0578E
CITY OF LA QUINTA
OT`E' va\\dation
`N roper tesan APPLICATION FOR PERMIT
w\tth P const�t� PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
th\s {or"I. ert Penn\t .
encroachm
F
//,bn of public or private curbs, driveways, pavements, sidewalks, parking,. lots, sewers, water mains
blic works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
April ]A.., 1990 Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
OF CONSTRUCTION OVERSIZE LOAD
�ct"address or. Description of Location)
PURPOSE OF CONSTRUCTION —
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL_CAT 14G
Motor Grader, 3-adle tractor,, 2 -axle trailer
. 1016 w, 112,343# GW
•'•SIZE OF EXCAVATION, IF NEEDED
Sketch (attach construction plans if, appropriate)
HAUL ROUTE: Starting.at
AVENUE 48 to WASHINGTON to
I-10
MOVE ON: April 12, 1990
APPROXIMATE TIME WHEN WORK WILL BEGIN Aptil 12, 1990
Effective 8:00 p.m.
APPROXIMATE TIME OF COMPLETION April 12, 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:
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
CAL -PERMITS INC. P.O. Box 799, San Bernardino, CA (800.).344-1911
Name of Applicant (please print) Business Address Telephone No.
SCHWAB SALES 195 E. Warner Rd., Chandler AZ 85225
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
R,
FEES: Subdivision Improvement Permit — Class I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs 0 51 zp4-12-90 10
IT ` LA41(kW
AI_ 1 10.00
Minor Improvement Permit — Class IV: See attached schedule
Inspection .Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
Recorded by
$
10.00
$ 10.00
Date
PERMIT VALIDATION
PERMIT NO. 0.578
DATE APPROVED 4/12/90
EXPIRATION DATE d/1 ?.4QQ
DATE ISSUED4/12/90 / -
awry D. Wf%d�?/dSAdministrative 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
i^4,
Subdivision Improvement Permit — Class II I
IiA
DATE: April, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION OVERSIZE LOAD
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL CAT 14G
Motor Grader, 3-adle tractor, 2 -axle trailer
10161"w, 112,343# GW
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN April 12, 1990
Effective 8:00 p.m.
Sketch (attach construction plans if appropriate)
APPROXIMATE TIME OF COMPLETION April. 12, 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:
HAUL ROUTE: Starting at
AVENUE 48 to WASHINGTON to
I-10
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
y 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. :
4 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
CAL PERMITS INC. P.O. Box 799, San Bernardino, CA (800) 344-1911
Name of Applicani (please print) Business Address Telephone No.
SCHWAB SALES 195 E. Warner Rd., Chandler AZ 85225
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'
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
10.00
$ 10.00
Receipt No.
Received by Date
Recorded by
_, 5t:�i6RlJeeu.
PERMIT NO.
Si .: � 1)4 qf.2-'90 i0.0f i0
PERMIT VALIDATION
0578
DATE APPROVED 4/12/90
EXPIRATION DATE 4/12/94
4/12/90
DATE, ISSUED
/Jury D. CoTteY/CLSAdministrative Authority
TELEPHONE: (619) 564-2246
"Froin the desk of"
Frank Reynolds
City Engineer, '
�G1 Gi/G� 6 oS��e s .
el- Ad.
cia-, ew e
46