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0797
{ 7 . NOTE: r With proper validation m i. this for -constitutes an encroachment permit , CITY OF 'LA. QUINTA r APPLICATION FOR •PERMIT 'PUBLIC WORKS CONSTRUCTION(ENCROACHMENT); ' t " 0 F.9wSw- i 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 • - Y + SubdivisionImprovement Permit — Class 111 DATE: Minor Improverherit.Permit Class IV MOVE EQUIPMENT, LOCATION OF CONSTRUCTION 1• '~(Street address or Description of Location)' ; • , PURPOSE OF CONSTRUCTION f Sketch (attach construction plans if appropriate) ' s ' DESCRIPTION OF CONSTRUCTION • BARBER GREr^.NF PAxii~ n HAUL ROUTE AVE_ 50' TO WASHINGTON. TO -10,6 WIDE All -ELSE LEGAL HWY :11.1 DIMENSION OF INSTALLATION•OR REMOVAL HAUL DATE 8-21-90. 4 y SIZE OF EXCAVATION, IF NEEDED. y 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 - ' y 'paction and placing permanent resurfacing and/or replacing improvements) . .In consideration of the granting of this permit,'the applicant hereby agrees to: .Indemriify,-defend and ,save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all*,,, y.' 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 a5. arproximate result of any work:undertaken.under the permit granted pursuant to this application.. , - } ,x Notify, the.Administrative Authority, at least twenty-four (24), hours in advance of the time when.workwill 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 necessaryas the result of this work, r Signaturo Applicant or Agent ! MAS fi>aV `nAhTn 'Arlt, nnnT, 'P40. BOX. 1767 INDTn rA n97n7 ' Name of Applicant (please print)' , T 'Business Address ;r '; Tel No. • ,• .Name of Contractor and Job Fo're'man ' Business Address. Telephone No.' ON FILE _ ON+ FILE' Contractor's' License No. ` City BusirUpLliaAs�e No' TA L� 14 45'33 50.0ON•FILE s . . Applicant's Insurance Company Policy Number , FEES: Subdivision Improvement. Permit — Class.I1I ' Public improvements: 3%of estimated construction costs' Private improvements: 3% of estimated construction'costs ` Minor Improvement Permit — Class IV: See attached schedule _o 0719-7 -inspection Fee r r" $ ' PERMIT VALIDATION PermivFee i 10.00 0797 • ,. PERMIT NO. ' A. Penalty DATE APPROVED 8-21-90 Cash. Deposit -Surety Bond / if required EXPIRATION DATE �`R_1)1 _can . TOTAL: $ ria nrT n ) / vza--xar`-- 10'00 DATD Receipt No. B Received by Date ' J `� Administrative Authority Recorded by TELEPHONE: (619) 564-2246 �- .. - _ ' -�°TT"h'�•T�-IOi'l!C'r!.-'M'N^'M �M !!M M1 4w N �1t � �r•41. �f.. `i r r �Ir M N 1! i► N'�f W W M 41 �b M �jv Y Au�Y MRY 1!y' IMS Y Y ,�.�.Mi'4 �� 4 T Y T w wi�i pJ� �i NOTE: With proper validation this form constitutes an 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 13-21-8EI Subdivision Improvement Permit — Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MAOVE EQUIPMENT (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION BARBER GREFw,r pw'°p 1016 WIDE A11 ELSE LLGAT, DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED Sketch (attach construction plans if appropriate) HAUL ROUTE AVE 50 TO WASHINGTON TO HWY 111 HAUL DATE 5-21-90 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. � 1 Signature of Applicant or Agent MASSYY_ DAWT) zimn T>nr+t, Za.O• 13OX 1767 X DTO CA A9an? Name of Applicant (please print) _V- A"�r Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. On FILE ONN FILE Contractor's License No. City Business _License �jNo.... , ry 14 ON FILE �0�A�H �p('61L��Iw�O tmo 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. Received by *: prr v,10.00 Date 0797 i� PERMIT VALIDATION PERMIT NO. 0797 DATE APPROVED 3-21-90 E'XPI;RATI-ON DATE 5-21—gf1 { F DATE,.ISSU.ED - X8'21"90 ` Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246. NOTE:. . With 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 8-21-90 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) t DESCRIPTION OF CONSTRUCTION BARBER GRF' NF. PAVER HAUL ROUTE" AVE . 50 TO WAS TC 10,6 WIDE All ELSE LEGAL HWY 111 DIMENSION OF INSTALLATION OR REMOVAL HAUL DATE 8-21-90 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN ONE DAY. 01%LY : -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 Quintaand to pay for any additional replacement necessary as the result of this work. Signatur Applicant or gent D1ARSFV nANn AND RQC_ Poo- BOX. 1767 .TNnTn r,A Q22�a- Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. ON FILE ON FILE Contractor's License No. City Busir��li n $5 g_''i-90 i4 .ON FILE io CSA i TOTAL 10.00 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit - Class II Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs. Minor Improvement Permit - Class IV:`See attached schedule U 7 97 Inspection Fee- $ If PERMIT VALIDATION Permit Fee 10 00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10 .0 0 vxa— T Receipt No.. PERMIT NO. 0797 DATE APPROVED B-21-90 P AT10 DOE - Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 _ ------14'= With proper validation this form constitutes an 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 I Subdivision Improvement Permit —Class III DATE: //' M 4 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MD 9/ % EQUJ Omen+ (Street address or Oescription of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 25AC-be./G (2PeAf- e, 12KPP— U+Sf � DIMENSION OF INSTALLATION OR REMOVAL �7 SIZE OF EXCAVATION, IF NEEDED 4v n I APPROXIMATE TIME WHEN WORK WILL BEGIN VIALA APPROXIMATE TIME OF COMPLETiON ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfilling, com- nn .paction .and placing permanent resurfacing and/or replacing improvements) - 6n e, P—> Ac4 oyi '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.grented pursuant to this. application. Notify the Administrative Authority at least twenty-four 1243 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 necessaryas the result of this work. , Signature of(Applicant or Age t ,f'1 a -SO a �n� � i�G!w•& 0.1J e*i 2tv7 ��Pr`o '4a -0 oa Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's License No. City Business License No. • �1'J �i j �' dh Fi. ,, � Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class III Public improvements: 3% of estimated construction costs Privets impravementi; A of estimated cgnstructign costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ Permit iron.j19' ©O Penalty Cash Deposit -Surety Bond if required A Q ]✓r��/1 TQ TA L i $ ee�aae �yq�M�1 �rMrrr h6e101 Nov Rialvid by 960.6rdod by N? PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE ee'}' QQUED ....,._... _.... _.� __ .. ... „ ., , t'1Y - - - - •ru rA d.minll'tFative AuthorltY T�LEPNaN�; (�1�) 564�2��6