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li
NOTE: y.>
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 Dike public works improvements, in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit —Class II I
May 17, 1990
DATE: Minor Improvement"Permit Class IV
LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location)
PURPOSE OF. CONSTRUCTION 905 barber areenP
10'6" wide height and wei.aht ledal
DESCRIPTION OF CONSTRUCTION
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 AT FRED
WARING SOUTH TO TAMPICO
HAUL DATE: -.May 17; 1990 or
May.18,. 1,990
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.
F
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.
j Signature of Applicant or Agent
Massey Sand and Rock- 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.
'...... e V TA
1.8.i �i _
Contractor's License No. City Business License No.
on file
Applicant's Insurance Company -Policy Number
FEES: Subdivision Improvement Permit —Class III
pp 5f87 U 44#���i 7-•90 i0
Public improvements: 3% of estimated construction costs i� �`ARH i 10.00
Private improvements: 3% of estimated construction costsTQ 0643 643
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
PERMIT VALIDATION
PERMIT NO. .0643
DATE APPROVED 5/17/90
EXPIRATION DATE 5/18/90
DATE ISSUE.D--`-5/17/990y0n
By c Ad(.(�//yy t�l v TSI tA14-9-1
Administrative Authority
TELEPHONE: (619) 564-2246
's`. �.r� i',./�..u'✓'-,�_..-w-r.�... •.-• Y .-. _ �'�.: w �.�"^ � - !' .r- .. _ _ ,. .-acv �..i.r�M=-•� .� .�•M • "•h..'ti�. . ... _ N� . �.... r � -.
f �
• `w!+'wrw.!il. @a�.•tiu w � wr•Yi r � w r ---------------
NOTE:
--Y—MrWwww---6NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
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: May 17, 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move , equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 905 barbi'z areene Sketch (attach construction plans if appropriate)
1016" wide height and weight legal.
DESCRIPTION OF CONSTRUCTION HAUL' ROUTE: WASHINGTON AT FRED
WARING SOUTH TO TAMPICO
DIMENSION OF INSTALLATION.OR REMOVAL
HAUL.DATE: May 17, 1990 or
May 18, 1990
SIZE OF EXCAVATION, IF NEEDED
ONE DAY ONLY
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)
t
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.
Yl !.•='�S%%l r.. til i/ i � r'r. -.>'`'
Signature of Applicant or`Agent
Massey Sand and Rock 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.
Contractor's License No. City Business License No.
on fi1e,
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. $ II
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
051; AN '166 A r-90 10.009.0
Ne 0043
PERMIT VALIDATION
PERMIT NO.. 0643
DATE APPROVED 5/17/90
EXPIRATION DATE 5/18/90
DATE ISSUED --f 5/17/90 ,
By �4 &,A� A' �+ .4 : _ice"►
Administrative Authority
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)
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 I I I
DATE:/ Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DIMEN91ON OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
i i c �yow vcT
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 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.
Name of ApplicayrSt (please print).
gnature of 9gplicant or Agent A
Business Address Telephone No.
Name of Contractor nd J b Foreman Business Address T "ph a No.
o
Contractor's Li en,No� City Business Licen a No._.
Applicant's In urance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 31% of estimated construction costs
Private improvements: 3% of estimated construction costs N�
Minor Improvement Permit - Class .IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
PERMIT VALIDATION
PERMIT NO..
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPH®NK: (693) 664-3346