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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
May 10, 1990 Subdivision Improvement Permit —Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION mn��o s�rnti r+mcn+
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION 265 Barber Greene
1016" wide, height and weight legal
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 AOUTH TO
AVE. 52 -WEST TO BERMUDAS SOUTH TO
EISENHOWER
MOVE ONi May 11, 1990 or
May.14, 1990
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.
Signature of.Applicant or�,Agent.
Massey Sand and Rock Co PO Boxl76.7.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 Wn 409 in 4140 05-0-90 14
Applicant's Insurance Company PolicyoNumberR 1 1BIHL. 1 IV. Ulu
FEES: Subdivision Improvement Permit— Class I II
Public improve ments:• 3% of estimated construction costs
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: $ 10.00
Receipt No.
Received by Date
Recorded by
N2 0fi37
PERMIT VALIDATION
PERMIT NO. 0.637
DATE APPROVED 5-/10/90
EXPIRATION DATE
DATE ISSUED /-X10190
By
Administrative Authority
TELEPHONE: (619) 564-2246
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NOTE: '
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
1 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
DATE: May 10, 1690
LOCATION OF CONSTRUCTION mnv� atxt� i rim an h
(Street address or Description of Location)
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 265 Barber Greene
1016" wide, heiciht and weight legal HAUL ROUTE: WASHINGTON SOUTH TO -
AVE. 52 WEST TO BERMUDAS SOUTH TO
DIMENSION OF INSTALLATION OR REMOVAL EISENHOWER
MOVE ON: May 11, 1990 or
SIZE OF EXCAVATION, IF NEEDED May 14, 1990
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.
Signature of Applicant orAgent
Massey Sand -and Rock Co PO Box1767. 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 Anr W) 10 4140 OS—0-94 h-94 14
Applicant's Insurance Company Policy)Nunr&"r•W 1 1UTAL. 1 IV. Vv
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 Feb 10.00 II
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
Received by
$ 10.00
Date
0637
PERMIT VALIDATION
PERMIT NO. 0637
DATE APPROVED 5/10/90
EXPIRATION DATE 5/1.4/90
DATE ISSUED - -y/10/90
By
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 III
DATE:/G Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION 0�lrG(i�NSTRUCTION
Ga _,
Of
DIMENSION OF INSTALLATION OR REMOVAL �a
i�l-kYti•✓l/r� �A
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, 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 124) 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 jWpipficant or Ag t
I^., �v
Name of Appli (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor' /icense No. City Busines License No.
Applicanf's,'nsurance 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 l�
Inspection Fee $ II PERMIT VALIDATION
Permit Fee
Penalty
Cash Deposit -Surety Bond
if requircd .
TOTAL: $
Receipt No.
Receivod by Date
Recorded by
PERMIT NO.
DATE APPROVED
EXPIRATION OATS
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246