1047NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
WIE_ TRIP DUMC'511C COAD PEEKAT
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
DATE
4-7--91
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit —Class I I I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE- 'La U I P Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION L/ Z3 5CKA EK
DIMENSION OF INSTALLATION OR REMOVAL 14'1+ )D r VJ
1 I Do 000 LESS
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)
44-A V L 9 OtJTE
u_)Acb 4 1 kjG70N ST
'FUD w Q R i NG -TO i NiV 1 111
In consideration of the granting of this permit, the applicant hereby agrees to:
MAUL DATE.
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 �u
Signature of Applicant o gent
UUEV0. lzK)G . -7ci - 91) e-00MUN CLUB 6. :314 S -1178
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No. .
coi r-1 LE oly FILA
Contractor's License No. City Business License No.
Onl F1LC oN FILE:
Applicant's Insurance Company Policy Number
FEES: Subdivision Improveme6t Permit — Class I I I(100�iE`CFSPH f S��O�AL 0?-91� i0.A0
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
)D .00
$ 10,00
Date
147
PERMIT VALIDATION
PERMIT NO. 104-7
DATE APPROVED 4' Z —C% I
EXPIRATION DATE Z' G i
DATE ISSUED
By �►^ w•----
ministrative Authority
TELEPHONE: (619) 564-2246
4A f
i3 r
i'
°2�wk04ieX+a
NOTE: i
With proper validation
this form constitutes an
encroach ment'permit CITY OF: `LA: QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)�� t.Sw4
ONS. TKIP 0UI R-5IZC.. (,,DATA PEE KAIT �oFT��
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 APPROV;ED.SUBDIVISIONS
Subdivision Improvement Permit — Class III
DATE: 44-1-` 9 .f Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street'address or Description of Location)
Mf 1E1
PURPOSE OF CONSTRUCTION bVp U I P Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION R OUT'
UJAS4IIUGTON 'ST
DIMENSION OF INSTALLATION OR REMOVAL /4'1+ 'FftF—D WAR..ING, TU N-bU\l 111.
110 000 LESS
SIZE OF EXCAVATION, IF NEEDED
'APPROXIMATE TIME WHEN WORK WILL BEGIN NAVL DATE
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 an,d.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 Quinia and to pay for any additional replacement necessary as the result of this V
Signature'of Applicant o gent
AlVEVO:. 'EK3G. -7 Ci -511 CO NTIN GLIA6 6. x-15 -117 Is
-Name of Applicant (please print) Business Address • Telephone No.
Name of Contractor and'Job Foreman Business Address Telephone No.
.. �� �! L� roti �! L� •
Contractor's License No. City Business' License No.
Qui P1`L nM IFI L -C
Applicant's Insurance Company Policy Number
FEES: 'Subdivision Improvement Permit —Class III UQ i'$'' i 0 4-0''-91 r? ..
z iR `C� H .�O AL Wage
Public improvements: 39/o of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule` O' T
'Inspection Fee$ i' . PERMIT VALIDATION +
Permit Fee )0.0o PERMIT NO. 1041 0 41
Penalty :.
Cash, Deposit -Su rety Bond DATE APPROVED
itrequireclL EXPIRATION DATE q ~ Z Q I
TOTAL>. $ 1 y O® -2
DATE ISSUED
Receipt .No.
By _�_
Received by Date �.. ,,s 7 44,lfvd, . Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
NOTE: •
With proper validation
this-forli�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 I
Subdivision Improvement Permit = Class 111
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 OF CONSTRUCTION lI�
DIMENSION OF I STALLATION OR REMOVAL 1
1 V1
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN ,
APPROXIMATE TIME OF COMPLETIONnl
ESTIMATED CONSTRUCTION COST$
(Including removal of all obstruction, materials, and deb: -is, 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 124) 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 Quints and to pay for any additional replacement necessary as the result of this work.
` Signature of A plcant o 61gent
.Nuevo Engineeririg, Inc. 79-811 Country Club, Bermuda°Dunes 619-345-1778
Name of
A�ppli It /(please print) Business Address Telephone No.,
Name of Cont or and Job. Foreman
U4
Contractor's License No.
Applicant's Insurance Company
11
Business Address Telephone No. .
City Business Li se No.
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
,nspection Fee $ II
ermit Fee
enalty
ash Deposit -Surety Bond
required
TOTAL: $
No.
eceived by Date
ecorded by
Policy Number .
yo7
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
:DATE ISSUED
By
Administrative Authority '
TELEPHONE: 1619) 564-2246