0345NOTE:
1kh 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
Subdivision Improvement Permit —Class I II
DATE: 11/1/88 Minor Improvement Permit Class IV x
LOCATION OF CONSTRUCTION Starts at manhole 305' S/0 Ave.* 50 E/S Eisenhower ends
at telephone cable marker 345' SIO manhole or 140' N/o bridge incline
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION need to trench approx. Sketch (attach construction plans if appropriate)
350 to place cable
DESCRIPTION OF CONSTRUCTION
See Permit # 331
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 11/1/88
APPROXIMATE TIME OF COMPLETION 12/30/88
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 .
Hood Communications 'PO Box 845 Bannina CA 714 84.9-1121
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
#378587
Contractor's License No. City Business License No. `
Insurance Co. of North America (See attached certificate)
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 $ 35.00 11
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL
Receipt No.
10.00
$ 45.00
Received by Date
Recorded by
1 hr inspection fee @ $ 35/hr = $35.0
p00518? 10ee720 ii Oi--88
1.0.0
49
5.0 N§ASH J. oja15L 1 45.=,A .0
PERMIT VALIDATION
PERMIT NO. 345
DATE APPROVED
_- 11/1/88
EXPIRATION DATE 2/28/89
DATE ISSUED
By f� .
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:
With proper validation,
this form constitutes an CITY OF LA QUINTA
encroachment permit '
APPLICATION FOR PERMIT
+ PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)c�
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: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OFCONSTRUCTIONDIMENSION OF INSTALLATION OR REMOVAL
.SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
: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 is work.
01
Signature of Applicant or Agent
A/19 C) /If Al fr ,4- 130�! �?yS
Name of Applicant (please print) Business Address Telephone No.
Nam of Contractor and Job Foreman Business Address Telephone No.
Contractor's License. No. / City Business License No.
Z Ca NA r f /¢.41-ieri'c�r
Applicant's Insurance, Company Policy Number
FEES: ,Subdivision Improvement Permit —Class III ��/' /I7SP�'G�iv11
Pubii,CJmprove)?.gents: 3% of estimated construction costs ;i:erm i,f '7:e�
Private improvements: 3% of estimated construction'costs
r N° 345
Minor Improvement Permit ,Class IV: See attached schedule '�'CS, �o
Inspection Fee „., $ •PERMIT VALIDATION
Permit Fee
PERMIT NO.: 7 -�
Penalty
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE
i TOTAL: $
. , DATE ISSUED /
Receipt No.
By
Received by. Date dministrative Authority
Recor,ded,by TELEPHONE: (619) 564-2246