4165NOTE:
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 pivate 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 P r it `Class III
June 16, 2004 �� 1
DATE: Minor Improvement Permit Class IV
11
LOCATION OF CONSTRUCTION 7-985 �v mida Montes a - Villagef Gas Station
(Street address or Description of Locatio.Jn)
� �,M SIdV appearance ®f cOrne appropriate)
PURPOSEIOF CONSTRUCTION p Pp 1 Sketch (attach construction plans if a
of Avee4ilida Montezuma & Aveni .a Bermudas
DESCRIPTION OF CONSTRUCTION BujLjd a one (1) step up l
retairdog wail, fill with dart, cover with stone
pavers J J ! *S a Attached Sp cial Conditio s*
DIMENSION OF INSTALLATION OR RE"MOVALApprox. 30' X 15J'
SIZE OF EXCAV1ATION, IF NEEDED
APPROXIMATE T'`ME WHEN WORK WILL BEGIN JuuC dv,r�vvt
1 1 \
APPROXIMATE TIME'OF COMPLETION July 1, 2004
ESTIMATED CONSTRUCTION COST $ n000.00
(Including removal of 11 obstruction, materi�a�s,�andebris, backfilling, com-
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 fro /andainst 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.
r
Signature of Applicant or Agent
Newell Invsstmenr Services, Inc. (Ted Newell), FOB 1574, LC, CA 92253 (760) 668-1964
Name of Applicant (please print) Business Address Telephone No.
G,L. Scrivens, 61-400 Yucca. Road, Mountain Center, CA 92561 (760) 349-3327
Name of Contractor and Job Foreman Business Address Telephone No.
807645 02484
Contractor's License No. City Business License No.
First Financial Insurance Co. 151F000600
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor. Improvement Permit — Class IV: See attached schedule �, 416
Inspection Fee $ 0.00 PERMIT VALIDATION
Permit Fee No Fee
PERMIT NO. 4165
Penalty 0.00 5/15/04
Cash Deposit -Surety Bond DATE APPROVED F
if required 0.00 EXPIRATION DATE 6/15/05 i
TOTAL: $ No Fee
DATE ISSUED
Receipt No.
BY
Received by Date Administrative Authority
Recorded by Telephone: (760) 777-7075
Erw
NOTE:
W' h 1'd t'
It proper va I a Ion
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
Subdivi ' n ImprovemenrPefm4 — Class III
DATE: June 16, 2004 Minor Improvement ermit ss IV
LOCAION OF CONSTRUCTION 77-985 venida Monte zu a — 'Village Gas Station
(Street addless or Description of Locat
PURPOS OF CONSTRUCTION Prov appearance of corne S4
of Ave ida Montezuma & Aveni4a Bermudas —
DESCRIPTI N OF CONSTRUCTI N B -ld a one 1 stepu
retaini wall, fill w th d'rt, cover with stone
avers *S
DIMENSION 4F INSTALLATIO OR R MOVALApprox. 30 x. 15
SIZE OF EXCA\AATION, IF NEEDED
APPROXIMATE TOME WHEN VkORK WILL BEGIN 'June 20, 0?� 04
APPROXIMATE TI E OF CO PLETIO Jul 1 2004
ESTIMATED CONS RUCTI N COST $ 2 000.00
(Including removal o all obs ruction, mater Is, and de s, backfilling, com-
paction and placing p rman nt resurfacing an or replacing improvements) _
In consideration of the ra ting of this permit, the applicant hereby agrees to:
(attach construction plans if appropriate)
Attached Spacial Conditions*
Indemnify, defend• and save the City, its authorized agents, officers, representatives and employees, harmless fro and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or d age to persons or property
happening or occurring as a proximate result of any work undertaken under the permit granted pur�sua tto 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
Newell Investment Services, Inc. (Ted Newell)., POB -1574, LQ,.CA 92253 (760) 668-1964
Name of Applicant (please print) Business Address Telephone No.
G.L. Scrivens, 61-400 Yucca Road, Mountain Center, CA 92561 (760)•349-3327
Name of Contractor and Job Foreman Business Address Telephone No.
807645 02484
Contractor's License No. City Business License No.
First Financial Insurance Co. 151F000600 ,
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 $ 0.00
Permit Fee XXMMX= No Fee
Penalty 0.00
Cash Deposit -Surety Bond
if required 0.00
TOTAL: g No Fee
Receipt No.
Received by Date '
Recorded by
N® ,,,..1.4165
PERMIT VALIDATION
PERMIT No. 4165
DATE APPROVED 6/15/04
EXPIRATION DATE - 6/15/05
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075
With prop& validation
this form constitutes an
encroachment permit
S
1 , 1
G
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 I II
DATE: June 16, 2004 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION I77, 985 �venida Montezu ` -Village Gas Station + �`
(Street address or Description of Locations)
PURPOSE OF CONSTRUCTION �prov appearance of corne
of Avenida Montezuma &(Avenida Bermudas
DESCRIPTION OF CONSTRUCTION Build a one (1) step up
retainiVg wall, fill with dirt, cover with stone J
pavers f
DIMENSION OF INSTALLATION OR REfMOVALApprox. 30' x 15/"
SIZE OF EXCAVATION, IF NEEDED t
APPROXIMATE TIME WHEN WORK WILL BEGIN June 20, "04
(attach construction plans if approbriate)
e Attached Spelcial Conditio
APPROXIMATE TIML-OF COMPLETION July 1, 2004 /
ESTIMATED CONST�rparmanent
UCTION COST $ 2.000.00 /
(Including removal oll obstruction, materi'als, and debris, backfilling, com-
paction and placing resurfacing and/or replacing improvements)
"In consideration of the\gra �iting of this permit, the applicant hereby agrees to: Zand
Indemnify,.defend• and save the City, its authorized agents, officers, representatives and employees, harmless f�mainst 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.
4
Signature of Applicant or Agent
Newell Investment,Services, Inc. (Ted Newell), POB 1574, LQ, CA 92253 (760) 668-1964
Name of Applicant (please print) Business Address Telephone No.
G.L. Scrivens, 4-400 Yucca Road, Mountain Center, CA 92561 (760) 349-3327
Name of Contractor and Job Foreman Business Address Telephone No.
807645 02484 '
Contractor's License No. City Business License No. /
First Financial Insurance Co. 151F000600
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 N21 4165
Inspection Fee $ 0.00 PERMIT VALIDATION
Permit Fee XXZU= No Fee
PERMIT NO. 4165
Penalty 0.00 6/15/04 '
Cash Deposit -Surety Bond DATE APPROVED
if required 0.00 6/15/05
EXPIRATION DATE
TOTAL: $ No Fee
Receipt No.
Received by Date
Recorded by
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075
0'e'.14dr;.l±�`t-",a2'
A� r
kr
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 I I I
DATE: dune tb, 2004 *+� Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION #77-985 ivenida Montaaa a - Vil'lfagef fans Ststian
(Street address or Description of Location) k
PURPOSE:OF CONSTRUCTION Improvqr appeariance of corne Sketch (attach construction plans if appr)priate)
of Avenida Montezuma 4 JAVeZida Bermudas }
DESCRIPTION OF CONSTRUCTION Euiid' 'S Atlas (I) 6t*P up ►
ret4inl1ig Wall, fill with dirt, cower nth stone t
pavers ! *S c Ai.ttacbed Sp clal CoYsditio G*
DIMENSION OF INSTALLATION OR REMOVAL APPrA ' U" �e I l
SIZE OF EXCAVATION, IF NEEDED
1
APPROXIMATE TIME WHEN WORK WILL BEGIN June .?' +U0)4
APPROXIMATE TIME OF COMPLETIONw July 11 2004 �
ESTIMATED CONSTRUCTION COST $ \2,000.00 f` i
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/oF replacing improvements)
In consideration of the\•granting of this permit, the applicant hereby agrees to: Zd
Indemnify, defend roand save the City, its authorized agents, officers, representatives and employees, harmless fainst 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
happening11
or occurring as a proximate result of an work undertaken under the permit ranted 9 P Y P g 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
Newell. lnventment Services, Inc. (Ted Newell.), P S 1574, LQ, CA 92253 (760) 668-1964
Name of Applicant (please print) Business Address Telephone No.
G.L. Scrivana, 61-400 Yucca Road, Nountain Center, CA 92561 (760) 349-3.3.27
Name of Contractor and Job Foreman Business Address Telephone No.
807645 02484
Contractor's License No. City Business License No.
Virot Financial. insurance Coo 151F000600
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 $ 0.00
Mun No Fees
Permit Fee
Penalty 0.00
'Cash Deposit -Surety Bond 0.00
if required
TOTAL: $ No Fees
Receipt No. 4
Received by Date
' MS
PERMIT VALIDATION
PERMIT NO. 4165
DATE APPROVED 6/15/04
EXPIRATION DATE 6/15/05
DATE ISSUED
By
I
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
I
Subdivision Improvement Permit — Class III
DATE: June• I * ` Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 171-985 Avenida 1! ontazuaa .. Village' Gas $tatiyn
(Street address or Description of Location) 1
PURPOSE OF CONSTRUCTION lrove'ppearance of corner . Sketch (attach construction plans if appropriate)
of Avenida Montezuma 6 "on an be`muaaas � ,
DESCRIPTION OF CONSTRUCTION Build a oue (1) a€ep up )
retaining wall', I± 11 w1th airt, cover with asps ne
pavers �g � At.tac€�ed r�►+riciai Couditiona*
DIMENSION OF INSTALLATION OR REMOVAL&VProX*
SIZE OF EXCAVATION, IF NEEDED
tt
APPROXIMATE TIME WHEN WORK WILL BEGIN Junk 4u' Zt#V4
APPROXIMATE TIME OF COMPLETION 'fury 4, ZUu4
ESTIMATED CONSTRUCTION COST $
!
(Including removal of -all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of th0granting 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 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
Powell laventm.etnt S+ xvtcaa, Inc. (Ted Weaved), POB 1374, LQ, CA 92253 (760) 663-1964 !
Name of Applicant (please print) Business Address Telephone No.
G.L. $criveao# 61-400 Yucca load, Mountain Cc -titer, CA 92561 (760) 349-3327
Name of Contractor and Job Foreman Business Address Telephone No.
$0 7645 02484
Contractor's License No. City Business License No.
First rinancial. Ineurance Co. 151F000600
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
0.00
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
0.00
0.00
X"21M No Fee
Receipt No.
Received by Date
PERMIT VALIDATION
PERMIT NO.
4165
6/15/04
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by
Telephone: (760) 777-7075