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0605NOTE: With proper validation 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 Subdivision Improvement Permit — Class II I DATE: Xpril . 27, 199.0 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 rai- 633 gnraper ' H�. 13!62w, 90L HAUL ROUTE:. 50th and Washington to Highway 111 DIMENSION OF. INSTALLATION OR REMOVAL Traffic. Pilot -Cars will be required (.2) SIZE OF EXCAVATION; IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN HAUL DATE: May 2, 1990 , APPROXIMATE•TIME'OF COMPLETION, ESTIMATED CONSTRUCTION COST $ c (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,clefend'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. Signe of Applicant or Agent. ' Schwab 'Sales ` ' 175 E. Warner, Rd. Chandler, . AZ Name of Applicant (please print) Business Address Telephone No. , r 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 Public improvements: 3% of estimated construction costs'. Q05 .' 3 9.9 4. 27--90 i0 Private improvements: 3% of estimated construction costs �yi�o:�a.„ . i T(JTAL .I. if)`:0© Minor Improvement Permit — Class IV: See attached schedule_ ®� ®� + Inspection.Fee. $ PERMIT ,VALIDATION a Permit Fee 11.00 PERMIT NO. -0605 Penalty - e. Cash Deposit Surety Bond DATE APPROVED 4'/27/90 if required EXPIRATION DATE 5%2/90 TOTAL: $ 10.00 4%27/90 DATE ISSUED Receipt - No.' Received by Date Administrative. Authority v Recorded by 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) 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 I II DATE: Xpril 27, 1990 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION move equipment (Street address or Description of Location) PURPOSE OF CONSTRUCTION 1.Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION Cat 633 SrraoPr 1512H. 1316"w, 90L DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN HAUL ROUTE: 50th and Washington to -Highway 111 Traffic Pilot Cars will be required (2) HAUL DATE: May 2, 1990 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 (24) hours in advance of the time when work will be started. Comply with all applicable City Ordinances, the terms and conditionsof 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. Signabee of Applicant or Agent`' y Schwab Sales 175 E. Warner Rd.-Chanoler, AZ Name of Applicant (please print) Business Address Telephone No. . Name of Contractor and Job Foreman Business Address Telephone No. on f ile on f ile Contractor's License No. City Business License No. on file Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I II Public improvements: 3% of estimated construction costs%(?aj �a 4 9 9 p4-27`94 f5� Private improvements: 3% of estimated construction costs '"'�� liTAl iii "'Q� Minor Improvement Permit — Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. 11h. 00 $ 10.00 Received by Date Recorded by • •t :i 0 UOU0., PERMIT VALIDATION PERMIT NO. 0605 DATE APPROVED 4/27/90 EXPIRATION DATE 5/2/90 DATE ISSUED i 4/27/90 By— Administrative Authority TELEPHONE: (619) 564-2246