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0757+`.i"14.�-►:r*-VC'-V�y, zi,C ,ai#�" jY<_ ii6�wf4 * Yi < t• re wl. �c `��d, 41.i�!gi:jiy+Md''Y?�9wit'T•�'•✓M•.ii KK -w. �.��•r�. �.-K w.'h► .M �i'�1.i. — •yaw ir.r ••• �.�.-w ti �n v�� ry+w-K ti NOTE:. With proper validation. Qom_ this form constitutes an encroachment permit CITY OF. LA QU.I NTA 83 - , .APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) c� ONE TRIP 'OVERSIZE LOAD PERMIT �lnr raa9 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 I II DATE: 7-2.5-90 Minor Improvement Permit Class.IV LOCATION OF CONSTRUCTION avrm SQ. &jt-fft-r-_cin (Street address or Description of Location) PURPOSE OF CONSTRUCTION mOVe equipment Sketch (attach constructionfans if:a p ppropriate) DESCRIPTION OF CONSTRUCTION trailer mounted drill rig HAUL ROUTE: ave 50 &jefferson north DIMENSION OF INSTALLATION OR REMOVALI3' 8"h 10"77 w on Jefferson to city limits 6012111 316verhang 88,600 wt 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 ) move On one day .Only) paction and placing permanent resurfacing and/or replacing improvements) In consideration of the grantingof 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 oroccurring 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. - 'i 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 r Signature of Applicant or Agent McCalla BROS 53-381 hwy 111 coache-i`1a 'CA 1 800—.:344--1912 4 ' Name of Applicant (please print) Business` Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. 51001.1 cl-c-57 " Contractor's License No. City Business License Na. hartford ins. group n 84clrp35032e Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit - Class I I I i© Public improvements: 3% of esti r gated construction costs'.=. Private improve ments:.3% of estimated construction costs Minor Improvement Permit Class IV: See attached. schedule Inspection Fee $ Permit Fee 10.00 :. Penalty Cash Deposit -Surety Bond if required - TOTAL Receipt No. Received by Recorded by $ 10.00' Date 00518` .10'b055 0.7-25-g0. i0 CASH i TOTAL'. 1 " 0.00 N2. 0757 PERMIT VALIDATION • PERMIT NO. 0757 DATE APPROVED-2S—gt7 EXPIRATION DATE 7"30-90 DAZISSED 7-2 -�0 By� ,Ol /Administrative Authority TELEPHONE: (619) 564-2246 With proper validation `• {R\ter•/."�/��-j(�'� , this form constitutes an CITY OF LA QUINTA encroachment permit 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 Subdivision Improvement Permit — Class I I I DATE: 7-29—()0 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION Ame .50 A JAffArson (Street address or Description of Location) PURPOSE OF CONSTRUCTION move equipment Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION trailer mounted drill rig HAUL ROUTE: ave 50 &Jefferson north 13 8"h 0`9'w on Jefferson to city limits DIMENSION OF INSTALLATION OR REMOVAL 6012"l 31overhang 88,600 wt SIZE OF EXCAVATION, IF NEEDED f. APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- )m ove on one_ day only) 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 McCalla BROS 53-.381 hwy 111 Coachella CA 1 800- 344-1912 Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. 510011 cl-c-57 Contractor's License No. City Business License No. hartford ins. group n 84clrp35032e 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 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL Receipt No. $ 10.00 Received by Date Recorded by J0 CASH i I'OTAt ~i5 90 10.0010 AN- 0757 PERMIT VALIDATION PERMIT NO. 0757 DATEAPPROVED 7-25-90 EXPIRATION DATE 7-30-90 DATE ISSUED 4f 7'225 ,90 By .`i(.(/tel .K..�f'.0!4 - � Administrative Authority TELEPHONE: (619) 564-2246 NOTE: With proper validation this.form constitutes an encroachment permit CITY OF LA 1QUINTA 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 111 DATE: MinorImprovement Permit Class IV LOCATION F CONSTRUCTION e` (���� 441. 13' (Street address or Description of Location) PUagPOSE OF CO STRUCTIO Sketch (attach construction plans if appropriate) l D DESCRIPTION OF CONSTRUCTION ' ' 4 t4 l� ZEF-F—r25d1J DIMENSION OF INSTALLATION OR REMOVAL or- ry .so 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 save the City, its authorized agents, officers, .representatives and employees, harmless from and against any and all penalties, liabilities or lou 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. e Comply with, all applicable City Ordinances; the terms and conditions of the permit Fd all applicable rules and regulations of the City of L.a Quinta and to pay for any additional" replacement necesiary as the result of thi work. Signature of Applicant Agent 5 ,5 �/ 1711 Name of Appficant (please print) B siness Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. roi2 p .N. roup g' C LA P 3 5O 32 E , Applicant's Insurance Company Policy Number` FEES: Subdivision Improvement Permit — Class.( I,I +. , Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction 'costs U Minor -Improvement Permit - Class IV: See attached schedule Inspection Fee $ Permit Fee Penalty Cash Deposit -Surety Bond if required TOTAL: $ , Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE ISSUED By Administrative Authority TELEPHONE: (619) 5642246 �:-:— -�-�•-'-mss--�=�--=- - -- �..�.�,• "`N'"�.�_ .�� +r 'tz•T✓ `. ; �..• w ." w+ ..t i �`"�i��' ,/ �'�j,-.�yH�j .• r T�S1it'1 �•ti L^'T•i`„"_} w j1 �r`r� :r•. y�— �L F.;.. k.�•-.niti- y .AY,[»G t"- wrr' � .t -.�'., �^ h�. .P11S1. .A .. ,}t �+" {• � ,r S#°.� �t (.pL 'FERMI I' ''J'RLlr_HRI.� TEL 1-7'- ?J—mac ` 2 �� 1 .7u.1 ,.90 14 23 No .00? P 01 ' t rALjF0_j?NjA PERMIT SERVICES ALL FEES PREPAID P.Q. Box 799 • San Bemardlno, California 92402 • (714) 381-2261 r San Berhardino Sa» Francisco Redding•;' Marysville Fresno Los Angeles ' (714) 381.2261 (415) 626.0616 (916) 246-7523 (916) 743.7161 (209)•445.3151 (213) 617.9870 Attention Driver: -SENT 3Y:MVC n .4 BRtJ00ACHEL' ',-2N_J� ;� 56 � G1�a�t�'?5 a-+ 1 114 ��� ;b Z;9 ' r> A4 C RTIFICATE OF INSURANCE ISSUE CATS PRODUCER THIS CCRTIPICATE 19 199UEO 0 A MA116R OF. INFORMATION ONLY AND CONKERS . NO RIGHTS UPON THE CaRTWIGATE IiOLD`.R, T o;S Cz RF% TIFIQA7E GDES NOT AIA�ND;•r';:'' EXTEND OR ALTER THE QOVEHAU AFFORDED RY THE POLICIES BELOW l+R4K 8. HALL & CCI. OF Md, , XNC.:. _ —' 1 tan N. BROR1)WAY I BOATMEN' 8 . TDWEf<COMPANIES { AFFORDING COVERA�S 8T. !�(aUYBs MO b3 02 4314) 4'3 1 0 1 (:1 COMPANY A au�•opae HARTFORD 'NSQRANCE.0Rp.Q COMPANYINSURIO 7 MCCAL-L.A BROga oOinPANY'C e ' L@T7ER '"•;' A DIV. OF L.AYNE—WESTERN. CCI. , INC. .. Y.. 5Z-181 HIGHWAY 111 COMPANY G `. a, pax 966 A •� �r�ACHI� t_� , CA 92236., , ...... �•: ,'�; COMPANY THIS IS TO CERTIFY THAT TiHE POLICIES OF INSURANCE LISTED &FLOW 4AV9 BEEKISIVED "C• TH9 INSURED INAMID ABOVE FOR THE POLICY PERIOD � d.S INDICATED, NOrNITHBTANOINo ANY REOUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTkrR DOCUMENT WITH RI?SPECT TO Wy1CH THIS CERTIFICATE MAY AE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED 8Y THE POLICIES DUCRIBED HEREIN 1$ SUBJECT TO ALL THE ` AMS EXCLUSIONS AND COW0jTIONt3 OF 9UGH POLICIES. LIMIT$ BHwWN MAY HAVE BEEN REDUCED BY PAID CLAIh,E, + POLICY bfFBCTIVE ;IPDI.ICY 9XP4RATION' CO TYPE OF IN9URANBB i0L1,.Y NUMBaR ALL LIMIT® !X rNCU ANoa # TR DAY! (MM1o0tYY) I DATE (MMIDONY) I 19 l�} OBNpf1AL LIA®ILITY ; GENERAL AGRPEr3ATH . ! .GV�. S` i A: ;I 0 �, �•9 X COMMCROIAL GENBR46 LIA@ILITy PRCLUCtd COk•Q bre AbQREQATL + I CIC ; ' I f S CLAIMSMADH X OCCUR., �L�'OL.�+�'`;3F►OL+SE."' I PEfiSONAL B,{�VEii7iS:t�Q`N;URY 112 omut"e 8 COviAAvTOR'8 PROT.` K: X CONTRACTUAL v PAE CAMAOE (Any one 4n)'.......... a �►C1'f ` 1 %l'rr ,C4 WENS@ In vnI Potoenl AU7OM091LE LIA9161TY 000INED i`* A .X.. ANY AVTO 0",S—C�1—eta, c►�--e;)1y-fit 'urr,1T .I r�{�9..: r �-''"�` ALLOWNaDAUTOS 84ABRP35033E eoc+ 6v..• 1 ! i INJURY 8 { >} 1 8Cri6DUL9D AVTOS NJ 84ASRP3 5034E , 'Per pe.tson # pIIRQO AUT08 , TX 84ALRP35035E r: srao;LY NON-OWNtO AUTOS INJURY ' 6 X MA 84MCs"'F''��S�aw.+{s� (Perl.Cloel: y GARAGE LIA1ILIiY I'ADPER7Y DAMAGE EXCESS LIABILITY EACH A ATE , OTHER THAN LMeWELLA FDRM ",r`�F;/ L'• • ... ....• WORKER'S C........OMPEne010N . _.. ... • . .. .. .. aTA�U�GRY 4 a^ I a PEACH ACCIDIINTI j >,F AND ,�,. A. n�"^(��"�t�; �1°��Ci1�L7� _ ..,. �9��G�I(DISEASE--pOLIDY�ISttT),_.1", t BMP Y6R8' L#A91LITv 84W8RP3 5L1Z 1 C `i_"lG B ^. j 15(.Y0 1D)BER66•►EACN IMPILOYEld + 6ilORIPTION OF OPERATIONBILOCATIONS/VEHIOLEW 18PEC1AL ITIMO y ,, . CERTIFICATE HOLDER _ CANCELLATION ' CITY OF LA QUINTA "AS ADDITIONALLY .�SHOVLO ANY.QF THE ABOVE DE3CRIBc ?OLIvIEB 6£ fif+iC#:L! £D aBPORt 'I's t. INSURED �� t ! f gXPtRATf0.F1 BAT@ THRi180F, THH ISBJING COMPANY WILL, INDEAVi�QS TO I 78105 CALLF, ESTApO 1. MAID' =;'DAYS WRITTEN NOT1Cg TO THE CERTIFICATE HOLDER RAhiECftO T1i8tI �•. B ' LEFT, BUT•FAILURJE TO MAIL SUCH N0710E'8HALL,iMPO$E'NO'OHLIGATION OR-,I LA QTJ.INTA ,` CA .. LIA911 7TY CF�ANY KIND UPC\.THE CQPAPANY, ITE n0EUT3 QR R°PRl:3sNTATiVE8. �t r"`• � - " ` • ! .AUT RIZIAEPRBQENYATI ,.+ • i v .nye t � ti _ ' 1 a..: .t- :s t.tK 'Y. '•A 17� - i 'Y,�i'tt:t � i -4�., •,:L, �, .. ` - l y 7 tr 4 �� �! .�� � ^'iiC.. -%_n• T d' �. ..p ''a. _s:{.i 91 .'i. '��.•Sr. ^ti, �s ".S'As .��•. .a ( r�2.i!`s77���5,.' ��+;��,