4573NOTE: -
With'proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
V
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,
r
Subdivision Improvement Permit —Class I
Janua3ry 3. 2006
DATE: Minor Improvement Permit Class IV �w•
LOCATION OF CONSTRUCTION Desert Shells, 60th and Madison Ave.; TM 32201 ,
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Off —site street, AC, con—
crete, sidewalk etc. (See PSN 05097)
DESCRIPTION OF CONSTRUCTION See Plan Set No. 05097
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION TWO WIR21 l
ESTIMATED CONSTRUCTION COST $ 129�940100
(Including removal of all obstruction, materials, ancFdebris, backfillin
paction and placing permanent resurfacing and/Nrhe
placing improvements)
In consideration of the granting of this permit, /applicant hereby agrees to:
Indemnify, defend• and save the City, its autho%r)ized agents
penalties, liabilities or loss resulting from claims or court
happening or occurring as a proximate result of any work,
Notify the Administrative Authority at least twenty-four (;
Comply with all applicable City ordinances, the terms and
La Quinta and to pay for any additional replacement nece
Tommy Archuleta 27§w8193
Dr.
Name of Applicant (please pri
Name of Contractor and Job Foreman
Contractor's License No.
tch (attach construction plans if appropriate)
ing Pre -con M�ting
ing current liability insurance
ughout lengty of project
officers/presentatives and employees, harmless from and against any.and all
action and arising out of any accident, loss or damage to persons or property
undertaken under the permit granted pursuant to this application.
14) hffols in advance of the time when work will be started.
Acon/itions of the permit and all applicable rules and regulations of the City of
ssary as the result of this work.
w
Signature of Applicant or Agent
ite "I" Bermuda Dunes. CA 278-8193
Business Address , t
Business Address
Telephone No.
Telephone No.
City Business License No.
Applicant snsurance Company Policy Number
FEES: Subdivision Improvemen
Public improvements`
Private improvements
Minor. lmprovemen Perr
Permit — Class I II
3% of estimated construction costs
�3% of estimated construction costs
it\, Class IV: See attached schedule
Inspection Fee $ "
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
4'573
PERMIT VALIDATION
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 II I
DATE: 3anuar y 3, 2006 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Dese-rt Shells, 60th and -Mad-son Ave.; rM 3220,
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Off —site street, AC, con—
_cr,ete, sidewalk etc. (See PSN 05097)
DESCRIPTION OF CONSTRUCTION See Plan Set No. 05097
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
(attach construction plans if appropriate)
endlntc-, Pre —con Mi4etin
g current � ability insurance
bout le:tgt of project -
APPROXIMATE TIME OF COMPLETION Wp
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, an debris, ba/itions
g, om-
paction and placing permanent resurfacing and/ replacing ie ents)
In consideration of the granting of this permit, he applicanagrees to:
Indemnify, defend and save the City, its autho zed a fits, ofepresentatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from clai or co t actarising out of any accident, loss or damage to persons or property
happening or occurring as a proximate result of any wor ununder the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four 12 1n advance of the time when work will be started.
Comply with all applicable City Or n Rces, the terms and c of the permit and all applicable rules and regulations ofthe City of
La Quinta and to pay for any ad itiona replacement necessare result of this work.
Touzzny Archuleta 271
Name of Applicant (please pri
8193 ✓ Signature of Applicant or Agent
ou;at'ry Allo Dr. Suite "1" Bermuda Dunes, C�
I N Business Address
Name of Contractor aria Job ForeNian
Contractor's License No.
Applicant s;t,nsurance
Business Address
FEES: Subdivi'sIN Improvem t Permit — Class III
Public imp vements\30/�o�of'esti mated construction costs.
Private impro mentof estimated construction costs
Minor. Improvement rClass IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
8-211;9
Telephone No.
Telephone No.
City Business License No.
Policy Number
ti
N! 4573'
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075
NOTEF'
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 II I
DATE: January 3, 2006 Minor Improvement Permit Class IV --�
LOCATION OF CONSTRUCTION Desert Shells, 60th and Madison Ave.; TM 32201
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Off —site street, AC, con—
crete, sidewalk etc. (See PSN 05097)
DESCRIPTION OF CONSTRUCTION See Plan Set No. 05097
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
(attach construction plans if appropriate)
ending Pre -con Meeting
P nding current 1 ability insurance
th oughout lengt1f of project
APPROXIMATE TIME OF COMPLETION Ttan W—) ,
ESTIMATED CONSTRUCTION COST $ 1199-91101MJ /
(Including removal of all obstruction, materials, an debris, backfilling,//com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this permit,,he applicant here//b� 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 of d arising out of any accident, loss or damage to persons or property
happening or occurring as a proximate result of any work�undert�ken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twenty-four 1241 ho// rs in advance of the time when work will be started.
Comply with all applicable City Orffinances, the terms and c`on¢itions of the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additiona\replacement necessary// as the result of this work.
Tommy Archuleta 4-8193
Name of Applicant (please print)
Name of Contractor and Job F
Contractor's License No.
Signature of Applicant or Agent
to "1" Bermuda Dunes, C1
Business Address A
Business Address
8—�149
Telephone No.
Telephone No.
City Business License No.
Applicant'sd_,nnssurance'Compa�v Policy Number
FEES: Subdivisian Improvemel
Public improvements
Private improvement
Minor Improvement Per
t Permit — Class I I I
:N3% of estimated construction costs
s: 3% of estimated construction costs
mit\, Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
I `- 4573
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075
7
NOTE:
Witl 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 II I
DATE: January 3, 2006 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Dersert Shellu, 60th and Madison Ave.; TH 32201
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Off —cite aitreat. AC. con"
Crate, sidewalk etc. (Sine
DESCRIPTION OF CONSTRUCTION
Plan Set No.
(attach construction plans if appropriate)
Pre -can H*ting
/ P nding currant l b.ility lneurance
DIMENSION OF INSTALLATION OR REMOVAL th oughout langtly of project
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN ASAP
APPROXIMATE TIME OF COMPLETION TWO W6616
ESTIMATED CONSTRUCTION COST $ 129.940100
(Including removal of all obstruction, materials, and debris, backfilling
paction and placing permanent resurfacing and/or�replacing improver
In consideration of the granting of this permit, he applicant hereb%
Indemnify, defend. and save the City, its author zed agents, offi
penalties, liabilities or loss resulting from claims or court actin
happening or occurring as a proximate result of any work; unde
.v �
Notify the Administrative Authority at least twenty-four (24) h
1
Comply with all applicable City Ordinances, the terms and cod
La Quinta and to pay for any add itional�replacement necessary
r
nts)
agrees to:
o
cers,Jrepresentatives and employees, harmless from and against any and all
n and arising out of any accident, loss or damage to persons or property
r taken under the permit granted pursuant to this application.
urs in advance of the time when work will be started.
itions of the permit and all applicable rules and regulations of the City of
as the result of this work.
Tot=y Archuleta 27 -$193 Signature of Applicant or Agent
David Saccualo 74407 Country Cl b Dr. Suite `I" Bermuda Dunks, CA $76-8199
Name of Applicant (please print) Business Address Telephone No.
i
Name of Contractor and Job F
Contractor's License NoA
Business Address
Telephone No.
City Business License No.
Applicant" Insurance Company Policy Number
FEES: Subdivi
Permit — Class I I I
Public improvements.N3% 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
F . 4573
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Telephone: (760) 777-7075
N;OTE:1�l"s•
s With'`proper validation
this form constitutes an rITY
encroachment permit
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: Je►imary 3. 2006 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Uocart Shod., 60th wid Madi.non Avo. > TH 37201
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Off --site iF Ito—ot, AC, ton -
crate, aideval etc. (Sea PSN 05097)
DESCRIPTION OF CONSTRUCTION Sac Plan Sot 112• 55097
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
Sketch (attach construe
r
PaTsdi.ng Pro -con H
P tixd.ing current k
th ho long \ou9
1l
APPROXIMATE TIME WHEN WORK WILL BEGIN ASAP
f
APPROXIMATE TIME OF COMPLETION TWO WoOkO
ESTIMATED CONSTRUCTION COST $ 129.940,100
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/orreplacing improvements) _
In consideration of the granting of this permit, the applicant hereby agrees to:
on plans if appropriate)
tins
ability irraurance
of project
Indemnify, defend• and save the City, its authorized agents, office rs,f'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, undertayyken 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.
Tormy Archuleta 275-8193 ; � Signature of Applicant or Agent ,
David Saccuako 74-607- Country Cl. b Dr} Suite "1" Barauda Dunoo, CA 75.8199
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address
Contractor's License NO.' �.
Telephone No.
City Business License No.
Applicant's1nsurance Company Policy Number
a
FEES: Subdivision Improvement Permit — Class I I I
Public improvements:�3% of estimated construction costs
Private improvements: 3% of estimated construction costs
h
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
.IV
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
4,
By
Administrative Authority
Recorded by I Telephone: (760) 777-7075