513-
. 01
Owl
Wit proper validation •
"this form,constitt]tes an
'. * encroachment permit, CITY OF LA QUINTA'
APPLICATION FOR -PERMIT" -
PUBLIC WORKS-. CONSTRUCTION (ENCROACHMENT)
c�
+ For,the construction of public or, private•,curbs, driveways, pavements, sidewalks, 'parking lots, sewers; :water mains. ,
and other Pike public works improvements in connection with,MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
k Reference: W:O.. #543'':11299-i '
1 •`• + i' , Subdivision Improvement Permit = Class�111 , •• -'
�« .DATE:. January 19 •1990 Minor Improvement Permit Class IV' }
` LOCATION OF CONSTRUCTION A-,TP _ 9i4._ NT/g 'inn', W/n R4;;rfi Gnn St- A' Magi gnn st-- 1w /q •150'-
,.
S/O, Airport' Blvd'-'& Madison Street .at AVenue 58 '
(Street address or Description of Location) '
.�..' '
PURPOSE OF CONSTRUCTION telet)hone service -to the Sketch (attach construction plans if appropriate)
i:. area. S/O P.G.A 7,West '� +•
x` DESCRIPTION OF CONSTRUCTION place 2 — telenhone
manholes and 60' of 2" power cond..` See attached Drawings
~" Reference W.PO#543;71299-I
'DIMENSION.OF INSTALLATION OR REMOVAL ' •r. " .
See attached dwas'A—B—C
;SIZE OF EXCAVATION, IF NEEDED 14' T,.x7' ta_xl0 C1PPPJ
-
APPROXIMATE TIME WHEN WORK WILL^BEGIN 3/30/90
•''
.. k. APPROXIMATE TIME OF COMPLETION• ' 4/30/90
- ESTIMATED CONSTRUCTION COST $
41
�i (Including removal of,all obstruction, materials, and debris, backfilling; com
paction'and'placing permanent resurfacing and/or replacing improvements)" ' 4
y In consideration of the granting of this permit, the applicant Ihereby agrees to: !: R
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 applicatiori.'
r, Notify the Administrative Authority at}least twenty-four.(24) hours in advance of the time when work will be started. •�.
� e
r Comply with all applicable City.Ordinances, the terms and conditions ofthe 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 +f
1,41
Signature of Applicant or Agent'.
G.T.
E•.'California83-7,93 Dr. Carreon Blvd,'Indio," CA 92201 '•619/342-0535.
Name,of Applicant (please print) r Business•Address t A Telephone No., "
Name of Contractor and Job Foreman 't Business Address Telephone No.'
Contractor's License No: • i City'Business License No: . • ;
Applicant's Insurance Company ., Policy Number,
,
FEES: Subdivision Improvement Permit = Class I I
r Public improvements: 3% of -estimated construction costs r s • } '.. ' r t,
r Private improvements:'3% of:estimated construction costs ' • - ,
s , .
Minor Improvement Permit — Class IV:,See attached schedule ,
G. D, :3 .
Inspection Fee= $ _0— . 4 'PERMIT VALIDATION ,� ,Ile ,
Permit Fee t —0— y 513 ,
a PERMIT.NO.
'Penalty. J• s • • r -'
1/2
Cash Deposit Surety Bond , '• DATE APPROVED 2/=90• '
•if required•' 6/30/9.0
t y .EXPIRATION DATE +;
TOTAL: $ -0- f Ar • "1/2' 90
y f DATEJSSUED--
r Receipt NO: y - J ' r/`. /:r/c%,-L,.�%t • . :.,'/ - �1 ,
Received by '1 Date By. • ' Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
M
t
<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
Reference: W.O. J[543-11299-I
DATE: January 19, 1990
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION Ay,-, SA . N'/9 Inn' W/O A.IA(ii cnn fit K MArli acin St P/5 1 C;0I
S/O Airport Blvd & Madison Street at Avenue 58
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION telephone service to the
area S/O P.G.A. Ilest
DESCRIPTION OF CONSTRUCTION place 2 — telephone
manhola and 60' of 2" power cond.
DIMENSION OF INSTALLATION OR REMOVAL
See attached3 dwas A—D—C
SIZE OF EXCAVATION, IF NEEDED 1.4' Ta,x7' w.` 3_0 c1pp-_
APPROXIMATE TIME WHEN WORK WILL BEGIN 3/30/90
Sketch (attach construction plans if appropriate)
See attached Drawings
Refernnce W.PO. 4543-71299-1
APPROXIMATE TIME OF COMPLETION � /30/90
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 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
G.T.B. California 03-793 Dr, Carreon Blvd, Indio, CA 92201 61.9/342-0535
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
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
Recorded by
-0-
-0-
-0-
Date —
PERMIT VALIDATION
PERMIT NO. 513
DATE APPROVED 1/22/90
EXPIRATION DATE
6/30/90
DATE ISSUED 1/22/90
By9 �. r
Administrative Authority
TELEPHONE: (619) 564-2246
iy✓ FROMJ INOIO ENG &YCONST. >3:16.1990 -17:08
crillfoinla
.0 FOLLOW
FAXWESSAGE
4„ (Fill out,Completely)
TOTAL NUMBER OF PAGES DATE TIME
(Include Cover Sheet) *'Y`` REC'D' '
SC .
NAMIF (First, Last),. n n
rLA
NOTE:
4ith 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
REFERENCE:W.O.#543-31299-I
Subdivision Improvement Permit,— Class III
DATE: January. 19, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 'Ave 54, N/S 300' W/O Madison St & Madison St E/S 150' S/0
Airport Blvd & Madison St at Ave 58
(Street address or Description of Location)
PURPOSE O D STR CTION telephone. service to the area Sketch (attach construction plans if appropriate)
�U �.G.A. West
DESCRIPTION OF CONSTRUCTION Place 2 - telephone manholes
and 60' of 2 •power cond,. -SEE ATTACHED DRAWING'
DIMENSION OF INST.-,LLATION OR REMOVAL REFERENCE:W.O.#543-71299-I
See attached dwqs A-B-C
SIZE OF EXCAVATION, IF NEEDED 14' 1L.x7'•W.x10 deep
APPROXIMATE TIME WHEN WORK WILL BEGIN 3-30-90
APPROXIMATE TIME OF COMPLETION 4-30=90
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 agents, officers, representatives and employees, harmless from and against any arid 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.
(7,t.
Signature of Applicant or Agent
GTE CALIFORNIA, 83-793 DR-Carreon-Blvd., Indio.;;CA. 92201 619/342- 35
Name of Applicant (please print) ' Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City 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.
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE'ISSUED
By
Received by Date
Recorded by - TELEPHONE: (619) 564.2246
Administrative Authority