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1
NOTE:
With proper validation
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 II
DATE: July 31, 1990 Min6r Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
N
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION 633 Cat scraper
)DIMENSION OF -INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
HAUL•ROUTE: WESTBOUND ON AVE. 50
TO WASHINGTON, NORTH BOUND TO
FORTH OF CITY LIMITS
HAUL DATE t '311 I -To
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:
10 51 CASH i TOTAL i i_g0 i0.00 14
i .
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.
I Signature of Applicant or Agent
Massev Sand and Rock PO Box 1767 Indio, CA
Name of Applicant (please print) Business Address Telephone No. .
Cattract Construction 15030'Slover Fontana, CA 92335 714-355-1146
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's 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 construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL:
10.00
$ 10.00
Receipt No.
Received by Date
Recorded by
�° .0'63
PERMIT VALIDATION
PERMIT NO. 0763
DATE APPROVED 7/31/90
EXPIRATION.DATE 8/1/90
DATE ISSUED �� N U
By
Administrative Authority ,
TELEPHONE: (619) 564-2246
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C
NOTE:
With proper validation
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 III
DATE: July 31, 1990 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 633 Cat scraper HAUL ROUTE: WESTBOUND ON AVE. 50
TO WASHINGTON, NORTH BOUND TO
NORTH OF CITY LIMITS
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
HAUL DATE: r{ lqo
0 SiCASH i i�OTAL i i--vo io.00 14
_APPROXIMATE TIME OF COMPLETION
r. 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:
ti
Indernnify, 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
Massev Sand and Rock PO Box 1767 Indio, CA
Name of Applicant (please print) Business Address Telephone No.
Cattxact Construction 15030 Slover Fontana, CA 92335 714-355-1146
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's'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 construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.00
Receipt No.
Received by
Recorded by
Date
0703
PERMIT VALIDATION
0763
PERMIT NO.
DATE APPROVED 7/31/90
EXPIRATION DATE
8/1/90
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246