Improvement Permit Class IV
'
- Tract Avenue 52,. La Quinta :t•
�'.
-'24890.
LOCATION OF CONSTRUCTION' t
'West ofJefferson East. of'Cal'le Rorid.oi y
` - - <r. ,•
,.c
(Street address or Description of Location) r /7
ti
-
P fitP SE OF NS RUCT ON Construct` Sketch (attach construction plans if appropriate)
9'iffewa��C.
`r•
_
, mpro_yemen s
wiae
r
�lc8e TION OF CONSTRUCTION `/^L•n`AVA^ {
1 u ewe 11 KK � WJQ �2C' • OI�AL�e�' C.rlr�•�'�1,�n�S.
~
77 I
` �' >
•
DIMENSION OF INSTALLATION OR REMOVAL t X t L r
Approach
SIZE OF EXCAVATION, IF NEEDED
,
APPtpffff�(UJJJ gt1E WHEN WORK WILL BEGIN 8 00 - a • m • + + . • s+
' r ^
r
•+
�.
APPROXIMATE TIME OF COMPLETION
` r•
,ESTIMATED CONSTRUCTION COSTS
r . •,, '+
(Including removal of all obstruction, materials, and debris, backfilling; cam•
•
�- r ,•
• 'rpaction and -placing 'permanent resurfacing and/or replacing improvements) -
;In consideration of the granting of this permit, the,applicant,hereby agrees to:
. Indemnify,'deferd 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 „
-i 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 Q4) 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
k.
la Quince and to'pay for any additional, replacement necessary as the est of this work:, y
_
f ■ I <{
, '.
4 ., SignatureofApplicanAgent "
KSL Land Corporation 55-9 O'PGA•Blvd 760/564-7189
Name of Applicant (please print) _ ' , Business Address ;Telephone No:
• V. _ - .
.r
'I)e.sert Communities_ Concrete- 79.301 Country •Clubt.•345 t4598
,, ,.
•"
`Name of Contractor and `Job Foreman '• 'Bus�'qess Addre Telephone No.• f . -
ermu8a.,Dunes
r
• -- }
+. ,, I "
Contractor's License No. +, City Business License No. '-
"
Zurich Insurance Co` ' �' GL0683881504 - `
•
,. i, • Policy Number
Applicant's Insurance Company4
, ;� ,. ~'
c M i
FEES: .Subdivision Improvement Permit — Class 111 -
•
r
r lz
Public improvements: 390 of estimated construction costs
+.
4 ,'+ wS 4'
'• •
Private improvements: 3%of estimated construction costs •.• j, '+ • ' a
r
`
Minor`Improvement Permit — Class IV: See attached schedule , 2774
-.
���'' ^• t
y,
Inspection Fee $�
PERMIT•VALIDATION.= .
t s ^
0�= F
. tr
`�
Permit Fee
y PERMIT,NO.•
t
,
`
*
APPROVED o
`
r •
ash.c+urety Bond * t
DATE
•;" „`'i
�C
I
if required ;
EXPIRATION DATE
` r-
TOTAL:' $
-
ISSUED
•ti
. Receipt No. -t
,DATE
. r
+
c,
�-
Received by Date
By. .
�, ry�Administrative Authority •+
„-
Recorded by + y =
Telephone: (619) 777-7075'
<...
.wry - _ J , �Tw• .. 4., • ,�,' _ � • ..
_
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER
aG
KSL LAND CORPORATION 1 ST BANK OF PALM DESERT
;.
73-000 Highway 111
SS-920 PGA Boulevard At Monterey
?s
La Quinta, CA 92253 Pohn Desert, CA 92260
90 4120
t'.
1.222
DA`fE ;.;.. CHECK NO.
AMOUNT;
i.
October 8, 1998 12023 $******1 873 00 - .
f
Pay: *"*****'*"*One thousand'eight hundred seventy three dollars and no cents
"
'PAY :'<.'°CITY OF LA QUINTA .
TO THE 78-495 CALLE TAMPICO
ORDER OF
LA QUINTA, CA 92253
9?P'^i@'?': :'z ': z''=: `� : THE BACK OF THIS DOCUMENT CONTAINS AN ARTIFICIAL WATERMARK -HOLD AT AN ANGLE TO. VIEW
11600 L 20 2 3o' is L 2 2 2', L 2000, 6 2 5 ?0 4 L0 3o'