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0558•t NOTE: With proper validation 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 1 Subdivision ImprovementPermit— Class II I DATE: Anri 1 9 . 1 AAfi Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MOVE EQUIPMENT (Street address or Description of Location) PURPOSE OF CONSTRUCTION payer 1016" wide Sketch (attach construction plans if appropriate) height/weight legal DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN HAUL ROUTE:. AVENIDA.BERMUDAS TO JEFFERSON VIA EISENHOWER TO AVE %I TO JEFFERSON 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 offApplicant orgent MasseX Sand and Rock Co PO Box.1767 Indio//, CA Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address r Telephone No. on file on file Contractor's License No. City Business License No. ,r/on file on file Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class II 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. 10.00 $ 10.00 Received by Date iIg518��sW i B'-1,A4—T-vo 1ii..000 Ns 0554 PERMIT VALIDATION PERMIT NO. 0558 DATF APPRnVFn 4/5/90 EXPIRATION DATE 4/5/90 DATE ISSUED ! 4/5/90 By Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE: With proper validation 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 II I DATE: Anri.l 5 1990 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MOVE EQUIPMENT (Street address or Description of Location) r PURPOSE OF CONSTRUCTION Paver ,10' 6" Wide Sketch (attach construction plans if appropriate) height/weight legal. DESCRIPTION OF CONSTRUCTION HAUL ROUTE: AVENIDA BERMUDAS TO JEFFERSON VIA EISENHOWER TO AVE DIMENSION OF INSTALLATION OR REMOVAL 88 TO JEFFERSON 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) 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 ofJAppllcant or Agent Massey Sand and Rock Co PO Box 1767 Indio,,, CA 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 on file. . '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 Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ Permit Fee Penalty Cash Deposit -Surety Bond if required 10.00 TOTAL: $ 10.00 Receipt No. _ f Received by- Date Recorded by NS 0559, PERMIT VALIDATION PERMIT NO. 0558 DATE APPROVED 4/5/90 EXPIRATION DATE 4/5/90 DATE ISSUE r� 4/5/90 f By— Administrative Authority TELEPHONE: (619) 564-2246 M. t ,NOTE: With proper validation this form constitutes an 'CITY OF LA QUINTA - encroachment permit APPLICATION :FOR 'PERMIT �. PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) Foy.. the construction of public or private icurbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED'SUBDIVISIONS ' t Subdivision Improvement Permit— Class II DATE: % —"�' 'Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address oi� Description of Location) PURPOSE OF CONSTRUCTION Sketch'lattach construction plans if appropriate) . DESCRIPTION•OF CONSTRUCTION" • - �iyq/kl� /,62'aM�� - . a YDIMENSION OF INSTALLATION OR REMOVAL ' a . SIZE,OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTIOWCOST $ (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 orp'roperty •.._happening or .occurring'as a proximate result of any. work -undertaken under the permit granted pursuant to "this, application. r, -iw• Notify the Administrative Authority at least, twenty-four (24) hours inadvanceof the time whemwork 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 A licant or'A nt Name of Applicant (ple se printf Business Address Telephone. No. Name of Contractor and Job Foreman Business Address Telephone No. Contra ctor's.Lice rise No. i City Business License No. 'Applicant's Insurance Company Policy Number. FEES:; Subdivision Improvement Permit —"Class IIf y Public improvements: 3%of estimated construction costs Private improvements: 3% of estimated construction costs 1�T0 Minor Improvement Permit — Class,IV: See attached•schedule lr ^ Inspection Fee' $ r PERMIT VALIDATION Permit Fee PERMIT r I NO. < Penalty DATE APPROVED Cash Deposit -Surety Bond • " _ if required EXPIRATION DATE" TOTAL: $ DATE ISSUED "Receipt No i µ. . By -Received'by' Date Administrative"Author ity ` Recorded by TELEPHONE: (619) 564-2246, . pi. .