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0561771. #J11 NOTE:. With proper, validation this form constitutes an encroachment permit t CITY OF LA QUINTA APPLICATION FOR- PERMIT - PUBLIC WORKS. CONSTRUCTION (ENCROACHMENT) ' .ONE TRIP OVERSIZE LOAD PERMIT ` OF Fdrr-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 � 'ril " 5 DATE: �- P r 1990 _ , • Minor Improvement Permit Class IV, LOCATION OF CONSTRUCTION MOVE EQUIPMENT (Street addressor Description of Location) PURPOSE OF CONSTRUCTION GOmaCO. Curb maChlrie. Sketch (attach construction plans if appropriate) 10' wide, legal height/weight It DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED HAUL ROUTE: EISENHOWER. AT,COLIMA 'TO WASHINGTON TO FRED WARING.DRIVE MOVE ON April 9, 1990 APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ '.� (Inbluding`removal of all obstruction, materials, and debris, backfilling,.com- �� paction and placing permanent resurfacing and/or replacing improvements) In 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.proxiYnate result of any work undertaken under the permit granted pursuant to this application. Notify the Administrative. Authority at 1east 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 o`f Applicant or gent MACCEV C Mn Amn POCK ('� pn Boy 1 7�2 InAin., CA Ui7n7 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. F_i� nn fi•1 o is 'Contractor's License No.' City Business License No. on file Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit-.Class.111 i.p . 005181 S8 324 po4-i5-90 10 PubIL lic improvements: 3% of estimated construction costs; •..: ; Private improvements: 3% of estimated construction costs 0561 Minor Improvement Permit Class IV: See attached schedule4 Inspection•Fee $ Permit Fee 1.0.00. Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. n�til DATE APPROVED ' 4 /5 /90 EXPIRATION'DATE 4/9/90 4 DATE ISSUED By Administrative Authority TELEPHONE: (619) 564-2246 NOTE: With proper validation this form constitutes an encroachment permit CITY OF. APPLICATION LA QUINTA L 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 andother like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS ril 5 ] 990 Subdivision Improvement Permit —Class I II DATE: 4p , Minor Improvement Permit Class IV 'I MOVE EQUIPMENT LOCATION OF CONSTRUCTION (Street address or Description of Location) Gomaco curb machine -� PURPOSE 0 CONSTRUCTION Sketch (attach construction plans if appropriate) 1. 0' wide, legal height weight DESCRIPTION OF CONSTRUCTION HAUL ROUTE: EISENHOWER AT COLIMA TO WASHINGTON TO FRED WARING DRIVE D'IMENSION'OF INSTALLATION OR REMOVAL MOVE ON April 9, 1990 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- oP acti n and lacin ermnnent resurfacin and/or re lacin im rovements) 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 of7Applicant or Agent ; MAGC'P'V CAWi A n RnrK r•n_ Pn Rnx 1767 Tndin. CA A2202 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. ^n f 4 Ism ) Contractor's License No. on; file ' City Business License No. on file Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class ll l 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 Recorded by Wi8t9N 274TA#�~15-9a AI10.00 0561 PERMIT VALIDATION PERMIT NO. 0561 DATE APPROVED 4/5/90 EXPIRATION DATE 4/9/90 DATE ISSUED, 4/5/90 By Administrative Authority TELEPHONE: (619) 564-2246 r TV NOTE: ;. 'With proper'vaiidation— �: this form constitutes an encroachment permit. CITY OF LA QUINTA x APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION, (ENCROACHMENT)rd * For the 'construction "'of public or private curbs, driveways, pavements, sidewalks,'park ing lots, sewers, water mains " ".'and other like public works improvements in •connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS _ 'Subdivision Improvement Permit Class III DATE: �, Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF•CONSTRUCTION • _i , Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION `' �'y✓Y%/''e C `DIMENSION OF INSTALLATION OR REMOVAL tot) a®--�� Fri 4)&A SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN_. ���*� I' �' ���iLi i�� �• APPROXIMATE TIME OF COMPLETION , c ESTIMATED CONSTRUCTION COST $. � ��.,� /0 (Including removal of all obstruction, materials, and debris, backfilling, com paction and -.,placing permanent resurfacing and/or replacing improvements) i 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 gent Name of Applica (please print) t Business Address.. Telephone No. Name of Contractor and Job Foreman Business Address Telephone No, Contractor's License No. n 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 ' AT 00 Minor Improvement Permit —Class IV: See attached schedule Inspection Fee $ PERMIT VALIDATION„ Permit Fee I 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) 5642246. .