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0776°:�! a., _,L.,�„ � ,._;ayv. i•:--+ rs'Y+i.lnz.•'�y�5i++•.+5. '�(,' . ,�:. r{�„'•�.,z�y*':�V'• �k"�`�',.py4•'"'"�ea�e',n�'`*�'6M+y"t+�` '��' hsT'9�r++r'�i "' �,,.M `S • ` `-moi s 'p' ,',"- ��'r`" +��,i�t� t,� " -�•.ae.-w:rw.v�+uur-.�:cc3:e+r«y++•.a-w.-wa�.:.rr-.+.r.., r;. r ,� .-e : _'/._...�.. — ..".. � .� ... —'v.:r. .r ... w .u... � , .... .. .� .....�..,.... . ,.._.—........ s-..`... ,. NOTE w With proper validation cz 2 this form constitutes an encroachment permCITY- OF it LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION- (ENCROACHMENT). - 7• Sw�ti 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: 8-9-90 Minor Improvement Permit Class IV LOCATION OF. CONSTRUCTION M(1VF. T?OTTTPMT+'TTT (Street address or Description of Location) PURPOSE OF CONSTRUCTION" Sketch (attach construction plans if appropriate) DESCRIPTION,OF•CONST RUCTION -- �� m��r�L HAUL ROUTE '('RATTT 1 'T-TrTGT-iT 1 J Tmaoxr nc^ ��T..m►ni�" 52 AND .JEFFERSON WEST BOUND .TO : BONPC PrTR1)T,1� r�ir�r�um 1 -7, )0 n BERI�tUDAS '.SOUTH BOUND TO NOGALES DIMENSION OF INSTALLATION. OR REMOVAL ' HAUL ROUTE DATE �8-9-90 .SIZE OF, EXCAVATION, IF NEEDED 8-10-90, ONE DAY ONLY 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.. Signature,of. Applicant or Agent MASSEY SAND P PDX i T mT ' Name of Applicant, (please print) Business Address. Telephone No.• Name of Contractor,and Job Foreman Business Address 2t� Telephone No. ON FILE. Contractor's'License No. City Business�License No. pplicant s Insurance Company PolicyNumber FEES: Subdivision Improvement Permit — Class I I 053 h b 8-09-90 • i0 Public improvements: 3% of estimated construction costs 10" JN i 1 OT . i i0 00 Private improvements: 3% of estimated construction costs Q 6776.' A �p !°� ACD�o . Minor Improvement Permit — Class IV: See attached schedule - Inspection Fee $ PERMIT VALIDATION Permit Fee 10.20 LTTE0776- PERMIT NO. . Penalty DATE APPROVED Cash Deposit -Surety Bond S i if required EXPI•RA�F9N_DATE /Cl—ta—i A O 19 /� A.A o O C ..- v TOTAC: $ 10.00 v DATE 1. 1:1' Receipt No. Received by Date` Administrative Authority Recorded by 1 TELEPHONE: (619) 564-2246. , - , , ... , s.ti.. - � :tea , �. ,,� .. :... - -e. ,�;_ :�-�,•..':. � -sy . �� .., .. .. .. "0 : +;.��.c!i+a+►�1�..-i�i *nY++",w!,+� F� Ir 6i. w ..-a..+ — �. .r rw-a. — — — — — w r — r w F� b w M �r:'r.i+. wi. r ...•r e. a+. r. www. r.�...•sr � +.-.s...M,•v� `NOTE: With proper validation 2 this form constitutes an r � O CITY OF LA QUINTA encroachment permit 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 III DATE: 8-9-90 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION PQT1TPMrh7rP (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) K mnn� rn DESCRIPTION OF CONSTRUCTION 2 ,I;;. HAUL ROUTE— CRAIN 15 RPT52 AND JEFFERSON WEST BOUND TO r_u°P 1 1 TnTTMMU P M T t*rtTEN BONES PIJRPT:F'. UIPTr_um 17')050 T Ro BEW-1UDAS SOUTH BOUND TO NOGALES DIMENSION OF INSTALLATION OR REMOVAL HAUL ROUTE DATE 8-9-90 SIZE OF EXCAVATION, IF NEEDED 8-10-90 APPROXIMATE TIME WHEN WORK WILL BEGIN ONE DAY ONLY 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. f MASSEY SAND AND Name of Applicant (please print) Signature of Applicant or Agent Business Address Telephone No. Name of Contractor and Job Foreman Business Address :.4 Telephone No. ON FILE Contractor's License No. City Business License No. , :J.. r- ApplicantLu'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: Receipt No. Received by Recorded by 10'00 FTT.T' $ 10.00 Date 10051 ,ASH i6OTA0L8 ip9-90 io.00 10 N' 0776 PERMIT VALIDATION 0776 PERMIT NO. DATE APPROVED 0-0-1 A EXPI•R-AT10N.DATE'� %�—q-1 n A—} n—an DATE:I �FD8-9-90 �By Administrative Authority TELEPHONE: (619) 564-2246 . ;inn . � � � � �• / ' � . . NOTE: - - - .• • Wite proper validation 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 Subdivision Improvement Permit — Class II I DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF n-_ DIMENSION OF INSTALLATI(YN OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Sketch (attacstruction plans if appropriate) h�W.17eae P -, e,) 01 j�.s `x.A � APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION $ ST Co/ la -u I (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 A/gent f CJS 1 ame of Appli nt (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Addresslep one No. ,:, Contractor's License f�yi. 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 costa Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ �� Permit Fee Penalty doh P&ppiit-54tg1y Viand If raqulrad TQTAL; Receipt No,. Aia@luad 6y 1.aia Howled by - .....: No PERMIT. VALIDATION PERMIT NO. QAT9 APPRQV4P EXPIRATION DATE ®ATI IBBU19 gy - Administrative Authority TELEPHONE:1919) 990249