3037C •
NOTE:
With proper validation
this form constitutes an
encroachment. permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
f
1,
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
Subdivision Improvement Permit — Class II I
DATE: 9-02-99 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 78-707 SAGUARO LA QUINTA CA 92253
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION INSTALL BLOCK AND WROUGHT
IRQN _k'A1tL _ AS AUTHORIZED BY PERMIT # 9909-056 ISSUED
BDESCRIPTION OF CONSTRUCTION bNiJCdIX.
CEMENT SLUT' BLOCK 1 TO 3 COURSES. FIVE COLUMNS APPROX
4 FT.TALL WITH STEEL FENCING IN BETWEEN.
DIMENSION OF INSTALLATION OR REMOVAL
33' x 24' x 16'
SIZE OF EXCAVATION, IF NEEDED 1' x I'6" FOR SLMe WALL,
2' x 2' FOR COLUMNS
APPROXIMATE TIME WHEN WORK WILL BEGIN 9-20-99
APPROXIMATE TIME OF COMPLETION 10-04-99
ESTIMATED CONSTRUCTION COST $ 1-500.00
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
Sketch (attach construction plans if appropriate)
In consideration of the granting of this permit, the applicant hereby agrees to:
SEE ATTACHED DRAWING.
SEE ATTACHED CONDITIONS.
Indemnify,defend 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
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 of this work.%�
Signature of Applicant or Agent
JACK NELSON 78-707 SAGUARO LA QUINTA. CA 564-1351
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman
Contractor's License No.
Business Address
Telephone No.
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III > ! x
Public improvements: 3% of estimated construction costs
► •
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
100.00
$ 100.00
Date
-. 07
PERMIT VALIDATION
PERMIT NO. 3037
DATE APPROVED / -�
EXPIRATION DATE
r
DATE ISSUE.
���
gyi-
Administrative Authority
Recorded by
Telephone: (619) 777-7075
e
-----------------------------------------------------------------------
r.
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit S
APPLICATION FOR. PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
C�y0F 71��ws
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
Subdivision Improvement Permit — Class II I
DATE: 1 79 Minor Improvement Permit Class IV
LOCATION OF C/CONSTRUCTION 74 - 20 7 sZ 4' o c? le CD / 1 O eL-A�,(k
F/QC9 N r yQ oQ U
(Street address or Description of Location)
PURPOSE OF CONSTRUCTJON o �- 3" Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION ¢ + u c�;� I
Co a X S'CI o t old tom.
4e.11,tv!
DIMENSION OF INSTALLATION OR REMOVAL I
(
SIZE qF EXCAVATION, IF NEEDED / / o S j`
r,. / �Z I Y"2 or¢ Co/o-A+ 4
APPROXIMATE TIME HEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ —,T
(Including removal of all obstruction, materials, and debris, backfilling, corn-
-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Indemnify, -defend 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
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 a plicable rules and regulations of the City of
La Quints and to pay for any additional replacement necessary as the result of th' work.
J/ Signature of Applicant or Agent
aC`< //e%so-n 7 9' 707
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business' Address Telephone No.
Contractor's License No.
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class II I
Public improvements: 3%of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
Date
2774
PERMIT VALIDATION
PERMIT NO. ?O 3
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Admihistrafive Authority
Telephone: (619) 777-7075
SPECIAL CONDITIONS --PERMIT NO.3037
--- JACK NELSON ---
The block and wrought iron wall may encroach into the public right of way 1.5 feet (18 inches) as depicted
on the attached sketch, subject to the conditions of this encroachment permit.
1. The wall encroachment authorization is secondary to any public need. The wall may be removed
without replacement'by the City, or by the permittee at the permittee's expense, if necessary:
2. As of the permit issuance date, there are no known, or planned, public facilities or utilities that need
to utilize the encroachment area in question. If in the future, a public need arises whereby use of the
encroachment area in question is needed, it is understood that the public need takes precedent and
the permission granted by this permit to make use of the public right of way may be revoked upon
written notice from the City.
3. Install block and wrought iron wall as authorized by Permit # 9909-056 issued by the Building and
Safety Department.
T