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0564NOTE-. With proper validation this form constitutes an + encroachment permit CITY OF LA QUINTA 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: 4/6/90 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MSE EQUIPMENT (Street address or Descri'iiori of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION.OF CONSTRUCTION John Deere 690-D ExcHvation backhoe HAUL .ROUTE: EAST ON COLIMA TO AVENIDA BERMUDAS; NORTH TO TAMPICO DIMENSION OF INSTALLATION OR REMOVAL - EAST TO WASHINGTON,. NORTH TO. I -10 - 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. Whitney ffiach Name of Applicant (please print) Signat re of Applicant or Agent inc 20 Ip�Ave. Riverside, CA 682-5353 ness Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business�License No. on file, John Deere, Ins. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III p p 3 7 p ' Public improvements: 3% of estimated construction costs 0518 A H FTRTALrOb-90 i0.00iq Private improvements: 3% of estimated construction costs �� O Minor Improvement Permit —Class IV: See attached schedule N2 �i 0 Inspection Fee $ Permit Fee Penalty Cash Deposit -Surety Bond if required 10.00 TOTAL:. $ 10.00 Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 0564 DATE APPROVED 4/6/90 EXPIRATION DATE ' d/ti/AD DATE ISSUED 4/6/90 By�— Administrative Authority TELEPHONE: (619) 564-2246 -.. ..� •.:. _ ........,. .�-, ... :..:. ._,. ,_ _� � .. .� __ _ , _ _ _ Vim. _ _ . ' _ .a. yg NOTE. With proper validation this form constitutes an ' encroachment permit ri CITY OF, LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONE TRIP OVERSIZk 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 • i 4/6/90 Subdivision Improvement Permit — Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MUDE EQUIPMENT (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION John Deere 69.0-D Excavation backhoe DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attach construction plans if appropriate) HAUL ROUTE: EAST ON COLIMA TO AVENIDA BERMUDAS, NORTH TO TAMPICO EAST TO WASHINGTON, NORTH TO I-10.. n 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. Whitney Mach Name of Applicant (please print) � ign-ature of Applicant or Agent , -y inc 20 1� eAve. Riverside, CA vBusiness Address 682-5353 Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. on tile, John Deere, Ins. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I1 Public improvements: 3% of estimated construction costs 8. 6 a' 32 4 -Ute �q0 10 �p• �A�H i . ��TAL i •. ,40.00 Private improvements: 3% of estimated construction costs ;Q 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 4DIrl 4 PERMIT VALIDATION PERMIT NO. 0564 DATE APPROVED 4/6/90 EXPIRATION DATE f4/6/90 DATE ISSU.E'D,/f- 4/6/90 By "~ Administrative Authority TELEPHONE: (619) 564-2246 „ — — — NOTE: L ., 3 With proper validation this form constitutes., onstitutes 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 -work s improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit = Class III DATE: ¢' 0 9'<2 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION �� i� /� %%��✓� �� v� �` / /� �, in Ti4 i – (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF/. CONSTRUCTION `�• nn �t (% n• ri /i K- ,A /1 /S n L tq /J G - � C��.%'/00 " �9�C ,� >E d,. /�✓.; (}!��/?l� A), DIMENSION OF INSTALLATION OR REMOVAL _ -]^OG r �� a �qS �`' • 'fid - � % 'fes% r .,> ,7 � tS ! ' x, , `n ' l� �� OC.Z"J •' 'CA-) 0S 11 r:Als Y-1do r o SIZE OF EXCAVATION, IF NEEDED _L APPROXIMATE TIME WHEN WORK WILL BEGIN '� 5 �• , APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ (Iricludino 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 vpenal tie' s,"I`abi�it�es`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 (20, 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' adriitional replacement necessary as the .result of thi work. y t, in ' gnature of Applicant or. Ag'en't -W00,11 ► n eon ' Name of Applicant (pleas�,print) Business Address �� P�.1, C((VTelephone No. Name.of Contractor and Job Foreman Business Address Telephone No. Contractors Lic se. No. - City ,Business License No. Applicant'sInsu ce Com ,'_ Policy Number, FEES: Subdivision Improvement Permit — Class I I I 1'r ,4 Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs NO Minor Improvement Permit — Class IV: See attached schedule l� Inspection Fee $: I PERMIT VALIDATION Permit Fee PERMIT NO. Penalty DATE APPROVED Cash Deposit -Surety Bond if required EXPIRATION DATE ' TOTAL: $ DATE ISSUED Receipt No. B , Y Received by Date z Administrative Authority Recorded by TELEPHONE: (619) 564-2246