0694++-NM+-C'K,i+w�r�.�rw-u.cT�-�"�+'09++e fi��cf+a"r^. +rt, w:. a� `. ..w, ,+..�r... r. r..� r «r_+.w.w �,�. �.�. w rte i.� �f. +w r wr�...i�. rr r �#w•w r+� � wv .�a ...�.. ..� .� w �. � r r M ..
NOTE: '
With proper validation
this form constitutes an CITY OF LA QUI NTA
encroachment permit.
APPLICATION FOR. PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE LOAD PLRD1Ir
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, 1990
LOCATION OF CONSTRUCTION move naf-Ument
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 i r%Anr
91611 uidaj 14 h, 65 length -legal weight HAUL ROUTE: t3ASHINGTON SOUTH TO
. TA',7PICO AND EAST ON TAMPICO TO
DIMENSION OF INSTALLATION OR REMOVAL CALLS RONDO, iRtTURN TRIP TMIPICO
TO WASHINGTON NB OUT OF CITY LIMITS
SIZE OF EXCAVATION, IF NEEDED HAUL DATE: June 13, 1990
APPROXIMATE TIME WHEN WORK WILL BEGIN J0 CnS J Q OTAL t 2-9a 10.00 34
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. p'
y
Name of Applicant (please print)
Signature of Applicant or Agent
Business Address
Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on
Contractor's License No.
on fUn
City Business License -No..
On file
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I'l 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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
Receipt No.
10.00
$ 10.00 .
Received by Dafe.
,vn 0 3 n 4
PERMIT VALIDATION
PERMIT NO. 0699
DATE APPROVED 6/12/90
EXPIRATION DAT /12/90
DATE ISSUED 6/1i/9Q
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246
NOTE:
With proper validation '
this form co; stitutesJan
encroachment permit
,. CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
' ONE TRIP OVERSZZE LOAD PERMST-'
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, 1990
LOCATION OF CONSTRUCTION move .ecdinment.
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
Subdivision Improvement Permit — Class III
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION R man r4„ car
9'6" wide, 14 h, 65 lengt 'legal weight HAUL ROUTE: WASHINGTON SOUTH TO
TAMPICO AND.EAST ON TAMPICO TO
"DIMENSION OF. INSTALLATION OR REMOVAL CALLS RONDO, RETURN TRIP TAMPICO
TO WASHINGTON NB OUT OF•CITY LIMITS
SIZE OF EXCAVATION, IF NEEDED HAUL DATE: June 13, 1990
APPROXIMATE TIME WHEN WORK WILL BEGIN C105i82 10 5020 f}G-1a'-90 14
• itJ CASH i TOTAL 1 i0.o0
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing-arid/or replacing improvements)
In consideration of the granting of this permit, the. applicant hereby agreesato:
Indemnify, -defend and save the City, its authorized gents, 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. s
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 Applicant (please print)
Signature of Applicant or Agent
A. ►.-s o 1 .1.1R
Business Address
Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on filp. on file
_ Contractor's License No. �` City Business License No.
on file -
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class I'll
` - Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs Ns 0694
Minor Improvement Permit — Class IV: See attached schedule 4 + K
Inspection Fee $
Permit Fee 10.00 '
4
Penalty
Cash Deposit -Surety Bond ,
if required
TOTAL: $ 10.00
Receipt No
+ Received by
Recorded by
Datej
I . I 4
PERMIT VALIDATION
PERMIT NO. 0694
DATE APPROVED 6/12/90
EXPIRATION DATE /12/90
DATE ISSUED "`6/12/90
By
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)
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: J�C/ Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attac,4 construction plans if appropriate)
DIMEN
TION 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)
In consideration of the granting of this permit, the applicant hereby agrees to:
PW
y
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,'ioss 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.
Signature0
f Applicant or Agent/,
)rk.a eo ttd e-9 -V
Name of Applica t (please pr' t) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address elep one No.
Contractor's License No. City Business License No.
'Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class 111
Public improvements: 3% of.estimated construction costs
Private impreyements; 3T9 of estimated onstruction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
P@r�ali�
Cash Deposit -Surety Bond
if required
TOTAL;'___- -
Receipt No.
Naaaly sd key - bio
Recorded by
N0
PERMIT VALIDATION
PERMIT NO,
DATE APPROVED
EXPIRATION DATE ____...-----•-._
DATE ISSUED
Admimlitra-tivo A wthafl ;y
TELEPHONE: (619) 5642246
rr .
NGTE: .
With proper validation '
this form constitutes an
encroachment permit
CITY OF 'LA QUINTA
APPLICATION, FOR PERMIT,
PUBLIC WORK9 CONSTRUCTION (ENCROACCHME T)2
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: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION M 690 P P Lel
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach onstruction plans if appro riate)
' DESC IPTION OF NSTRUCTION
/Q'm
DIMENSION dF INSTALLATION OR R OVAL C
/n /
I
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ �/,t.. / Oct
(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 hereb;V 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 o Applica t or Agent j/j
124J
:1Z 7 X Z0;'
Name of Applicaryf (pie a print) Business Address Telephone No. r,;W,,We
Name of Contractor and Job Foreman Business Address Telephone No.
/0
Contractors License No. City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class III
Public improvements: 3% of estimated construction costs
Private improvements; 3% of estimated conanction costa
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee
f
e
Penalty .
Cash Deposit -Surety Bond
if required
TOTAL; _--
Receipt No.-
-
I Q@WVed %y bate
Recorded by
kNIE,
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE r
DATE ISSUED -- - - -- - -
By
Administrative Authority
TELEPHONE: (619) 564.2246