0574NOTE:
With proper validation
this form constitutes an
encroachment permit
f
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
DATE: April 12, 1990
LOCATION OF CONSTRUCTION punt» EQUIRME ` T
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION 966 Cat Loadax
1016" w, 1.416" H, green weight
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/12/90
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION 4/12/90
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:
HAUL ROUTE; FRED WARING West
to WASHINGTON South to AVENUE
52 West to BERMUDAS South to
EISENHOWER
MOVE ON: April 12, 1990
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.
MASSEY SAND AND ROCK CO.
Name of Applicant (please print)
Signature of Applicant or ' gent
P.O. Box 1767, Indo, CA 92202
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 Pile
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III �0051�3 A�Q S 4T TR4-j2-90 a0.'J4/3,
Public improvements: 3% of estimated construction costs JSNN R
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:
Receipt No.
Received by
Recorded by
.$ 10.00
Date
0574
PERMIT VALIDATION
PERMIT NO. 0574
DATE APPROVED 4/12/90
EXPIRATION DATE 4/12/90
DATE ISSUED 4/12/90
By
Jerry D. Coffey/A'd ninistrative Authority
TELEPHONE: (619) 564-2246
i"
NOTE:
With proper validation
41
is this form constitutes an.
encroachment permit
C
Y / 0
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction. of rpublic 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
DATE: April 121'1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION M017r. VQj1T1 Lfir?Jm
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _ Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 966 Cat Loader HAUL ROUTE: FRED WARING West
i
1016" w, 1416" H, queen weight to WASHINGTON South to AVENUE
DIMENSION OF INSTALLATION OR REMOVAL 52 West t0 BERMUDAS South t0
EISENHOWER
SIZE OF EXCAVATION, IF NEEDEDMOVE ON: Aril" 12., 1990
APPROXIMATE TIME WHEN WORK WILL BEGIN 4/12/90
APPROXIMATE TIME OF COMPLETION 4/12/90 `
4
ESTIMATED'CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
I.n 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%Agent t
MASSEY _SAND. AND ROCK CO. P.O. Box 1767, Ino.., 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 'On File
Applicant's Insurance Company Policy Number
FEES: Subdivision improvement Permit—Class IIIp05i$ p 34 4-12-90 10
io .. A H S f@TAL 1 it Q;00
"Public improvements: 3% of estimated construction costs "
' Private improvements: "3% of estimated construction costs N. 0574
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee 10.00
Penalty .
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
$ 10.00
Received by Date
Recorded by
0
PERMIT VALIDATION .
PERMIT NO. 0574
DATE APPROVED 4/12/90
EXPIRATION DATE 4/12,/90
DATE ISSUED 4/12/90
By
Jerry D. Coffey/Rdrninistrative Authority
TELEPHONE: (619) 564-2246