4337FINANCE
cA Z3�
NOTE:
',With proper validation
this form constitutes an
encroachment permit
Revenue Code
CITY 'OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
Cm
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: 02-10-05 Minor Improvement Permit Class IV
20690 AVE 52 -- EAST .OF JEFFERSON — LA CANTERA
LOCATION OF CONSTRUCTION
31123—
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION TO BORE
DESCRIPTION OF CONSTRUCTION
HONE LINE.
ITS DRY DTILI
, CABLE.
DIMENSION OF INSTALLATION OR R MOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK 4LL BEGIN
(attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION _�02 14-05 ry
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 the granting of this permit, the applicant hereby agrees to:
Indemnify,defend• and save the City, its authorized age rs, representatives and employees, harmless from and against anyand 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 wor er a<e the permit granted pursuant to this application.
Notify the Administrative Authority at least twent our (24) hours in advance o he time when work will be started.
Comply with all applicable City Ordinances, the erms and conditions of the permit an all applicable rules and regulations of the City of
La Quinta and to pay for any additional repla ment necessary as the result of this work.
Name of Applicant (please print)
G & R UNDERGROUND (RUSTY)
Name of Contractor and Job Foreman
765654
Contractor's License No.
AMERICAN SAFETY INDEMITY
Applicant's Insurance Company
Signature of Applicant or
Business Address
Business Address
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimat c ion 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
Date
Telephone No.
760-360-7994
Telephone No.
005R7
City Business License No.
'EGLQW 202-05-03
umber
NOV.,: 4337,
PERMIT VALIDATION
PERMIT NO. 4337
DATE APPROVED 02-11-05
EXPIRATION DATE 02-11-06
DATE ISSUED
By
Administrative Authority
Recorded by Il Telephone: (760) 777-7075
:h (attach construction plans if appropriate)
C
CY
' ILI V
APPROXIMATE TIME OF COMPLETIO 02 14-05
ESTIMATED CONSTRUCTION COST $N,✓��
(Including removal of all obstruction, materials, and debris, 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 �horiied age""'nfs; officers, retatives a presennd 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.ern-derta en vaderrtthe permit granted pursuant to this application.
Notify the Administrative Authority at least twenty- of�(24) hours in advance f the time when work will be started.
Comply with all applicable City Ordinances, the/terms and conditions of the permit an d allapplicable 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
STEM KATZ �'� 407 _ .ARCT - P 7M ilUlltIR T_ CA 9A S(il 70;n_57R_nQ70
Name of Applicant (please print) Business Address Telephone No.•
G & R.UNDERGRODND (RUSTY) ( 760-360-7994
Name of Contractor and Job Foreman
765654
Contractor's License No.
ANMCAN SAFETY INDEMNITY
Business Address -1111" Telephone No.
00587
City Business License No.
Applicant's Insurance Company Policyy' umber
FEES:
v a`r ,
CITY,OF LA QUINTA''
APPLICATN. ION FOR PERMIT
iKS 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:11_Y02-10-05 �� �'\ Minor Improvement Permit Class IV
20690 AVE 52 — EAST OF JEEFERSON — LA CANTERA
LOCATION. OF CONSTRUCTION `,
":�,-NOTE'
Wirth proper validation
th.is form constitutes an
encroachment permit
PUBL
Tip 31123—
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION TO BORE
DESCRIPTION OF CONSTRUCTION
EIONE LINE.
NS , DRY E
, CA-OLE .
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated -construction
Private improvements: 3% of estimated construction costs
Minoll:lmprovement Permit —Class IV: See attached schedule
Inspection Fee $
Permit Fee 100.00
Penalty
Cash Deposit -Surety Bond
if required ter_
TOTAL: $�"��
Receipt No.
Received by Date
Recorded by',
144337
PERMIT VALIDATION
PERMIT NO. 4337
DATE APPROVED 02-11-05
EXPIRATION DATE 02-11-06
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075
'With proper validation
.this_form constitutes an
encroachment permit
,fir 'CITY,,"'OF LA QUINTAL
PUB 6' APPLICATION FOR PERMIT
I(t:`iWORKS 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
• ' 4 '",,,,Subdivision Improvement Permit — Class I I I
DATE:` 02" 10-25 ` , Minor Improvement Permit Class IV
20690 AV9 52 — - EM OF J '�tSON — LA CANTS iA '
LOCATION OF CONSTRUCTION -�-�•-
11
(Street address or Description of Location)
TO BORE
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR
SIZE OF EXCAVATION, IF NEEDED
#>Im
.`o" , DIKY Uhl 1' 1I5
a f C1116 E
AL NONE
APPROXIMATE TIME WHEN WORK WILL BEGIN
Blotch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION`"14-05
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 the granting of this permit, the applicant hereby agrees to:
Indemnify,. defend• and save the City, its authorized agg i"Etrs, 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 wor trndertaken � nder the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty'
wenty ofi ur Q,4) hours in advanc of the time when work will be started.
Comply with all applicable City Ordinances, the erms and conditions of the permi� all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this wor
Name of Applicant (please print)
G. & R UNDERGROUND (RUSTY)
Name of Contractor and Job Foreman
7656W
Contractor's License No.
A1=1120 SAFETY 1NDEMTY
Signature of Applicant or A nt
C.., PALK DESERT. Cm 9AA0 760-. 79-0910
Business Address Telephone No.
760--360-7996
Business Address Telephone No.
00587
"^�+•...,� City Business License No.
Applicant's Insurance Company Pol i-pyol umber
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated.censt M c ion costs
Private improvements: 3% of estimated construction costs
Minor. Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee 100.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by
Recorded by
Date
PERMIT NO.
N 433'
PERMIT VALIDATION
4337
DATE APPROVED 02--11-05
EXPIRATION DATE 02-11..-06
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075 '
y
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: 05 Minor Improvement Permit Class IV
20690 AVE 52 - BAST OF JEFVE N - LA C TUA
LOCATION OF CONSTRUCTION
TH 31
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION TO BORE ONE L .
DESCRIPTION OF -CONSTRUCTION 8 '
DIMENSION OF INSTALLATION OR
SIZE OF EXCAVATION, IF NEEDED
A L
APPROXIMATE TIME WHEN WORK WILL BEGIN
(attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION " -1b- 05
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 the granting of this permit, the applicant hereby agrees to:
indemnify,defend• and save the City, its aut o i e8 a en`t officers, re re eentafives and em to ees, harmless from and against an and all
Y, 9 P P Y 9 Y.
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 w suride�taken under_r thepermitgranted pursuant to this application.
Notify the. Administrative Authority at least twentfour (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
nt
STEM." 607'43 CAMA CT., PAM DESERT. CA 92150 760-578-0970
Name of Applicant (please print) . * �N_- Business Address Telephone No.
C A E UNDERMUND (RUM). � 169-360-J7994
Name of Contractor and Job Foreman
765654
Contractor's License No.
AMMCCAN SAFETY" INDEWITY
ness Address Telephone No.
00557
City Business License No.
i �02-�5�-i33
Applicant's Insurance Company Poky -Number
FEES: Subdivision Improvement Permit — Class II I
Public improvements: 3% of estimated�const'ruc ion costs
Private improvements: 3% of estimated construction costs
Minor. Improvement Permit — Class IV: See attached schedule
Inspection Fee $ .05A_ 11
LOO«00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required y
TOTAL: $
Receipt No.
Received by
Date
4337
PERMIT VALIDATION
4337
PERMIT NO
DATE APPROVED�ll�l
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by
Telephone: (760) 777-7075
•-a:NOT�--'_'
ion
With -proper validat
r this form constitutes an
encroachment permit
e
1•
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
w
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: 92"`10-05 Minor Improvement Permit Class IV
9 AVE 52 FAST Of J EWERSON — LA t:&NTM
LOCATION OF CONSTRUCTION 0r' -�
TK
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION TO BORE ARE LIKE.
DESCRIPTION OF CONSTRUCTION' ` U UL1A.LX.X[S
DIMENSION OF INSTALLATION OR REMOVAL iAn
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN V4&4#-Va
Sketch (attach construction plans itappropriate)
4
APPROXIMATE TIME OF COMPLETION,
ESTIMATED CONSTRUCTION COST $�
(Including removal of all obstruction, materials, and debris,Fbackfilling, 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 agentsofficers, 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 wo�yund"&404n"'underthe- permit granted pursuant'to this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance time when work will be started.
Comply with all applicable City Ordinances, the terms and conditions of the permit and"a�ll applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the result of this work? k
Signature of Applicant or Agent
O T. 1fi' 4 3 CASE .. PALK 01SERTo CA 9A50 760--576-0970
Name of Applicant (please print) � Business Address Telephone No.
Name of Contractor and Job Foreman ~"-^ ,.{ Business Address Telephone -No.
765654a --- N i&0587
Coil r KA r�sRLice"VikNo�' t i I iTSi' � :flL6i � City Business License
-i? �di3 0
Applicant's Insurance Company �yAIVumber
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimateo.constr'm16n" n costs
Private improvements: 3% of estimated construction costs
Minor. Improvement Permit — Class IV: See attached schedule
Inspection Fee $ "" -�k "
100.00
Permit Fee
i
• Penalty
Cash Deposit -Surety Bond
if required
.4�450.W-
TOTAL: $ ,. "
Receipt No.
Received by Date
Recorded by
4337
PERMIT VALIDATION'
4337
PERMIT NO.
DATE APPROVED 02- 1.1-05
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075