06931*.
:1k
may`.
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit .
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP PERMIT OVERSIZE LOAD
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: June 12,E 1990
LOCATION OF CONSTRUCTION move eauinment
Subdivision Improvement Permit — Class I II
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE.OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 633 scraper
h 1�"�"{ 1.3��"; len«th 90' w 120284 lbs HAUL ROUTE: AVE`. 52 do Washington
north" to I-10
DIMENSION OF INSTALLATION OR REMOVAL
4
Pilot cars required
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN. 6/13/90
APPROXIMATE TIME OF COMPLETION HAUL DATE: JUNE 13, 1990
ESTIMATED CONSTRUCTION COST $; 0 502 i0 4995 06-i2-90 14
(Including removal of all obstruction, niaterials,.and debris,. backfilling, com A� CASH i TOTAL 1 50.40
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.
Vn41-
Signature
of,Applicant or Agent'
Cal Permits PO Box 799. San Bermardino, CA 1800-344-1912
.Name of Applicant (please print) Business Address• Telephone No.
Schwab Sales Chandler AZ •1-800-344-1912
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 N? 0693
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee . $'
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: . $ 1n.00
Receipt No.
Received by
Recorded
Recorded by
Date _-
PERMIT VALIDATION
PERMIT NO. 0693
DATE APPROV ED/ 12 / 9 0
EXPIRAT ON DATE 6/13/90
•6/22/90
DATE ISSUED n
By
v Administrative Authority
TELEPHONE: (619) 564-2246
a f.
Fl3yu.
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NOTE:
p—w..wc.arsacaaan.ny.w..y—waawas w—aww,A+.ArY..eY.
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP PERMIT OVERSIZZ LOAD
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
Juno 12, 1990
LOCATION OF CONSTRUCTION move eauipment
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 633 scrAAer
h 15"9"; �1 1.'A'A" Innath 90' w 180284 lbs HAUL ROUTE: AVD. 52 �o 3a�hf.n f C�
north to 1-10
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/13/90
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
d 1 • f d/ I
pactlon an .p acing permanent resur acing an or rep acing Improvements)
In consideration of the granting of this permit, the applicant hereby agrees to:
Pilot cars required
):TAUT DATE a. JUNE 13, 19 9.0
3t�A�o l,99'i 0606--i2-go r :
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,,Aent
Cal Permits PO Box 799 San Bernardino, CA �� 1800-344-1912
Name of Applicant (please print) Business Address Telephone No.
Schwab Sales Chandler A2 1-800-344-1912
Name of Contractor and Job Foreman Business Address Telephone No.
on file on filo
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:
10.00
$ 10.00
Receipt No.
Received by Date
PERMIT VALIDATION
PERMIT NO. 0693
DATE APPROVED/12/90
EXPIRATION DATE 6/13/90
6/22/90
DATE ISSUED
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
j'ro NOTE: {
>, With proper validation
' this form constitutes an
{�encroachment permit `
CITY OF
LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ti OF'f[IB� t:
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: `�� " Z' Minor Improvement Permit Class IV..
LOCATION OF CONSTRUCTION ��/��� f.�/�•4 �j ��%+D'Z �plt�
A
(Street address orDescription of Location)
PURPOSE OFC,ONSTRUCTION Sketch (attach construction plans if a`
t ppropriate) -
' DESCRIPTION OF CONSTRUCTION-✓�`. sib ��. 4 / d �� .
.�'
DIMENSION O,� INSTALLATION OR..REMOVAL /'
4- A� 6 '
SIZE OF EXCAVATION, IF.NEEDED
i' APPROXIMATE TIME WHEN WORK WILLBEGIN
`k APPROXIMATE TIME OF COMPLETION
r
ESTIMATED CONSTRUCTION COST $
(Including removal of -all obstruction, materials, and.debris, backfilling;,com
,i paction. and placing"permanent resurfacing and/or replacing improvements)
ns:imow,.Inn.c—o. dnof _he 9 ra—ntin9,o_t"fhi-spermit,", the- apol i cant
ermrt"the-apPlicant hereby a rees,, to_:
Indemnif defend and save the City, y, 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 persona or property
i'
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 a d all applicabl rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary. as' the, result of. this ork.
41
Signature of Applicant or Went
R®;�:I 7(' 04���
Name of Applicant (please print) i Business Address Telephone No.
Name of Contractor aZJob Foreman Business Address Telephone No.
Contractor's License N t ' City Business.License No"'
�.,r9. ADnliranr-;risu�a,��� Company' ; — Policy Number 5
FEES: Subdivision Improvement Permit — Class I I I $
Public improvements: 3% of estimated construction costs _+ '
Private improvements: 3% of estimated construction costs
NO
Minor Improvement Permit — Class IV: See attached4 schedule
Inspection Fee $ PERMIT VALIDATION '
Permit Fee PERMIT N0.
—Penalty DATE APPROVED '
Cash Deposit -Surety Bond ,
if required
EXPIRATION DATE
TOTAL: $ DATE ISSUED
Receipt No.
By
' t Received by Date `� Administrative Authority
Recorded by- TELEPHONE: (619):564-2246.