0860NOTE: i
,! With proper. validation QC9�
this form constitutes an`
encroachment permit CITY'. OF LA ,QUI.NTA
APPLICATION FOR PERMIT '
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OF
�ws x
For the construction of public ' or private "curbs,' driveways, pavements, sidewalks, parking .lots, sewers, water mains-
and
ains"and other like public works improvements in connection with MINOR. IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision,lmprovement Permit`— Class Ill.
October- 3 1990
PATE: Minor Improvement Permit.Class IV -
-LOCATION OF CONSTRUCTION ..•n/s "Fred Warincf e/o Adams • '
(Street address or Description of Location)
PURPOSE OF. CONSTRUCTION - J'p'c+:al 9 „ow r,hnrio soYwiceSketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION saw . cut and•trench '
350' place conduit system GTE permit #a 0799 conditions
shall'apply.to' this permit
DIMENSION OF4NSTALLATION OR REMOVAL 16' • width ,
County of Riverside.permit,is
SIZE OF EXCAVATION, IF NEEDED 36" deep •� also required
APPROXIMATE TIME: WHEN WORK WILL BEGIN 10/0/90 '4 t' .
• APPROXIMATE TIME OF COMPLETION 10/10/9-0-1.—
ESTIMATED
0/10/90`ESTIMATED CONSTRUCTION COST $ 7,213,;00,.
(Including removal of all obstruction, materials, and debris, backfilling, com
paction and placing permanent •resurfacing and/or replacing improvements) a `
In consideration of the, granting' of this permit, the applicant hereby agrees '
Indemnify, defend and. save'the, City, its authohied agents, icer • e r tatives an employees, harmless from and against any and all
penalties, liabilities or loss. resulting from claims or cour ct n and arising out of' an accident, loss or damage to persons or property
happening or occurring as a•proximate•result f.any ork un ertaken under the permit ranted pursuant to this application. .,
Notify the Administrative Authority at le st tw my-four ► hours' in advance' of the tim when work• will be started. '
Comply with all applicable City �Ordinanc s,.the terms and conditions of the permit and all.a plicable rules and regulations of„the City of '
La Quinta and to.pay, for any additional epla ment necessary as the result of this work.
Signature of Applicant or Agent
Rick •Sorbel '849 'S.; Four-Eh St. Bannincj, CA` 714/849-1121
Name of Applicant (please print) '. BusinessAddress Telephone No.
Hood'Communica.tion- same same ,
Name of Contractor and'Job-Foreman•` . Business Address':;. Telephone No.
Contractor's License No. r City Business License:No.
t ,
Applicant's Insurance Company Policy Number
t
FEES: Subdivision Improvement Permit — Class I I I '-
Public improvements: 3% of estimated construction, &sts t
Private improvements: 3% of estimated construction costs , , • ,
Minor Improvement Permit _ Class IV: See attached scheduler �A -0860 , • i
Inspection Fee $ PERMIT VALIDATION .
Permit'Fee PERMIT NO. ,
t
Penalty '
-DATE APPROVED ”
Cash Deposit-Surety Bond
'
if required - EXPIRATION DATE '
TOTAL: $ �+ >' f
_r • DATE.ISSUED
Receipt No.
By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
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NOTE: -
�, With proper. validationiA
this form.constitutes an • •'` ; o
encroachment permit' CITY -OF LA• QUINTA' -
.*
APPLICATION FOR PERMIT $
- PUBLIC WORKS ' CONSTRUCTION (ENCROACHMENT)c� wSw�ti
,b b •
1 .xA-•
' For'the construction of public•or .private curbs'_clriveways, pavements, sidewalks, .parking. lots, sewers, water mains.
' and'othe'r like public, works•improvements„in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS -
` J r Subdivision Improvement Permit — Class'l l l
b
.Octoer .3 ' '
DATE: • � 1990 3 �'t • ,r ' + .` - '. � ''Minor Improvement Permit'Class IV
} LOCATION OF. CONSTRUCTIONt Y 'Wts Fred Wariir ix ii;lo Adams
(Street addressor Description of Locatiori)y Y.�,. `• .+t i
-s .PURPOSE OF CONSTRUCTION��.E,Sketch (attach construction plans if appr-opriate)' t
•. DESCRIPTION OF.CONSTRUCTION SBWwut-and`•.trench `
1350' place coriduit system _ •;0.
GTE -,P'd
mit j 479.9 •conditions
f • r' sh$11 ,.apply 'to.'this permit -
DIMENSION OF"INSTALLATION OR REMOVAL 16 width' .
• ~; county, of -Riverside •permit is. '
36" dee1� also reauite'd •t _
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE.TIME:WHEN WORK WILL BEGIN 1018194^ 4,
APPROXIMATE TIME OF -COMPLETION -10710/90'
"ESTIMATED CONSTRUCTION COST ,$ • �` '7,213.00c'.
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 grariting, of.this, permit; the applicant'herebyragrees to,
/� ' (Yd s '
Indemnify,. defend and sale the City' its authorized agents,,o'ffim,�r"ep_esent' atives mployees, harmless from and against any and all _
penalties; liabilities or loss- resulting from claims or•co�t act n and arising..out of any accident, loss or damage to persons or property
[ happening or•occurring as a proximate result of any wo,klu� ertaken under the permit granted pursuant to this application.
:. .
r Notify the Administrative Authority at least twenty-four (24) hours in advance of the time lwhen �work will•be started. '
., '.�'• a •�
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, asj the result of this�work.�• b 't
f � 1 _ ty-• ` �`Y _ •s � •
Signature of•A' plicant or Agent ,
1 �..
Ri;Ck .Sotbel 849 .. 'cru k S H r riixig., 'GA • 714/849-•x.121.5'' ,
` Name of Applicant (please print), ; Business Address , , ;�,' • ',{•Telephone No. b. .
,Hood commuhicatioh • 's game' ' ' ,•' same
Name of Contractor and. Job Foreman ''r,: ;.' ' Business Address '' ` ' ' Telephone No.
A` Contractor's License No:8 • '� - City Business License No.. = -
Applicant's Insurance'C'ompany• �, �a `y r` - Policy Numbera'
tFEES: Subdivision Improvement Permit _ Class III t • "•'
Public improvements: '3% of estimated construction Costs
Private improvements: 3% o_ f estimated construction costs
. , :~F N°; 0860 '
Minor Improvement Permit.—. Class IV: See attached schedule' '
Inspection Fee ;PERMIT VALIDATION
Permit Fee".
•' t PERMIT NO.
.' Penalty
Cash Deposit -Surety Bond t ;�' ,' -DATE APPROVED
if required , EXPIRATION DATE
14
TOTAL:
DATE ISSUED
Receipt No.
Received by Date Administrative Authority
Recorded by ' - TELEPHONE: (619) 564-2246
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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
Subdivision Improvement Permit — Class III
DATE: October 3, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION n/s Fred Waring e/o Adams
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION i r%e�f-a1 1 „A -t", n1ne_%n,-] OeSketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION saw Cut and trench
350, place conduit system GTE permit # 0799 conditions
DIMENSION OF INSTALLATION OR REMOVAL
16" widthshall apply to this permit
County of Riverside permit is
SIZE OF EXCAVATION, IF NEEDED
36" deep also required
APPROXIMATE TIME WHEN WORK WILL BEGIN 10/8/90
APPROXIMATE TIME OF COMPLETION 10/IU/90
ESTIMATED CONSTRUCTION COST $ 7,213.00
(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
Indemnify, defend and save the City, its authorized agents, officers,,�eprreeseFtatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or co t/ac �in and arising out of any accident, loss or damage to persons or property
1-1 happening or occurring as a proximate result of any workundertaken under the permit granted pursuant to this application.
Notify the Administrative Authority at least twe ty-four V4) hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, thel 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
Rick Sorbel 849 S. Fourth St, Banning, CA 714/849-1121
Name of Applicant (please print) Business Address Telephone No.
Hood Communication s ame same
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 I I
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
�° 0860
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246