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0584ti=er NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) • 4 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 DATE: 4/17/90 LOCATION OF CONSTRUCTION move equipment Subdivision Improvement Permit = Class I II Minor Improvement Permit Class IV (Street address or Description of Location) z ,PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 046 t -at hnarlar 1^16" • a„ n c n high, 1 maA l wai ght HAUL ROUTE: WASHINGTON SOUTH AT FRED WARING TO Ave. 52, west to DIMENSION OF INSTALLATION OR REMOVAL BERMUDAS, South 'to EISENHOWER SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN A1171911 r 4 APPROXIMATE TIME OF COMPLETION A11 7/9(1 ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- paction an 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. �Signaure of Applicant or Ag4nt TUT P.r =i?nA nnA Rne-le t^n. PO Box 1767 Indio, CA 92201 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. ^,sfilm on.file Contractor's, License No. City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class III Public improvements: 3% of estimated construction costs Private improvements: 31/o of estimated construction costs Minor Improvement. Permit — Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. 10.00 $ 10.00 Received by Date OUOSiO ASH i 1'0TAL -i 7w90 io loo . , N° 0584 PERMIT VALIDATION PERMIT NO. 0554 DATE APPROVED n .11 � / Q Q EXPIRATION DATE 4/17/90 DATE ISSUE., ! 4/17/90 By— Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 I J.Ft./' Ire.• 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 Subdivision Improvement Permit— Class III DATE: 4/17/90 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION move equipment (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION 499 nai- 1 oaclar ;;A:619,1 A e 6 ++ b iC-9h 1 P/Xa 1 NP i c-Tht DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 4/3-7/90 Sketch (attach construction plans if appropriate) HAUL ROUTE: WASHINGTON SOUTH AT FRED WARING TO Ave. 52, west to BERMUDAS, south to EISENHOWER APPROXIMATE TIME OF COMPLETION d /1 7 /()0 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 macnagnNr ganri And Rock Co. PO Box 1767 Indio, CA 92201 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No.. nn fi1P On -file Contractor's License No. City Business License No. nn fi1P Applicant's Insurance Company Policy 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 Inspection Fee $ Permit Fee _ Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Recorded by 10.•00 $ 10.00 Date 0�5011 ASW iSTOTAL-i7-g© i0.00i0 Nt° 0584 PERMIT VALIDATION PERMIT NO. 0584 DATE APPROVED Q/1 -7,/A0 EXPIRATION DATE 4/17/90 DATE ISSU,ED'r_>�,4 4/17/90 By Administrative Authority TELEPHONE: (619) 564-2246 -,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 III DATE:. Minor Improvement Permit Class IV ---� .LOCATION OF CONSTRUCTION `(Street address or Description of Location) PURPOSE OF CONSTRUCTION; Sketch :(attach construction plans if appropriate) •' s DESCRIPTION OFA ONSTRUC� ION Glj'""'`- DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED ` APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION, GJ ; ESTIMATED CONSTRUCTION COST $ (Including removal of'?II obstrua:Dn, in_-teriais, and debris, backfilling, com- paction and ;placing permanent resurfacingand/or replacing improvements) r. In cons ideration.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 dariage-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. 1, Signature of Applicant or Agent Name of Applicant (ea—se print) Business Address Telephone No. Name of Contractor -and Job Foreman Business Address Telephone No. Contractor' License No. _ City Business,/License. No. Applicant's surance'Company = Policy N tuber FEES: Subdivision ImprovementPermit-Class III ; a Public improvements: 3% of estimated construction costs Private improvements:,3% of estimated construction costs U Minor Improvement Permit•-, Class IV: See attached schedule' , a. 'Inspection Fee $'' PERMIT VALIDATION Permit Fee I Y _ PERMIT NO.' Penalty. DATE APPROVED. Cash Deposit -Surety Bond ` if required • EXPIRATION DATE ' TOTAL: $ DATE ISSUED Receipt No. By . ' Received by Date Administrative Authority Recorded by t TELEPHONE- (619).564-2246