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0557-... �..I y1 .�, -..: ,.--._i..r _-rte -. Y ...- ._ - _ ..'�+r.":,an , ' _ •. W..,•i..�•Y'..w a �� fi.. ._ ._ - .. n_ — r _ .-. _. .- v+... -- _ -._ ,. .._ .� _, NOTE With proper validation this form constitutes 'anwLw• CITY OF LA .QUINTA' encroachment permit F0: t . APPLICATION FOR• PERMIT A PUBLIC "WORKS CONSTRUCTION (ENCROACHMENT) s. One Trip Oversize' Load Permit, ' : �oF�ti �` ;. For the construction of public or private curbs,'driveways; pavements,•sidewarks, parking lots,'sewers, water mains :and othe���Iike3public works improvements in connection with.MINOR IMPROVEMENTS and'APPROVED SUBDIVISIONS �. Subdivision.lmproyement Permit Class III 4/4/90 DATE:' , Minor Improvement.Permit Class IV LOCATION OF CONSTRUCTION MOVE EOUIPMENT 4 (Street address or Description of Location) c ' PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)L =Witires lfWi+;h",Q1nt� hnaxal I . `k DESCRIPTION OF CONSTRUCTION j 'HAUL ROUTE: WAS_ HINGTON •TO CALLE 1 ► TAMPICO'EAST TO TR 24890 r4 DIMENSION OF INSTALLATION'OR REMOVAL ; SIZE OF.EXCAVATION, IF NEEDED �• 'APPROXIMATE TIME WHEN WORK WILL BEGIN -1,4/4/90 APPROXIMATE TIME OF�COMPLETION •' j' e ESTIMATED CONSTRUCTION COST $, ' (Including removal of all obstruction; materials, and debris, backfilling, com pacfion land placing permanent resurfacing and/or replacing improvements)zo •' 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 ad.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. •; -. . ., y. ► .. ', - - r . ,.. t JET •�, '. - Notify, the Administrative Authority at, least twenty-four (241,hours in advance of .the time when work will`bestarted. { '• 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 land to,pay for any additional replacement-necessary as the result of this work. Signature'of Applicant 6r'Agent F'iJ. Stow'olls , Jr. J PO - Box '1059" Indio CA 774-"1359 ,'Name of Applicant (please print) `< Business Address .�,; '.;TelephoneNo. A `Name of Contractor- and Job.Foreman Business Address. ".` ,, .L Telephone No.� ` �. goon .ii e s f onrfle �: r Contractor's License No.�t City Business License No. Applicant's Insurance Company Policy Number' FEES: Subdivision Improvement Permit —.Class III ` Public improvements: 3% of estimated construction costs ' 0 18 i0 `3if6'04-03"-5►0' 13 ,Private improvements: 3% of estimated RS s contruction costs r tri: ,. 1 I;H S OTAL t O.OU - � .• t°��_: 'x'�t Minor Improvement Permit — Class-IV: See attached schedule;0557,' • Inspection Fee $ Y. r. PERMIT VALIDATION, Permit Fee ! 1 nn PE• .0557 RMIT NO. Penalty ., 4/3%90 Cash Deposit-Surety Bond, '• ', DATE APPROVED'' if required EXPIRATION'DATE4 /d /9n: TOTAL: DATE ISSUED Receipt No. ' YBy Received by Date ` Administrative Authority Recorded by TELEPHONE: (619) 564-2246 r iU •NOTE.- .With propef'valida.tion this form constitutes an CITY OF LA QUINTA encroachment permit 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 III DATE: 4/4/90 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MOVE EQUIPMENT (Street address or Description of Location) PURPOSE OF CONSTRUCTION TI—D02--r Sketch (attach construction plans if appropriate) 10' wide (with a1nn board) DESCRIPTION OF CONSTRUCTION HAUL ROUTE: WASHINGTON TO CALLE TAMPICO EAST TO TR 24890 DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 4/4/90 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: 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 F.J. Stowells, Jr. PO Box 1059 Indio, CA 774-1359 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. oon file on file 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 15182 1 3106 04T03 -90 Private improvements: 3% of estimated construction costs ltCASK 1 TOTAL 1 N2 Minor Improvement Permit — Class IV: See attached schedule . 0557 Inspection Fee Permit Fee Penalty Cash Deposit -Surety' Bond if required } TOTAL: 10.00 $ in_nn Receipt No. Received by Date PERMIT NO. PERMIT VALIDATION 0557 DATE APPROVED 4/3/90 .1n, Old 13 EXPIRATION DATE 4/4/90 DATE ISSUED a 4/3/90 By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE:r I . 4 With proper validation this -form constitutes an t _ encroachment permit 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 IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit— Class 111 DATE. if / _I Minor Improvement Permit Class IV LOCATION OF CONSTRUCTIONS i (Street address or Description of Location) l PURPOSE OF CO UCTION Sketch (attach construction plans if appropriate) , - '-� tin PIC o 1316- Ho r r\ DESCRIPTION OF CONSTRUCTION {C1-(�is°t5 l DIMENSIOROF INSTALLATION OR REMOVAL t 3+ SIZE OF EXCAVATION, IF NEEDED!-,, APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ Ilncluding.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, r- Signature of Applicant or Agent r- 'Name of Applicant (please print) Business Address , 'Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. ,City Business License No. r Applicant's'Insurance Company Policy Number CC C`P_ , 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 F Penalty Cash Deposit -Surety Bond - if required. 1 TOTAL: $ Receipt No. Received by• Date Recorded by PERMIT, . VALIDATION PERMIT N0. t / DATE APPROVED . EXPIRATION'DATE DATE. ISSUED ' By Administrative Authority TELEPHONE: (619) 564-2246 4 .