2849 (2)Sent. B.y: PGA WEST RESIDENTIAL ASSN INC; 760 771 5125; Nov-3-98 12:14PM; Page 3/3
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11/82/1998 17:06 7687777155 CITY OF.LA QUINTA PAGE 01
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NOTE:
l Vft props 'altation
y t*a form whillia°p to CI1Y OF LA OUINTA
Il Maoaohmem permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the eomwmartlen of public of orlvem curbs. driveways, paerrmenta, sidewalks, puking lots, fewer, water miins
end of" like pu41le works IrnprowatmerNs in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
- Subdivision Improvmtheftt Petml% - Cleats tit
7/ O,aTI; Minor lmorovwwm mlt elm Iy
/ LOCATION OF CONST UCTION t L�
1 ` . Odom or q.®t.tlse
PUttuw >i pR QQN9TRf,ICTIQN stab tettacAWDG^�• -r �n piers if apprpprittel
/ nub -ILL
w(_ OiiCRIPTI p QQN$f pyCT1Q /� r"�eV«..{t 1'��[ �� r v11i'�fjF
- � " DIMENSION, F INSTALLATION 0 OV
!1! r SIZE OF EXCAVATION, 1 NEEDED
APPROXIMATE TIME WHEN WORK WILL, BEGIN I I — 5 ' 1x
I
APPROXIMAT! TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST E --
(Irt4wing repo lot so / Ilwe 10 m. man fOIR-
004*00 and ohacing perm"Rent relurfeeinp and/or roolaoinp imoro-•ments)
In eonsumeration of tta gbrrtinfl of this parrnit, me appiloant hareby wees to: ,
IndamnlhdOoM and stairs dts DIN. n► eU-m4ed @VM., o(fimrr, repntwnh•f'nrr and wn•to-e-t, nary+ ye,rryn aaa .wA'1 /aV and all
OMfnIN, lleealnw or Ipa raatldq re ttalun of
rtntAlr ecbn one alllna *us of •nr RNdanl, loan or darnapt ro carters er orminr
"""ingot ollalrrtno » a "Ximsew relVtt of •n- erore wtdartow -hdar dye wrail lrartaa ovea-eM is this swicatioa,
111e60t• dw Adnsirtle la AVtbotlw at Neat twenWdaw 1741 harp in edgtfee el du time nelM waft will be am ad.
"VAN hAdl Mi epoweaeU GtY OAmetaea, IM tarmr and esaeitierd of eM and Mt epgieaele rvltl/�d "o" er Me
1. Olrlm lay ORpair for aw eddltlwes rears ~1 Mte s" a that row" A'wan. 'I. -
Telephone Me. 77 1-1 a 3 4
8WiMp rAdddress �✓ Telephone No,
So III �t/% w..I---�i:,l,.i.�f •��
Appli0wro Insurana.
Flaft. sayivhlart Impeovermont Permit - Class III
public Imoevarwena: 3wiff wirrletad wnaf/uetidn dean
Mvw it site "mm: ?% of setimeted eenatrvetien doru
Mina Into"vemom,pormit - Clay IVI See amahed 1~mle
ffupacdon Fee 3
Prwelq�.
Ca�rr�� t t ttt BoneAMR
Ir'we,etl m-6 _.
TOTAL: i
Realtrt No.
Rowk, s ey Dote
Reowded by
PMky Ntwnper
'
ri , /ryly{
2774
1lRMIT VALIDATION
p411M"T NO,
DATE APPROJED
1XPIIIATION
DATE ISSUED
low
AdminilVetnt AVlha'ltY
Tellapnort.: (6i9) 777-7075
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