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4418n NOTE: SAC 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 6/21/05 Subdivision Improvement Permit — Class III DATE: —555 Desert Club Drive AP I1fnclr71( pf9Y Ue6j Permit Class IV LOCATION OF CONSTRUCTION tS 11 (Street address or Description of Lo ation) PURPOSE OFCONSTRUCTI N Precise Grading It SCRIPTION,OF CONSTR CTION G ading, Dra PSNo 05049 a d 05085 DIAENSION OF -INSTALLATION OR RE40VAL 125 SIZEVF EXCAVATION, IFINEEDED APPRCIXIMATE TIME WHgN WORK WALL BEGIN APPRO (MATE TIME OF OMPLETI v� ESTIMA ED CONSTRUCT ON COST s - (Includin removal 'of all o struction, aterials, and debris, backfilling, c paction a placing perma ent resurf cing and/or replacing improveme In conside tion of the gr nting of t is permit, the applicant hereby Indem ify,.defend,and save the Ci its authorized agents, officers, repr penalti , liabilities or loss'resultin from claims or court action and ari happeni g or occurrin as a proxi ate result of any work undertaken un Notify a Administr ive Authorit at least twenty-four (24) hours in a Comply ith all appl cable City Or inances, the terms and conditions o La Quint and to pa for any addi "onal replacement necessary as the Sketch (attach construction plans if appropriate) 9394 r6 J to: es ntatives d employees, harmles from and against any and al si g out of ny accident, loss or mage to persons or proper er the per it granted pursuant t this. application. ance of t time when work wi I be started. the permit d all applicable rule and regulations of the C' y of cult of this ork. Signature of Applicant or Agent James F. ell 100 Drake's anding Rd., S e. 105, Green rae, CA 9 904,415-46 —0900 Name of Applica (pl ase print) Business'Address /.elhone No. Mar P well u ll Pacific Construction Co. address abov 760-40 —4848 Name of Contractor and Job Foreman Business Address Telephone No. '14F,1 5 Contractor's License No. City Business License No. NIC Insurance Company. G5513998 Applicant's Insurance Company icy Number FEES: Subdivision Improvement Permit — Class I I I Public improvements: 3% of estimated construction costs ` C(% eU1 6,z�,/ l Private improvements: 3% of estimated construction costs 5 5 Minor. Improvement Permit.— Class IV: See attached schedule N!- 4418 Inspection Fee $ _ PERMIT.:: VALIDATION Permit Fee 4418 PERMIT NO. Penalty Cash Deposit -Surety Bond DATE APPROVED if required EXPIRATION DATE TOTAL: $ DATE ISSUED Receipt No. BY Received by Date Administrative Authority Recorded by Telephone: (760) 777-7075 With -proper vat idati;onY this form"'constitutes ari encroachment permit'— CITY 'OF LA QUINTA `- � --APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction oflpublicl*or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public work`im�provements,in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS 6/21/05Subdivision Improvement Permit - Class I I I DATE: '1-555 Desert Club Drive AP # 770 Minor Improvement 00Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Lo Iation) PURPOSE OF CONSTRUCTION Precise Grad 1 I t D SCRIPTION OF-CONSTR���J1CTION G ading, PSNo 05049 arld 05085 DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IFINEEDED Sketch (attach construction plans if appropriate) APPROXIMATE TIME WON WORK WILL BEGIN 7/7/05 APPROXIMATE TIME OF OMPLETION 8/15/05 ESTIMAT11ED CONSTRUCTION COST a 2�o (Includindhremoval of all obstruction, materials, and debris, backfilling, c Nm- paction a______n111111d placing permanent resurfacing and/or replacing improvements) _ In consideration of the granting of this perm it,�-_tlie(applicant Hereby agrees to: Indemrjify, defend• and save the Cily, its authorized agents, officers, representatives penaltillls, liabilities or loss resulting frorh claims or court action and arisieg out of i n . x,".. N happeni`g or occurring as a proximate result of any work undertaken under the per Notify t e Administrative Authority! at least twenty-four (24) hours in advance of t Comply with all applicable City Ordinances, the terms and conditioris off the permit La Quint and to pay for any additional replacement necessary as the 5esult of this s r,r A f` Janes F. ell 100 lralw anding„Rc Name of Applicant (please print)•V r► Mark Powell o-11v Pacific dAstructiot Name of Contractor and Job Foreman 1 �6§§�3995� �4h19� Contractor's License No. NIC Insurance Company Applicant's Insurance Company 1 93,9(4 .6 J employees, harmless Ifrom and against any and al iy accident, loss or dyamage to persons or property it granted pursuant V this application. time when work wi I be started. id all applicable rule and regulations of the Ci. y of ,ork. a /Signature of App icant or Agent 105 , Green rae , CAS 9� 904 415-46� -0900 Busi ess Address Telephone No. address {abov1 760-401-4848 Business Address V Telephone No. City Business License No. G5513998 - 7 ,Po. cy Number FEES: Subdivision Improvement Permit - Class I II ( ( V Public improvements: 3% of estimated construction costs 15 SU �'� 6�Z' Private improvements: 3% of estimated construction costs O� Minor Improvement Permit - Class IV: See attached schedule 4418 le� Inspection Fee $ PERMIT VALIDATION Permit Fee 4418 PERMIT NO. Penalty Cash Deposit -Surety Bond DATE APPROVED ` if required EXPIRATION DATE TOTAL: $ DATE ISSUED Receipt No. By Received by Date - Administrative Authority Recorded by Telephone: (760) 777-7075 a -- NOTE: With proper validai this form constitut encroachment perr 't 2 n , s. an 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 6/21/05 M Subdivision Improvement Permit — Class III DATE: 51-555 Desert Club Drive AP .ino7ImprovementCPermit Class IV —001 LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Precise DESCRIPTION OF CONSTRUCTION vrnSa.A.aag PSNo 05049 add 05085 t DIMENSION OF INSTALLATION OR REMOVAL SIZE',F EXCAVATION, IFINEEDED APPR XIMATE TIME WHI-N WORK WIt L BEGIN 7/7/05 APPROXIMATE TIME OF COMPLETIO 8/15/05 ESTIMAJED CONSTRUCTION COST - (Including removal of all obstruction, aterials, and debris, backfilling, c paction an'd placing permanent resurfdcing and/or replacing i mproveme In consideration of the granting of this'permit, the,. applicant hereby Indem `ify, defend, and save the Ci� ,` its authorized ,agents, officers, repre penaltiQs, liabilities or loss resulting from: claims or�court action and aris happem g or occurrinj as a proxi ate result of any work undertaken un Notify e Administrative Authorit at least twenty-four (24) hours in a% Comply 1 ith all appi cable City Or, the terms and conditions of La Quint{$ and to pa, for any additional replacement necessary as the 4e James F. ellj 100 P-gake's, anding„Rd:. � Name of Applicat't (pl ase print)' 4j ^' '`" .. ! 1business Address address a�b Sketch (attach construction plans if appropriate) H L.q -- � 1 m- ts) ad`rees to: sfentatives nd employees, harml( iehg out of any accident, loss or (Vance the per it granted pursuant of t e time when work v the permit nd all applicable rul( sult of this work. of trlc Powe11)3iy Pacific C©netruc Name of Contractor and Job Foreman s 346196 Contractor's License No. NIC Insurance Company Applicant's Insurance Company FEES: Subdivision Improvement Permit — Class I II S1�'4. 105, Ore Business Address 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. r Received by Date Recorded by from and against any and al IIamage to persons or proper y D this application. I be started. 0 and regulations of the C /Yof cant or Agent / rae, CAS 9,1904 415-46/�0900 ,./� 760-409--4848 TeJerphone No. Telephone No. City Business License No. G5513998 "`? Policy Number 4418 �1 PERMIT VALIDATION 4418 PERMIT NO: I DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority Telephone: (760) 777-7075 f- NOTE: With proper validation this form constitutes an CITY OF LA QUINTA r 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 6/21/05 Subdivision Improvement Permit — Class II I DATE: 51-555 Desert Club Drive AP Mein yr70 p182 001 Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION PreCfoe Grading DESCRIPTION OF CONSTRICTION 6MSAdaAg'\0ra PSNo 4500 a4d 05065 V DIMENSION OF INSTALLATION OR REM10VAL SIZE`OF EXCAVATION, IFINEEDED APPROXIMATE TIME WF APPROXIMATE TIME OF ESTIMATED CONSTRUC (Including removal of all paction and placing perm In consideration of the gr Indeman��ify, defend, and penalties, liabilities or happening or occurring Notify t1he Administrant Comply with all applic La Quinta and to pav; WORK WILL BEGIN Sketch (attach construction plans if appropriate) Lj 1�1 TION COST$` �r's • s{� as rsais,.�:u�.. obstruction, materials, and debris, backfill�ing om- an ent resurfacing and/or replacing improveme s) t anting of this permit, the applicant hereby agrees to: save the City, its authorized agents, officers, representatives E nd employees, harmless from and against any and all loss resulting from claims or court action and arising out of [any accident, loss or damage to persons or property as a proximate result of any work undertaken under the per nit granted pursuant to this application. ive Authoritl at least twenty-four (24) hours in advance of th'e time when work w II be started. r able City Ordinances, the terms and conditions ofithe permit Ind all applicable rule and regulations of the for any additional replacement necessary as the result of this work. i City of J JamesP. l l f 100 Arake' s l$and i, Name of Applicant (please print) Mark Fovel Wily Pacific Coau�x Name of Contractor and Job Foreman 346196 Contractor's License No. NIC Inczurnacu Company Applicant's Insurance Company Signature of AppFlicant or Agent ng 'Rd*, 8 . 105, Green�rrae, CA` c3�9D4 415-46�4�'�-©}©a Business Address Telephone No. ,� uc on f Co, address abov 760-40 �-4848� Business Address S Telephone No. 596, 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 Recorded by City Business License No. G5513998 "-' Policy Number I F .•% Li , . 4418 PERMIT VALIDATION 441 d PERMIT NO,. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority Telephone: (760) 777-7075 +NOTE: '\-:. •,, t �, With proper validation this form constitutes an encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) t 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 6/21/05 Subdivision Improvement Permit — Class III { DATE: Minor Improvement Permit Class IV 51--555 Desert Club 'drive AP 0 / rf3- 18E !_Uul LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTIONSketch (attach construction plans if appropriate) DESCRIPTION OF CON,STR ICTION ';Odlir8 \Oralna g6 r DIMENSION OF INSTALLATION OR REMOVAL t) SIZEbF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WI�L BEGIN APPROXIMATE TIME OF COMPLETION' bf 15/05 ESTIMATED CONSTRUCTION COST $'�""^''��` Y�` (Including removal of all obstruction, materials, and debris, backfilling, com- L. paction and placing permanent resurfacing and/or replacing improvements) In (consideration of the granting of this permit, the applicant 'hereby agrees to: IndemLy, defend• and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all/ penaltie�, 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 un der the permit granted pursuant t` this application. Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.! Comply Lth all applicable City Ordinances, the terms and conditions of/the permit Id all applicable rulesland regulations of the City of La Quint and to pay for any additional replacement necessary as the result of this work. r ! t tie of Applicant or Agent veil 100 Drr�klOs .�,landins Pd., Sty►. 2p5a Crass+ ram, CA 9 904 415-6644/0900 Name of Applicant�`(please print) �✓� Business Address i f Telephone No. Mark P0,W6 .�)KAil. Pacific Co:tatruC chits Ca. address abuvi 76�5•-#€#4�-484ti Qv, � r r f 1 Name of Contractor and Job Foreman Business Address % Telephone No. 346196 5963 Contractor's License No. City Business License No. NIC lusulrguica Ccmpauy r G55.13998 Applicant's Insurance Company 11 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 Recorded by r Policy Number r 4418 PERMIT VALIDATION PERMIT NO, - DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority Telephone: (760) 777-7075 l i, e