Loading...
0518NOTE: • . With proper validation f' 4. f this form coristitutes an '• ' •, � � ' .CITY OF" LA QUINTA,' ,. . encroacliment.permit " APPLICATION FOR PERMIT • . ` - ;' PUBLIC WORKS-CONSTRUCTION,`(ENCROACHMENT) c� ONE TRIP; OA OVERSIZE LD PERMIT �' `�;" oF�IE189 For :the' construction of public orprivate curbs, ..driveways, pavements, sidewalks, parking 'lots, sewers,' water mains ' and:Gother like public wo'rk's improvements in cohnection,with MINOR IMPROVEMENTS_ and APPROVED SUBDIVISI}ONS- . Subdivision Improvement Permit Class 11[ 3/6/90f r Minor Improement Permit Class.jlV*DATE: 1, LOCATION OF CONSTRUCTION — TR 9, 4.7 n 'T,akA T.a_ nti i t^if•a (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 'HAUL ROUTE: WASHINGTON TO,Ave. j 50, to `outside. City limits'' f DIMENSION OF INSTALLATION' OR REMOVAL 10 6 ° x 70 SIZE OF EXCAVATION ,'IF NEEDED' APPROXIMATE TIME WHEWWORK WILL BEGIN 3/6/90 APPROXIMATE TIME'OF COMPLETION t y . ESTIMATED CONSTRUCTION COST $ r (Including removal of'all'obstruction, materials, and debris;.backdling, 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,yloss or damage to persons or property, happening or. -occurring as a proximate*, result of any work undertaken under the permit,6ranted pursuant tothisapplication. 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 orAg �nt F.J. 'Stowell:. Jr. PO Box '1059 _ • io.:CA 92201 "* 7.74-1359.. a; ' Name of Applicant (please print) Business Address. Telephone No:; Name of Contractor and J66 Foreman Business Address Telephone�No. Gal T 105959 • ..... •. r„ . , ;F'•t � • '- .• .•Contractor's License No. City Business•License,No: �- California 4Farm �BA0715193 `,Applicant's Insurance Company' Policy Number FEES: Subdivision Improvement Permit — Class III �' a Tublic.improvements: 3% of estimated construction costs" Private improvements: 3% of estimated construction costs a'',' 5i_8'' g5,0 y2,5 b 03-06=90 10 - A,� ?AV AOTAI.' S i.0.00 Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $' " PERMIT VALIDATION tn_ Permit Fee on R PERMIT NOnSl . A Penalty A 3/ 6/ 9 0 f - Cash Deposit -Surety Bond .:DATE APPROVED if required EXPIRATION DATE 316/:90 r $ rn . nn 3/6/901 TOTAL: DATE ISSUED Receipt No. By Received by Date Administrative Authority ' Recorded by TELEPHONE: (619)'564-2246,, '�!�i�w{!�� J�ydir 44.N+1 T.�•MSIr�'w► M M rti by '�+ Rr Y .u.d.. +Yr .ir rw Y .i's?4 W -+M �i. Y Mr Y r .}..M W Y• ip .W .. m.s�y"�""' '.r .r � aif:`A ni � .wr'.�-, Y w +n ♦ Y M 'Ii"W NOTE: With proper validation this form constitutes `an CITY OF LA QUINTA encroachment :perm it APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONE TRIP OVERSIZE LOAD PERMIT 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: 3/6/90 Minor Improvement Permit Class.IV LOCATION OF CONSTRUCTION TR 9.4.9,in T,alra T,a nttinf-a (Street address or Description of Location) PURPOSE OF -CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION . HAUL ROUTE: WASHINGTON TO Ave. 50 to outside City limits DIMENSION OF INSTALLATION OR REMOVAL 10'6" x 701 SIZE OF EXCAVATION,'IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 3/6/90 APPROXIMATE TIME OF COMPLETION 3/6/90 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. F.J. Stowells, Jr. PO Box 1059 yvfto, CA Name of Applicant (please print) Business Address licant or Agent 12201 774-1359 Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Cal T 105959 Contractor's License No. City Business License No. Cal.ifornia.'Farm BA0715193 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 costs5? 25. 03`Ob-90 10 tpl0 Lt';i� I'fAL 1 0.00 Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ II PERMIT VALIDATION Permit Fee 1.0.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10 ., 0 0 Receipt No. Received by Date PERMIT NO. 0518 DATE APPROVED 3/6/90 EXPIRATION DATE 3/6/90 DATE ISSUED 3/6/90A Z1 By— Administrafive Authority Recorded by II TELEPHONE: (619) 564-2246 F J:'. STOWELLS, JR. J.,,:STOWELLS 'P: O:' BOX 1059 774-1358 INDIO, CA '92202,'90 ;7. -288/1222 - T. �lTISI Indio Office • - 45900 Fargo St: Sa)7k Indio, CA 92201 a e Xn 1:4 2 2 20' '21Hiq 3Q3 3 3 5: 0301 1 5n'8 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 DATE: L-2 LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL a Subdivision Improvement Permit — Class Ill 1 Minor Improvement Permit Class IV SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN -?!/,.. Pnn Sketch (attach construction plans if appropriate) P~ a APPROXIMATE TIME OF COMPLETION �4%413 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 lou 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 hi�5j;Jt. - Name of App Applicant or Business Address Lf 4' /VI Name of Contractor and Job Foreman Business Address Telephone No. 644. 7- AVS- 2_K_� 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. NO - Minor Improvement Permit — Class IV: See attached schedule 1V Inspection Fee $ PERMIT VALIDATION Permit Fee PERMIT NO. Penalty DATE APPROVED, Cash Deposit -Surety Bond if required EXPIRATION DATE TOTAL: $ DATE ISSUED Receipt No. By Received by Date Administrative Authority Recorded -by TELEPHONE: (619) 564-2246