0554NOTE:
With pr.oper'validation
this form constitutes an,
encroachment permit
4
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OVERSIZE LOAD ONE TRIP 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 III
DATE: 4/3/90 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION — MOVE F.OTTTPMEN.T
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION move -250 loader Sk t h ( h I f
DESCRIPTION OF CONSTRUCTION
f
DIMENSION OF INSTALLATION OR REMOVAL
1�ha�l •z�r7�1. l-,��r.l��- roiT,nv...se��}�
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/3/90,
e c 0 G construction p ans i appropriate)
HAUL ROUTE:. AVE. 50 to�Washington
to Eisenhower Drive, N to
Coachella Drive,
Co. Permit D-4-90-3
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.
Notifythe 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 wUoW.
Sigria'tu"Fe 6f/Applicant or Agent
F. J:°-Stowells PO Box 10.59 Vlndo, CA 92201
Name of Applicant (please print) Business Address —4 Telephone No.
Name of Contractor and Job -Foreman Business Address 4, Telephone No.,
on file on file
Contractor's License No. 'City Business License No. ,
,,on file
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class 1.11
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 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No
Received by
Date
100 5i CASH i 5i A�4 43-94.i0.40 10
0554
PERMIT VALIDATION
PERMIT NO. 0554
DATE APPROVED d /i fan
EXPIRATION DATE 4/3/90
DATE ISSUED 4/3/90
By
Recorded by II TELEPHONE: (619) 564-2246
Administrative Authority
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OVERSIZE LOAD ONE TRIP 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: 4/3/90 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION — MOVE EOUIPMENT .
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION move 250 loader Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION HAUL ROUTE: AVE. 50
to Eisenhower Drive,
Coachella Drive
DIMENSION OF INSTALLATION OR REMOVAL
-4dth hgigb I J oug= ht Co: Permit D--4-90-3
./ J fig
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/3/90
to
/3 90
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:
to Washington
N 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 4
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:
Signa'tu're 6f/Applicant or Agent
F. J. Stoweils PO Box 1059 VIndio, CA 92201 -
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on file on file
Contractor's License No. City Business License No."
.on file
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III gOSi ' 10 V -03-90 10
-Public improvements: 3% of estimated construction costs iQ CAS 1 0 rAi 10 ..00
Private improvements: 3% of estimated construction costs
N1• -p
0554
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: {' $ 10.00
Receipt No
Received by
Recorded by
Date
PERMIT VALIDATION
PERMIT NO. 0554
DATE APPROVED
4/3/90
EXPIRATION DATE
4/3/90
DATE ISSUED
4/3/90
By
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an
encroachment permit
i
CITY OF -LA QUINTA
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 IMPR,OVEMENTS'and APPROVED SUBDIVISIONS
Subdivision Improvement Permit - Class I II
DATE: `�-� ~ Minor Improvement Permit Class 1V
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 4.5_o U Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTR�1�
DIMENSION OF INSTALLATION OR REMOVAL
PPS/Q 11 1,f"ZIPUZ -
Tv
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION ' 70
ESTIMATED CONSTRUCTION COST.$ �
(lnclud!ng,remova! cf all obstructions, 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. r
of Applicant
K
Name of Applicant (please print) Bustness Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License N City Business Li se 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 lr
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
Il
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
r
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246
t
F.,X. S' TOWELLS, JR.'; . 3'3 4 8'
• M: J. 'STOWELLS: '• ,� �nri r ,.
P ' O:.BOX 1059 `t 774-1359
INDIO:CAt9?202:-9Q-288/1272
r
s.rcK
p_ L 45900:Far
4lndio; CA 92201
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