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0565.. _, .._:..,..-_...>.. .. , ....... �_...._ ,._.. .• ..r_...-_.. ��._-+,...-. - _. r_-�-7�.as:..-.-.... — ,rte.- .. •_ -.4G, ��}�+'t: _ - r 1 a 3 e r NOTE: 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 April 10, 1990 Subdivision Improvement Permit — Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MOVE EQUIPMENT 1 (Street address or Description of Location) PURPOSE OF CONSTRUCTION Goma co Curb machine Sketch (attach construction plans if appropriate) 10' wide, legal. hAi crhft-/tacm_i cTht' DESCRIPTION OF CONSTRUCTION HAUL ROUTE: SOUTH ON WASHINGTON TO TAMPICO. DIMENSION OF INSTALLATION OR REMOVAL MOVE ON: April 11, 1990 SIZE OF EXCAVATION, IF NEEDED QOSiQ 377 04-0-90 14 UTAL 1 1V.QO 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: ' � J 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 A ent' MASSEY SAND AND ROCK CO. P.O. BOX 1767, 3(ndio, CA 92202 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 Po.l-icy 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 N2 0505 Inspection Fee Permit Fee Penalty Cash Deposit -Surety Borid if required TOTAL: Receipt No. 10.00 $ 10.00 Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 0565 DATE APPROVED 4 /1 n/qn EXPIRATION DATE 4/11/90 DATE ISSUE 4/10/90 By Lk1lil.lryx�//f �'' �a "Administrative Aut'ho 0ity TELEPHONE: (619) 564-2246 I NOTE r 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 April 10, 1990 DATE LOCATION OF CONSTRUCTION MOVE EQUIPMENT Subdivision Improvement Permit —Class II I Minor Improvement Permit Class IV (Street address or Description of Location) Gomaco curb machine PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) 10' wide, leaal hP i.crht/wPjaht- DESCRIPTION OF'C.ONSTRUCTION r HAUL ROUTE: SOUTH ON WASHINGTON s 'TO TAMPICO DIMENSION OF INSTALLATION OR REMOVAL MOVE ON: April 11, 1990 SIZE OF EXCAVATION,,IF NEEDED p 05ill" g? r i C?C2ASW 1T07TRL4 i 040 i G. Q0 14 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 of Applicant or A ent MASSEY SAND AND ROCK CO. P.O. BOX 1767, Adio, CA 92202 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 II I Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs ff nn Minor Improvement Permit — Class IV: See attached schedule l� V Inspection Fee $ Permit Fee 10.00 Penalty Cash Deposit -Surety Bond if required 10.00 TOTAL: $ Receipt No. Received by Date Recorded by Y PERMIT NO PERMIT VALIDATION 0565 DATE APPROVED 4/10/90 EXPIRATION DATE 4/11/90 DATE ISSUED 4/10/90 i Administrative Auth4ity TELEPHONE: (619) 564-2246 r N07Er' � r With proper validation ,.> — • this form constitutes 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 works improvements in connection with MINORIMPROVEMENTS'and APPROVED SUBDIVISIONS _ Subdivision Improvement Permit - Class II t DATE: �` �© �U `' ` Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description.of Location) PURPOSE OF CONSTRUCTION Sketch (attach'construction plans if appropriate) . DESCRIPTION OFCONSTRUCTION l%w ✓YI�a�.-�-- DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION IF NEEDED Oa00 ' APPROXIMATE TIME WHEN WORK WILL BEGIN t APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ * (Including removal of all obstruction,, materials, and.dehris, backfilling,-com paction and placing permanent' resurfacing; and/or replacing improvements) ` t 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 124) hours inradvance"of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditions of th'e permit and all applicable rules and"regulations of the City of a La Quinta and to pay for any additional replacement necessary as the result of this work. Y .. V V y Signature of A' licant or Agent 9 Name.of Applicant (pl a print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address a Telephone No. , Contractor's License No. City Business License No. Applicant's Insurance Company Policy Number f FEES: Subdivision Improvement Permit - Class Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs 0 Minor Improvement Permit - Class IV: See attached schedule' Inspection Fee $ I PERMIT VALIDATION Permit Fee PERMIT N0. ' ' - Penalty � - �. DATE APPROVED: - Cash Deposit -Surety Bond if. required EXPIRATION DATE TOTAL: $ DATE ISSUED A . . Receipt No. f /fes By.: Received by: r • Date / ,(C Admin strative 6dithority Recorded by TELEPHONE: (619)'564-2246 4