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407044 4. 4- w NOTE: With proper validation this form constitutes an encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 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 III DATE: 1-20-04 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 71777 San Jacinto Dr Cross Street of Indian Hill (Street address or Description of Location) PURPOSE OF CONSTRUCTION Renair Pavinsc Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 3'x2'6" West Side of San Jacinto; 159' a sPL of San Jacinto Dr. 2 Cuts DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE. TIME OF COMPLETION )(-- ESTIMATED CONSTRUCTION COST$ t (Including remova of all obstruction, materials, and debris, backfilling, c m- paction and lacin' p permanent resurfacing Ind/or replacing improvemen s) In consideration of the granting of this per1mit, the applicant hereby ag ees to: Indemnify, defend and save the City, its 1 thorized agents, officers, Seprese tatives and a ployees, harmless fromZ against any and all penalties, liabiliti or loss resultind, from claims or court action and arisin out of any a cident, loss or damagI to persons or property happening or occ ring as a proxim'te res�lt of any work undertak n under the permit gr nted pursuant to t Is application. Notify the Admini rative Authoritj at lea t twenty-four (24) hours, in adva a of the tim when work will`be started. Comply with all applicable City Ordinances; the terms and conditions of the ermit and all applicable ruI hand regulations of the City of La Quinta and to pay for any additional replacement necessary as"the result pf this work. Signature of Applicant,orAgent Southern Ca f, iA Gas Co 1; PO Boy: 3003; Redlands, CA; 909-335-7963 Name of Applicant (please print) Business Address Telephone No. AM Ortega Construction: 10125 Channel Ad; Lakeside, CA; 619-390-1988 Name of Contractor and Job Foreman Business Address Telephone No. 04114 Contractor's License No. City Business License No. L Applicant's Insurance Company , Policy Number FEES: Subdivision Improvement Permit — Class 111 Public improvements: 3% of estimated construction cos'ti `` v Private improvements: 3% of estimated construction costs C Minor Improvement Permit — Class IV: See attached schedule ► R' 4 070 Inspection Fee $ 11 PERMIT VALIDATION Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No Received by Date PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority Recorded by 11 -Telephone: (760) 777-7075 NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 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 III DATE: 1-20-04 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 71777 San. Jacinto Dr Cross Street of Indian Hill (Street address or Description of Location) PURPOSE OF CONSTRUCTION Repair Paving DESCRIPTION OF CONSTRUCTION 3'x2'6" West Side of San Jacinto; 159' s/sPL of San Jacinto Dr. 2 Cuts DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDE APPROXIMATE TIME WHEN WORKWILL B9GIN APPROXIMAT TIME OF COMPLET'ON ESTIMATED CCIVSTRUCTION COST $ (Including remod of all obstruction, ateri Is, and debris, backfilli g, c m- paction and placin permanent resurf cing nd/or replacing improv men s) In consideration of the granting of t is pe mit, the applicant here y ag ees to: Indemnify,.defen • and save the C penalties, liabiliti or loss result! happening or occu ring as a proxi Notify the Adminis rative Authori its at(It thorized agents, officers,�ep fromlaims or court action an at to res of any work undertak u at leaAt twenty-four (24) hours! in Sketch (attach construction plans if appropriate) atives and a ployees, harmless frVsatplication. d against any and all out of any a cident, loss or damo persons or property the permit gr nted pursuant tot of the timed when work willAe started. Comply with all appicable City Or§iinancesl the terms and conditi ns of the ermit and all applicable rul and regulations of the City of La Quinta and to pa for any add! ional re Unecessarythe result f this work. Signature of Applican_o Agent Southern Ca 'f rria Gas Company; PO Boy: 3003• Redlands, CA; 909-335-7963 Name of Applicant (please print) Business Address Telephone No. M Ortega Construction: 10125 Channel Rd;.Lakeside, CA; 619-390-1988 Name of Contractor and Job Foreman Business Address Telephone No. r� 04114 Contractor's License No. V C City Business License No. Applicant's Insurance Company \ Policy Number FEES: Subdivision Improvement Permit — Class III Public improvements: 3% of estimated construction cos s �^� ,,� Private improvements: 3% of estimated construction co s 1 - �kMinor. Improvement Permit'— Class IV: See attached schedule i V 407 Inspection Fee $ II PERMIT VALIDATION Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Date PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority Recorded by Telephone: (760) 777-7075 NOTE-: With proper validation this form constitutes an encroachment permit CITY OF .LA QUINTA APPLICATION FOR PERMIT .PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 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 III DATE: 1-20-04 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 71777 San,Jacinto Dr Cross Street of Indian Hill (Street address or Description of Location) PURPOSE OF CONSTRUCTIONReaair Paving Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION -3'x216" West Side. �• of San'Jacinto; 159' s/sPL of San Jacinto Dr. 2 Inuttg . DIMENSION OF INSTALLATION OR REMOVAL r � SIZE OF EXCAVATION, IF NEEDED ) r APPROXIMATE TIME WHEN WORONILL BdGIN 2129/04\ r M ) APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, coyym- paction- and placing permanent resurfacing and/or replacing improvMen3s) In, consideration of he granting of this permit, the applicant hereby aglees to: \ i Indemnify, defend and save th'e�Cit', its thorized agents, officers, represe tatives and employees, harmless from end against any and all penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damagg to persons or property happening or occu nng as a proximate reslt of any work undertak under the permit gr nted pursuant to t fs application. Notify the Admi'is rative Authorit at.lea t twenty-four (24) hours in advance of the time when work will a started. ``. Comply with all appl'cable City Or�linance� the terms and conditions of the eermit and all applicable rule and regulations of the City, of La Quinta and to pa�for any addi6tional. replacement necessary as the result bf this work. Signature of Applicart ot'Agent Southern Ca f rnia Gas Com ny; PO Box 3003; Redlands, CA;: 909-335-7963 Name of Applicant (please print) Business Address Telephone No. AM O:rteaa Construction: 10125 Channel Rd;.Lakeside, CA; 619-390-1988 Name of Contractor and Job Foreman Business Address Telephone No. 04114 Contractor's License No. ��� C. City Business License No. lJ y Applicant's Insurance Company 1 Policy Number FEES: Subdivision Improvement Permit — Class 111 (` Public improvements: 3% of estimated construction cos is Private improvements: 3% of estimated construction cos s C_ C� Minor. Improvement Permit —Class IV: See attached sched �le r')�A V �'+a�i, 4070 a.. V v w Inspection Fee $ II PERMIT VALIDATION Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Date PERMIT NO, DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority Recorded by 11 Telephone: (760) 777-7075 NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 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: 1-20-04 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 71777 Sant Jacinto Or Crown Strcet of Indian Bill (Street address or Description of Location) PURPOSE OF CONSTRUCTIONn000ir PctvinR DESCRIPTION OF CONSTRUCTION 3"=2'6" Wont Jido of Sort Jacinto; ISVI a/oil. of ban Jacinto Vr. 2 Cutc DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDE APPROXIMATE TIME WHEN WORK�NILL BEGIN APPROXIMATE, ESTIMATED CO (Including remov paction and plat In consideration TIME OF COMPLETION f NSTRUCTION COST$ I l of all obstruction, materials, and debris, backfilling, com- ing permanent resurfacing and/or replacing improvements) Indemnify, deferid penalties, liabilitie happening or occL Notify the Admin Comply with all a La Quinta and to Sketch (attach construction plans if appropriate) granting of thtis perrmit, the applicant hereby agrees to: and save the City, its authorized agents, officers, representatives and a ployees, harmless fro or loss resulting` fromsclaims or court action and arisin�i out of any accident, loss or damag ring as a proximate result of any work undertaken under he permit granted pursuant to t 'is native Authority at least twenty-four (24) hourslin advance of the time when work will be ll�a 1 7 �y m and against any and all e to persons or property s application. started. placable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of )ay for any additional replacement necessary asfthe result of this work. Signature of Applicant.or`Agent nouthern IfIlo, Gass Co�D_V:PO Bon. 30031 Radlanda, CAt 009--335-7963 Name of Applicant (please print) Business Address Telephone No. tali; Ortega Corutruction: 10125 Channol Rd; Lai ocidr,, CA; 619-390- 1930 Name of Contractor and Job Foreman Business Address Telephone No. ( 04114 Contractor's License No. ,• ( ) r C C-' City Business License No. Applicant's Insurance Company t Policy Number FEES: Subdivision Improvement Permit — Class 111 Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction cost ss f• Minor. Improvement Permit — Class IV: See attached schedule r, Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority Telephone: (760) 777-7075 -.I w a • co NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) 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 III DATE: 1-20-04 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION 71777 Can .Jacinto Dr Crnua Street of Indian Rill (Street address of Description of Location) PURPOSE OF CONSTRUCTION ReVoLr Payinll Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 3'tt2*6" W"t Side of San Jacinto•, 15V' arorl, of ban Jacl ito 0 r. Z cuto DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN ( c APPROXIMATE TIME OF COMPLETION 1 { ESTIMATED CONSTRUCTION COST$ T (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) In consideration ofthe granting of tFiis permit, the applicant hereby agrees to: j t I 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 fromIclaims 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'e permit granted pursuant to this application. Notify the Administrative Authority- at leat twenty-four (24) hours in advance of the time when work will be started. * F 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. f r( '• i Signature of Applicant or Agent Southorn CAlfotnto Gnu Cd_bpant *' PO Don 3003; Radlando, CA; 909-33-5-7963 Name of Applicant (please print) Business Address Telephone No. lilt Ortato Conutructiont 10125 Chunnal Il.QI Lakootdc, GA; 619-•390-1900 Name of Contractor and Job Foreman Business Address Telephone No. 04114 Contractor's License No. ICity Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III 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 Date PERMIT VALIDATION PERMIT NO DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority Recorded by 11 Telephone: (760) 777-7075 1-26-04; 2:39PM;TECHNICAL SERVICES 19093357527 #F 2/ 4 ' WR # 1312973 a 91" NOTE= VAM yrawr widrWn ttua mit IVeaornpwwe MY OF LA WINTA �~ rawwd M+wnt pareni APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROaACMMENT) For 11M aw"wctlon Of "WWie Or 069M 6mbe, d+wrem pevemm tr, SWO-OM Wkkq am, am", mew mires N4 COW Gill "ink=s Ilnp *vWA t 1n aemaroNon..ia MINOR IMPROVEMENTSanalAPPROVEOs0001V1 ou DATE: 1-20-04 S"bovkian Iawommm hnnft - C4ts 111 Mktar lalap e—ON Fwmit Claw IV LOCATKIM OF CONSrRUCrION 71777:SAN JACINTO DR CROSS ST OF INDIAN HILL li�w o•rrrgmlam.f �. artlawl PURPOSE �OFCpONSTRUCTiON -vevTNr_ orlr.y_ .sT SME 0 MM: JASCitI�NeuTtO 159 ssL p atlttttfuetial piers If �oOrovdaal DIMtMS10N OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED AMROXIMATE 1AIME 29M"I•L SEQIM D AVING ON ONLYY APPROXIMATE TIME OF COMPLETION ESTIMATED CONbTRUCTION COST* (Ir dWkV tmrwmg of all Obunmalpn, wd&W414 W4 dsbrM, bA*twkq, COW p wdm and Dlmft Wmwwe M-fedrq &ww npypry Wwftom rmj In *—Wwatllon of tNa Wmzing of thin pomiL ma spoiwK An.by aras to: ana.r.rN, arfod a,y �,. err aM. lta.�awtsw qrw� oMiari, ntararimWiw uta.aslaNaL A- -W from ma ern am and an amn"um I+' mill- w boo "awsive haw ek mrJ w owes amwe ad arwq art of A" smicb „R l = or a.mM. to pw. it propow Nwa..a.s .r orwrim a*. tmwwww" PENN M ar Wolf wr rwkm www towa /wk ww4w pwft.at . wdapltaua,� kWh ar AoMmiWakm Ar"sip a swat bwr,l.faw L" hftm M .4ramw of a» vbw VA" "we .w be twr� ��M+► rrw AN aumoft Cap, Orrirrrs w ft . w *wwk►&M M ow wwk ow as "WROW4 n m WA r20AWW ♦ of aq cam .r v slaw w ♦,r awl iar w11 riliawr rrnw� attts.y as wow M w -N w Nwo of ApOkmM (P1wwWW% •. . R PERMIT COORaZNATOR 9a ' ToNpfiorr. N/p �� Noltr. of Qfu=W aM Job Farwrw. ♦trues Amn1.1 TaimphWof fiat Md city &akkl. Lbmm Na AfadicalYt fromwm Canto" • Po+kr Ntrttsr FEET: Subdi *&m lmm .- t tannic - r Oat 111 Publfo IM01 O INN 99 iX of sodmapd awwrutiion a % FtiWV"Ns rwrW 3% of !/dmrnd drsWctWn 9,m Minor Imww.m.rt PMr1Mt - Ckw IV: 6M a - d tdre" mp�cdan Pee rani: F.w .n.lq "It Depmg4waty Bald rquk•d TOTAL; "pt No. miwd 01r Dow Kwded W KRIAT VALIDATION PERMIT 140. DATE APPROVED EXPIRATION DATEE OATII ISSUED By Adminimativ. AuawrilV TELEPHONE: (619) W2246