0604NOTE:
With proper validation a
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) .
ONE TRIP OVERSIZE LOAD PERMIT
For the construction of public or private curbs, driveways, pavements, sidewal ks, 'parking lots, sewers, water mains
and other like'public works improvements in -connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
April 27, • 1990 Subdivision Improvement -Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION :move . equipment
i
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION HAUL .ROUTE: 50th and Washington
1 3 ,
.13'6",' stir 904' to Highway, 11.1
Traffic'Zilot Cars will be.
DIMENSION OF INSTALLATION OR. REMOVAL required (2)
SIZE OF EXCAVATION; I'F NEEDED HAUL RQ@E:� May 1, 1990. '
APPROXIMATE TIME -WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
-ESTI MATED 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 p6mit, 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.
Sign 6/e of'Applicant or Agent
S�hwah �a7Pc 175 E. Warner Rd, Chandler, AZ
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`_
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III Q051 1 3Q9 A4-27-90 i .f0
Public improvements: 3% of estimated construction.costs 1�1SN 1 I DIAL. 1 1(7 00
Private improvements: 3% of°estimated.construction costs ave r ®� ® A
Minor Improvement Permit — Class IV: See attached schedule `�� "
Inspection. Fee $ PERMIT VALIDATION
Permit Fee 10.00 PERMIT N0: 060,4
Penalty DATE APPROVED 4/27/90 .
Cash Deposit -Surety Bond
if required EXPIRATION DATE '5/1/90
TOTAL: $ 10.00
DATE ISSIJ�D� 4 27/90.
Receipt No.
Y
Received by Date Administrative Authority '
Recorded by TELEPHONE: (619) 564-2246
_
NOTE:
With proper validation 4 2
this form constitutes an
CITY OF LA QUINTA
encroachment permit
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
April 27, 1990 Subdivision Improvement Permit — Class I II
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION not 633 SC-'.:ar—or HAUL ROUTE: 50th and Washington
1r,12=, 1 3, 6"_ %.? qnT, to Highway 111
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
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:
Traffic Pilot Cars will be
required (2)
HAUL =WE: May 1, 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.
4.41t&
Signavure of Applicant or Agent
Schwab Sales 175 E. Warner Rd,`Chandler, AZ
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
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III 0Q' q �7�q0 iG
Public improvements: 3% of estimated construction costs i ds 'I 1 IG A� i it) „00
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. .
$ - 10.00
Received by Date
Recorded by
IN:. oOoll
PERMIT. VALIDATION
PERMIT NO. 0604
DATE APPROVED
4/27/90
EXPIRATION DATE .5/l/90
DATE ISSUED; 4/(127/90
By 1
Administrative Authority
TELEPHONE: (619) 564-2246