0601���'+4i-'wi��'�"T�i�``"`it'AW^�-ii.�.ur�>w'�i�v�°'�`i7W'+.'+4�^s 4 t�.JywY.°rw .�y � ^'V',� r• �wy�it^.MA""�'�'-iK�"&+k:�V'Rt✓Q�a,�'��9k: k ..y�y�y`'i� �?-;<Yi.:�U'�r . v'gbi ;i���� -
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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
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
Aptil 26.,. 1990 Subdivision Improvement Permit —Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION; M017E VQjjj'DMVNrr
(Streeraddress or Description.of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUC'PeN paver 10 6. wide
legal heicght and weight HAUL ROUTE: BERMUDAS NORTH AT
Eisenhower to Avenue 52 east to
DIMENSION OF. INSTALLATION'OR REMOVAL. Washington north to Fred Waring
SIZE OF EXCAVATION; IF NEEDED HAUL DATE: April ' 27, 1990
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including• removal: of all obstruction, materials, andAebris, 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( pplicant or Agpnt
Massey Sand and•Rodk PO -Box -1767 Indio, CA'92202
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address . Telephone No.
91le on file
Contractor's License No. City Business License No.
on file
Applicant's Insurance Company Policy Number
FEES: • Subdivision Improvement Permit — Class III
Public improvements: 3% of estimated construction costs 8p051 g' `' 10 3 Q4 -2b-90 i0
Private improvements: 3%of.estimated construction costs iQ CSN � �U7AL .f i0,(ilJ
Minor Improvement Permit — Class IV: See attached schedule
N2 0601
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 0601
PERMIT NO.
Penalty DATE APPROVED 4 /26190
Cash Deposit -Surety Bond
if required EXPIRATION DATE 4/.27/90
TOTAL: $ 10.00 DATE ISS4/.26/90
• U-Et5 /
Receipt No.
Received by Date By
/ vAdministrative Authority
Recorded by ! TELEPHONE: (619) 564-2246
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NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE LOAD
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
Apkil 26, 1990
LOCATION OF CONSTRUCTION MQ%7V VQTTTUMFW1I1
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION _
DESCRIPTION OF CONSTRUCrT-IM paver 1016" wide
legal height and weight
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
HAUL ROUTE: BERMUDAS NORTH AT
Eisenhower to Avenue 52 east to
Washington north to Fred Waring
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:
HAUL DATE: April 27, 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.
Signature of pplican or Aged
Massey Sand and Rock PO Box 1767 Indio,, CA 92202
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Addreis Telephone No.
on file
Cont'ractor's License No. City Business License No.
on f ile ' '
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
10.00
$ 10.00
Receipt No.
Received by Date
Recorded by
i5f.io 31 i26-90
f0
,40
iG
PERMIT VALIDATION
PERMIT NO. 0601
DATE APPROVED 4/26/90
EXPIRATION DATE 4/27/90
DATE ISSUED �/ 4/26/90
J Administrative Authority
TELEPHONE: (619) 564-2246
n -
NOTE!
With proper validation
this. form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLIOATION 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 111
DATE: �`�' ' Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF 'IN JCTION
DIM SION OF. INSTALLATION 04 REMOVAL
-Q-
SIZE OF EXCAVATION, IF NEEDED ' 6400�
APPROXIMATE TIME WHEN WORK WILL BEGIN `'' — + i�•cG+' K/ -•
6 ►'�: '- -V 7
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 124) 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.
Name of Applicant (plea print)
Signatur�oWApplicant or AAent
Business Address
Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
C
Contractor' License No. City Business Li se No.
Applicanjig 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
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
Date
N°
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By .
Administrative Authority
TELEPHONE: (619) 564-2246