0566NOTE:,
f
'With proper.validation
this forme constitutes an+
encroachment permit h- -J" 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
j and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit - Class III
DATE:. ' April .10, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION - 52nd Avenue between 3effearson and Washington
(Street address or Description'of Location)
PURPOSE OF CONSTRUCTION y Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION [�acira� �� T•�a;� HAUL ^ROUTE:'.- 52nd -to )WASHINGTON
TO MILES AVENUE..
DIMENSION OF INSTALLATION OR REMOVAL 633 Scraper
14'8 H., 13'-W, 75' L REQUIRES TRAFFIC CONTROL: 2 Pilot
-vehicles per California Vehicle
SIZE OF EXCAVATION, IF NEEDED Code
APPROXIMATE TIME WHEN WORK WILL BEGIN 4111/90 Requires County Permit
0-1-90-6
APPROXIMATE TIME OF COMPLETION 4/11/90
MOVE ON: April 11, 1990
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, corn-
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.. /
Oi6nature of Applicant or Agent (8 00 )
CAL PERMITS INC. P.O. Box 799, San Bernardino, CA 344-1911—
Name of Applicant (please print) Business Address Telephone No.
KEMMIS LOWBED P.O. Box 422, Temecula., CA
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Farmers Insurance Group 600221517
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit - Class II I
Public improvements: 3% of estimated construction costs 0518 1 39 4- 0-90 10
Private improvements: 3% of estimated construction costs .f 0(�sn TOTAL- 10.00
Minor Improvement Permit - Class IV: See attached schedule N2 r. 0566
Inspection Fee $ PERMIT VALIDATION
10..00.
Permit Fee s PERMIT NO.
Penalty �
DATE APPROVED 4/10/90
Cash Deposit -Surety Bond
if required 4 EXPIRATION DATE 4/11/90
f
TOTAL: $ 10.00'
DATE ISSUED a^f� n,/on
Receipt No. '. &&�,,_
Received by Date rry ,i'l/ Coffey /VAdministrative Authority
Recorded by TELEPHONE: (619) 564-2246 '
L
NOTE:
With proper validation
this form constitutes an
encroachment permit
a
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 I I I
DATE: April 10, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 52nd Avenue between 3efferson and Washincrton
(Street addressor Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION n�Prssi9a T.t�ati
DIMENSION OF INSTALLATION OR REMOVAL 633 Scraper
1418 H., 13' W, 75' L
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/11/90
HAUL ROUTE: 52nd to WASHINGTON
TO MILES AVENUE.
REQUIRES TRAFFIC CONTROL: 2 Pilot
vehicles per California Vehicle
Code
Requires County Permit
0-1-90-6
APPROXIMATE TIME OF COMPLETION 4/11/90 MOVE ON; April 11, 1990
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:
r
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.
�JJ 0
2Cx
ignature of Applicant or Agent (800)
CAL PERMITS INC. P.O. 799, San Bernardino, CA 344-1911
'". Name of Applicant (please print) Business Address Telephone No.
KEMMIS LOWBED P.O. Box 422, Temecula, CA
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No.
Farmers Insurance Group 600221517
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public e00 3% of estimated construction costs improvements: 051�3� f U X39 +- 0-90 10
p ��°6�sli �. TOAL. � i0
Private improvements: 3% of estimated construction costs 0 T
Minor Improvement Permit — Class IV: See attached schedule 0566
Inspection Fee $
10.00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. 0566
DATE APPROVED 4/10/90
EXPIRATION DATE 4/11/90
DATE ISSUED 4/10/90
By-
jdri ry D% Coffey /1,Admiriistrative Authority
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)
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
DATE.
LOCATION OF CONSTRUCTION
Subdivision Improvement Permit — Class III
Minor Improvement Permit_ �'Class IV ---
��
(Street address or Description of Location)
'PURPOSE OF CONSTRUCTION Sketch construction plans if appropriate)
DESCRIPTION A
3 � s c.ae f4 ncc� C, T'o ,j
DIMENSI
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN X./ t I .-_., - -
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal. of all obstruction; materia;s, and debris, b3ckfMing, 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.
(�`%�'� ���/12• l %� Signature of Applicant or Agent
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.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I -
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs N?
Minor Improvement Permit Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
Recorded by II TELEPHONE: (619) 564-2246