0701` - .�--''w:..'., �.d'�:.�3.:�,'°-'�`�'i��"-�:r�»'v��,i�`.�'�+�;�"�'q�,�'-�i"�.~cY'�'"'&A'`3t�`4,"tY`�•N I+AYE"y�is�."+7���,.•'"iF.�,+�:��°"t'�'���::�'��:A`�''.%�•+.o"t�.�.�".,:�''..
NOTE:
With proper validation
this form constitutes an
encroachment permit CITY ' OF , LAQUINTA ,
APPLICATION FOR PERMIT
t
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
a
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'lll
DATE: 6-13-90 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 • bomaa Grinder : - haulroute:
eft rin_:wide 14ft ht 65ft.ln legal wt. tampico & washington to 52
EB ,on Jefferson
,
• DIMENSION OF INSTALLATION OR REMOVAL-14-90haul date 6
SIZE OF EXCAVATION, IF NEEDED i
. • y
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION ,
ESTIMATED CONSTRUCTION COST $
N
(Including removal of all obstruction, materials, and debris; backfilling; com-
paction and placing''permanent resurfacing and/or replacing improvements)
Inconsideration of the, granting of this permit, the applicant hereby agrees to:,
Indemnify, -defend d 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. ` j
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. r
Signature of Applicant or Agent.
ma'ssey sand `& rock p.o. box176.7' indio;CA 9 Z 12" 0/1
Nameof 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
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 costsQSi$° 74.8R6-13-90--,0.000
to aY'L
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee $10.00 1
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ S10.00
Receipt No.
• Received by Date
Recorded by
PERMIT VALIDATION
PERMIT NO. -0 670.1
DATE APPROVED 6-13-90
EXPIRATION DATE 6-14-90
DATE ISSUED .6-13-90
By—
i/Administrative Authority
TELEPHONE: (619) 564-2246
�-�H�iM�--�"R4fK-�fd.�"�!1!^F��!� M Ir .� N 4 .r+.�r Y. Y'.'. �L'Y q�'ai. Y�i.'`Iw-tel Ali w �N w�Y u�. k�. ti. M es'!+�/.� # iw M•'�!•✓'v-tom.- W M��'i�,sY`wi--M.�"�Vi"f!4'NY
NOTE:
With proper validation
this form constitutes an
encroachment permit
I
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
6-13-90 Subdivision Improvement Permit — Class I II
DATE: Minor Improvement Permit Class IV
LOCATION OF"CONSTRUCTION move equipment
(Street address or Description of Location)
k
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION bomag grinder
9£t 6i.n. wide 14ft ht 65ft_ In legal wt.
DIMENSION OF INSTALLATION OR'REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
haulroute:
tampico & washington to 52
EB on Jefferson
haul date 6-14=90
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 n"d 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.
f .
Signature of Applicant or AgentW
massey sand & rock p.o. box1767 indi/o,CA 92"LO1
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
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 510 ,�?, �`-A 06-f3-90 to
Minor Improvement Permit — Class IV: See attached schedule 11U to. 00
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. - j6701
6-13-90
DATE APPROVED
EXPIRATION DATE
6-1.4-90
DAT EE II�S,S/U'ED 6j13-90
ett�
Administrative Authority
Recorded by II TELEPHONE: (619)`564-2246
NOTE:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC -,WORKS CONSTRUCTION (ENC OACHMENT)
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:
LOCATION OF CONSTRUCTION
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 approP riate)
ST
DESCRIPTION OF CO RUCTIONN ✓�&.q 4 4/aae-l'
DIME'I SION OF INSTALLATION 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:
Indemnify, defend and iave�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 properiy
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.
I Name of Applicant/(please print)
Signature of pplicant or Agent
Po
Business Address Telephone No.
Name of Contractor and, JJ b (Foreman Business Address Telephone No.
Contractor's 'License No. City Business License No.
Q vl, �r l i
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Pfiygt@ imprgument.i; 3% of eatimated conatrmign coats
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL; '
Receipt No..'
Rea@Itted by bate
Recorded by
N9
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
TELEPHONE: (619) 564-2246
Administrative Authority