0617NOTE:
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
May 2 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
DESCRIPTION OF CONSTRUCTION Cat 966 &oader
9110" wide. heiaht and weiaht legal
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED'
APPROXIMATE TIME WHEN WORK WILLBEGIN
Sketch (attach construction plans if appropriate)
HAUL ROUTE: BERMUDAS NORTH TO
AVE: 52 East to Washington
North to Fred Waring
MOVE ON•5/2/90
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 ih 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 Applicantt''or Agent
Massev Sand and Rock Co PO BOX•1767 Indio, CA 32201
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 I11
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.
10.00
$ 10.00
Received by Date
i08" CASH f4 7 (:iTAL i 9U SU .OU SO
N2 0017
PERMIT VALIDATION
PERMIT NO. 0617
DATE APPROVED. 5/2/90
EXPIRATION DATE 5/2/90
5/2/90
DATE ISSUED
By
v Administrative Authority
Recorded by II TELEPHONE: (619) 564-2246
NOTE: r
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE LOAD PER,IIT
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: flay 2, 1990
LOCATION OF CONSTRUCTION move equipment
(Street address dr Description of Location)
Subdivision Improvement Permit —Class II I
Minor Improvement Permit Class IV
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Cat 966 boader
9110" wide. height and waicrht legal HAUL ROUTE: BEPIIUDAS NORTH TO
AVE. 52 East to Vlashington
DIMENSION OF INSTALLATION OR REMOVAL North to Fred Varina
SIZE OF EXCAVATION, IF NEEDED MOVE ON 5/2/90
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:
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. 1%!
Signature of Applicant,or Agent
massey Sand and Rock Co PO Box 1767 Indio, CA 52201
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on f ile
Contractor's License No.
on file
on file
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
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.
10.00
$ 10.00
Received by Date
(ow °. _g 41"7 05-02-90
90
ntiV JA
PERMIT VALIDATION
PERMIT NO. 0617
DATE APPROVED 5/2/90
EXPIRATION DATE 5/2/90
5/2/90
DATE ISSUED
Y
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
■
NOTE:
With_ proper validation
this form constitutes an "
encroachment permit
CITY OF LA QUINTA
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 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)
DE RIPTION OF CON RUCTION>�►
...d�
/ /.%6t i..� L . e, Ae. /.e:� .0S .
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION -
ESTIMATED CONSTRUCTION COST $ ` --Z Q
(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 plicant or Age i
d a ce, L _'2_0 If
.Name of Appl' nt (please print) Business Address Telephone No.
Name of"Contractor and Job Foreman Business Address Telephone No.
Contractor License No. City Business icense No.
Applicant'iVinsurance Company Policy Number
FEES: Subdivision Improvement Permit —Class Ill
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs N� {
Miner Improyefrlgnt P@rmit — Glass IV See @tta6hed s6h0ulla —
Inspection Fee $ Il PERMIT VALIDATION
Permit Fee
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt..No.
Received by Date
Recorded by
;PERMIT N0,
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246