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07437 ' < 4Y .. sww-`M'-►•d•Lrt!.r• 41+.1 w'.••�+i+-r,.www+i'.:�r.�:• r..r r..wr .a.,.a .r .r..r .irr..,:.. • •.w.+-�... r,..—.. r.wa—.,'�i.:+.:.�+�....i....:..: +,.. rw .�I N.9TE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLICI 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 DATE: 7-18-90 LOCATION OF CONSTRUCTION — MOVE EOE' (Street address or Description of Location) PURPOSE.OF CONSTRUCTION DESCRIPTION -OF CONSTRUCTION BARBER GRRF[RTTP'. 10 TME IBGAL HEIGHT ISI HETGEIT DIMENSION OF INSTALLATION OR REMOVAL r SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV Sketch (attach construction plans if appropriate) HAUL ROUTE DATE PALM AVID 'SAGMWSH NIB ON WASHINWON OUT OF. CITY LIMITS HAUL DATE ONLY ON 7-19-90 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 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 Agent / MASSEY SAND AND ROCKS P.O. BOX 1776 TNDTO AA( Name of Applicant (please print) Business Address Telephone No. ON FILE Name of Contractor and Job Foreman . Business Address Telephone No. Contractor's License o. ON FILE ON FILE:,, City Business, License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I IQOSf B 07—iB-90 10 Public improvements: 3% of estimated construction costs 10 LASH 1 TOTAL 1 10.©0 Private improvements: 3% of estimated construction costs r� 0 A Minor Improvement Permit — Class IV: See attached schedule 1�S `f Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. 10.00 $ 10.00 Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 07$3 DATE APPROVED 7-18-90 EXPIRATION DA12&1 —RD DACE SSU b�0 gy �. i A( W � � nis r'Vve Authority TELEPHONE: (619) 564-2246 ,�w'� p�^^�; .,�'^ . i # - S •r, ,��a'�.i �'��,. _.. ..+,. J :y i,•, . �r,.1 �::. �_1 ,,,`..rj4.-e. -. ,..'� ..n.,fo5tiy-.y.,J'%' i-:'4,.�.�Y^.v-.•.,;r: i'^y+��'�''�" .%d-.7•�v'�'.:ji��.�.is►':� � 1.�..-.i.'•wra-. �.I �'�. �+P.+�'Fe�rsie�%.^4r=an+.dr6s.�iaMi.'+tr•w.'rH cow .c. �a. �.. K. W �s .._..c. o. -.., M r.-ari w r.. r r .a w .. o..�. w -N. s:.f. � a. s:.+. r +r +.. .�'v.-w r ra -� .r .. -a: s wr.-.�.•M- �•n NCD�l'E: With proper validation r� 2 this form constitutes an encroachment permit CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS 7-18-90 Subdivision Improvement Permit — Class I I I DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MM EQUIPMW (Street address or Description of Location) . PU RPOSE,OF "CONSTRUCTION DESCRIPTION OF CONSTRUCTION BIARBER MERE 70 TnME LEGPiL HMGW LENMRi MIQU DIMENSION OF,INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION a ESTIMATED CONSTRUCTION COST,$ (Including removal of all obstruction, materials, and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements). Sketch (attach construction plans if appropriate) HAM FDM DM. PALM AND SAmwm NSB ON V* -q I IG= OUP OF CITY LIMITS iiF1M, DATE ONLY CN 7-19-90 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. Signature of Applicant or Agent, MASSEY SAND AND ROCKS P.O. BOX 1776 1WI0 MA Name of Applicant (please print) Business Address Telephone No. ON FILE Name of Contractor and Job Foreman Business Address Telephone No. CST FILE Contractor's License No. City Business License No. ON FILE Applicant's Insurance Company Policy.Number FEES: Subdivision Improvement Permit —Class III 005in 5 07—iB-�90 10 Public improvements: 3% of,estimated construction costs iU CASH 1 TOTAL 1 1(1.00 Private improvements: 3% of estimated construction costs o �y A Minor Improvement Permit — Class IV: See attached schedule 1 p,o (`9t 1 Inspection Fee $ 10.00 Permit Fee Penalty Cash Deposit -Surety Bond if required 10.00 TOTAL: $ Receipt No. Received by , Date Recorded by di r PERMIT VALIDATION PERMIT NO. 073 DATE APPROVED 7-18-90 EXPIRATION DATE'19-90 ,1 ----._ ,,7-18;90 DATE ISSU,E'D'- - Administrative Authority TELEPHONE': (61.9) 564-2246 NOTE: With proper validation this form constitutes an encroachment permit CITY 'OF LA O.UINTA -A•L /VPLICATION 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 �� j�� Subdivision Improvement Permit — Class III DATE: / -A n Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Oescription of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION - l'&A Z — DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED Sketch (attach c nstruction plans if appropriate) a= - y 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 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. Q� ! ame of Appliezant (please print) Signature of Applicant or Agent Business Address Q Telephone No. Name of Contractor an/Job Foreman Business Address Te ph%ne No. Y- Contractor's License No. City Business License No. /J 1. / Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class III Public improvements: 3% of estimated construction costs Private impro m hits; Sia gf estimated Ggflitirmign wits Minor Improvement Permit _ Class IV: See attached schedule Inspection Fee Permit Fee Penalty Cash Deposit -Surety Bond if required • TOTAL; Receipt No..' . Naiad 6y Recorded by bate lr PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED Administrative Authority TELEPHONE: (610) 664.2246