DRVA2018-0010ta QU ~ ( ra
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DRIVEWAY APPROACH PERMIT APPLICATION
Applicant Information:
Applicant/Owner (please pthit name here): Joe W Stemmer jr
Applicant Address: 42215 Washington St., #355 Palm Desert CA 92211
Number Street City State Zip Code
Address or Parcel No. of work location, if different from applicant's address above:
53700 Eisenhower Dr, La Quinta CA 92253
Number Street
06 18 18 's Phone No: (760 ) 880-3525 Date: /__ Applicant
Applicant's Signature:
City State Zip Code
Approximate Start Date: 06 I 18 18 06 I Approximate Completion Date: / 24
...........j
18
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Contractor Information:
Address: Owner
Number Street City State Zip Code
Phone Number: (
760 880-3525 Contractors License Number: B605857
City Business License Number: 763387
Target Financial General Liability Insurance Company: Policy
Request for Inspection - Please call (760) 777-7097 before 1:30pm to request an inspection at least 24 hours
prior to your requested inspection date. The Hub Counter (760) 777-7125.
Please Note: Inspections are normally performed Monday through Friday between 8am and 4pm
Permit Fee $156 + $5 Technology Enhancement Fee = $161 Total Fee
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Permit No. Expiration Date O/ 101/ 101
14 /~Q'vj , 4---- Permit Issued by: _______ Date Issued
SigqJre of Adi1 rative Authority
Work Inspected by: Permit Completion Date: J.........J
Inspector's Signature
Comments:
Note: Driveway approach must be constructed per City of La Quinta Standard #221