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IL
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
i
Subdivision Improvement Permit — Class III
.DATE:. May 9, .1990 ' 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. Rarhar rraana.
1 0 F" wi ria hPi crh+• nnri wai rrh+• 1 rarfal HAUL ROUTE: WASHINGTON NORTH AT
TAMPICO TO FRED WARING DRIVE
DIMENSION OF INSTALLATION OR REMOVAL
MOVE ON.: MAY 10, 1990 `
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:
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, los's 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 re�sult,of this work.
Signature of Applicant o�rgAgent ,
MAssev Sand.and Rock Co PO Box 1767 Indio CA 9.2201
Name of Applicant (please print) Business Address Telephone No.
Name of•Contractor and Job' Foreman Business Address Telephone No. -
on file rn file
Contractor's License No. City Business License No.
on. file
Applicant's 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 I C - DD
penalty..
Cash Deposit -Surety Bond .
if required
TOTAL: $_
Receipt No
Received by Date
Recorded by
�AR7TA5 j09 �90 i0.00 10
PERMIT VALIDATION
PERMIT NO. 0635
DATE APPROVED' 5/9190
EXPIRATION DATE 5/10/90. '
o
DATE ISSUE -6 -f /ti /a /on,
By
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:
-----
..-..,.... — — .+ — — — r — — w w w ... — — �a..;..r r .w+...+ ......� r r :r .,... ------
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 I I
DATE: May 9, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION MOVE EQUIPMENT
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION Rarbpr Grp--pnp-
10' K" tai dp r hei aht. and uapi abt. lizaal
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
HAUL ROUTE: WASHINGTON NORTH AT
TAMPICO TO FRED WARING DRIVE
14OVE ON: MAY 10, 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 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 ofthis work.
N b ".' .
!%Signature of Applicant or" Agent
Massey Sand and Rock 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 m file
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
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
Receipt No.
Received by Date
W'56� &AL5 09--9() 10.00 io
PERMIT VALIDATION
0635
PERMIT NO.
DATE APPROVED 5/9/90
EXPIRATION DATE 5/10/90
DATE ISSUED 1 1519 /20
By—
Administrative Authority
Recorded by 11 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)' .
OP'[1�9 -
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
c Subdivision Improvement Permit — Class 111
DATE: �� 7U Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
P,URPOSE.OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DEPCRIP IRN OF;C,O STRUCTION L!/ "'-
r
DIMENSION OF INSTALLATION OR REMOVAL l �I
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, cam
paction •.and placing permanent resurfacing 'and/or replacing improvements►
In consideration of•the g�ariting 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 perrnit,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 A t
` c
Name of Appli t (please print) Business Address Telephone No.
Name of. Contractor and Job Foreman Business Address Telephone No.
Contractor's cense No: City Busih s License No.
Applicant's Insur ce Company Policy Number
FEES: Subdivision Improvement Permit — Class. III `
Public improvements: 3% of estimated construction costs
Private improvements: 3%'of estimated:construction costs A O
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee
PERMIT NO.
Penalty x
9-dah Nomitsgurety,Rend DATE APPROVED .
if Pd,qul?ep EXPIRATION.DATE
TOTAL:: $ DATE ISSUED
Receipt 'No.
By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246.