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0618NOTE: 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 imp;ovements 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 Sketch (attach construction plans if appropriate) DESCRIPTIO, OF•CONSTRUCTION air. a.=? -boar. .r_rAon 10 6 ` wi, _ . eight anct wei.gnt Legal HAUL .ROUTE: JEFFERSON SOUTH AT HIGHWAY 111 to AVENUE 52 DIMENSION OF INSTALLATION OR REMOVAL WEST TO BERMUDAS. SOUTH TO ,EISENHOWER SIZE -OF EXCAVATION, IF NEEDED MOVE ON 5/2/90 or 5/3/90 , r APPROXIMATE TIME WHEN WORK WILL BEGIN ` ONE DAY ONLY 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. 26 Signature of�Applicant o/Agent MaCApy Rand and Rn1ek -Cn ' 4'PO Ro3c 1767 Thdjn� CA 92.201 Name of Applicant (please print)' Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. nn f l.p cin file Contractor's License No. City Business License'No. on file ' Applicant's Insurance Company Policy Number . FEES: Subdivision,lmprovement Permit —Class III 33 ' Public improvements: 3% of estimated construction costs 0©502 . N 10?BTA 02-90 1.0.00 10 Private improvements: 3% of estimated construction costs O 6 Minor Improvement Permit — Class IV: See attached schedule No Inspection Fee $ PERMIT VALIDATION Permit Fee 1 n nn PERMIT NO. 0618 Penalty 5/2/90 Cash Deposit -Surety Bond DATE APPROVED if required EXPIRATION DATE 5/3/90 10.00 TOTAL:, $ DATE ISSUED 5/2/90 Receipt No. ' By �m /, A J, -i Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT t PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) x 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: May 2, 1990 . LOCATION OF CONSTRUCTION move equipment (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTIONOF CONSTRUCTION 2r5 R,arhor rZrAan J.0°6" wide, height ana weignt legal 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) Subdivision Improvement Permit — Class II I Minor Improvement Permit Class IV Sketch (attach construction plans if appropriate) .In consideration of the granting of this permit, the applicant hereby agrees to: HAUL ROUTE: JEFFERSON SOUTH AT HIGHWAY 111 to AVENUE 52 WEST TO BERMUDAS SOUTH TO EISENHOWER MOVE ON 5/2/90 or 5/3/90 ONE DAY ONLY 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 wor�k.f_ zo v \ .a+ Signature of Applicant oyAgent Massev Sand and Rokb 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. 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. 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 , Received by Date Recorded by I 0618 PERMIT VALIDATION PERMIT NO. 0618 DATE APPROVED 5/2/90 EXPIRATION DATE 5/3/90 DATE ISSUED 5/2/90 "_ By /4 A /, A 1--') L_ --j Administrative Authority 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) ----10 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: �Q Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED Sketch (attach construction plans if appropriate) APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETiON ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, •backfill ing, 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 A • licant'or Ag t /00/R. 176 �;' _1.,AA . Com. Name of Applicag (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's icense No. City Business icense No. Applicant's ffisurance Company Policy Number FEES: Subdivision Improvement Permit — Class III Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs00 l� Minor Improvement Permit — Class IV: See attached schedule j� Inspection Fee $ II PERMIT VALIDATION Permit Fee Penalty Cash Depwit=Surcty God If required TOTAL: $ Receipt No, Received by Date Reeorded by PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority T6LMONE1(61M 664°2246