0707.t,'""tJ7Y*,rN.+ # 7`„ h� `•,gkr. f'd�rz ;% '"",�'.�k, S �°S.a!"'" , ;!.'G9 i•s,'"Y..�yt�. �;,,',, nc-F'Ki{.
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NOTE:
With proper validation
this form constitutes an O4
1
encroachment permit CITY OF LA QUINTA
APPLICATION .FOR PERMIT + -
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OF
OVERSIZE LOAD'ONE•TRIP 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'
June 18, 1,990 Subdivision Improvemer t.Permit = Class IIT
DATE:
.Minor Improvement Permif'Class IV
LOCATION OF CONSTRUCTION move equipment, '
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
i DESCRIPTION OF CONSTRUCTION 10 .x '40 trailer HAUL ROUTE: .WASHINGTON TO
' CALLE • TAMPICO' �TO 'DESERT CLUB
DRIVE TO CALLE ESTADO,
DIMENSION OF INSTALLATION OR. REMOVAL '
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL'BEGIN June 18 1990•
APPROXIMATE TIME OF COMPLETION June•• 18 ; 1990 '
ESTIMATEDiCONSTRUCTION COST $
(Including removal'of all obstruction„materials, and debris; backfilling, com
paction and//placing :'permanent resurfacing and/or replacing improvements)
In consideration of Ithe 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 anyand all r
pgnalties, 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 permsX and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacement necessary as the. esult of th s`work. - .
SiOnature of Applicant or Agent (/
Sic
Mf Corp. 43�unburst St India CA
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
is a
Contractor's License No. City Business -License No. .
Partee Ins. '.Assoc AS 9001652
Applicant's -Insurance Company Policy Number
. FEES: Subdivision Improvement Permit - Class I I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit=Class IV: See attached schedule N2 ® 7•0 7
t
Inspection Fee $ PERMIT VALIDATION
' Permit Fee n/a
PERMIT NO. — (17(17
Penalty DATE APPROVED. '618/90 ”
Cash Deposit -Surety Bond
if.required EXPIRATION DATE 6/18/9.0
'TOTAL: $
DATE r. 1 >�+. Qn
Receipt No. F
By r'
Received.by Date. Administrative Authority
Recorded by. TELEPHONE: (619) 564-2246
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'y!%m:'3'� �'%1it'^ Z. � �-�;.,s.,.. �+^""i'=v-�.'�C-�"-� ,;A +.wr..Y�,.•."�.:.�..tty=:-�.5a�+:>�+c;a�i.�A'..+-.�� .'�:;,/yarrT
eo�.}�. ".�'Y!+.']:.^r .�{e �i.. M f K..c+. +. .:�s"r 6i1 Ye w� W OB r' -or •r,•a.: w •ri.. W s ��jr-.w •iiY..`.. A M N �-K`r� r .....tip: �.`tl+-w •w..r b .m d...w-r� .? :, "W� ..
NOTE:
With proper validation .
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OVERSIZE LOAD ONE TRIP 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
June 18, 1990 Subdivision Improvement Permit — Class III
DATE: 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 10 x 40 trailer
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN June 18, 1990
HAUL ROUTE: WASHINGTON TO
CALLE TAMPICO TO DESERT CLUB
DRIVE TO CALLE ESTADO
APPROXIMATE TIME OF COMPLETION June 18, 1990 _
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 agrees to:
r
i�- Ind4 nify,-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.
/Nomply
otify the Administrative Authority at least twenty-four (24) hours in advance of the time when, work will be started.
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 `e/result of this work.
Scsman Mfg.
Name of Applicant"(please print)
Si
4 3,k4
of Applicant or Agent /"/-
Business Address
st St Indi8, CA
Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business License No. `.
Partee-Ins. Assoc AS 9001652
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 n/a
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.,
Received by Date
Recorded by
N1 0707
PERMIT VALIDATION
PERMIT. NO. 0707
DATE APPROVED 6/18/90
EXPIRATION DATE 6/1$/90
DATE_ISSUED"�
By
Administrative Authority
TELEPHONE: (619) 564-2246