0800•# i'; 2" :•ayn� e-_•yyF,u;•.,,�t - ,tf+, '•�''t„ ` `n z.+,i +re A s. «. -: -+r s �,..�<.
s? ys+Vwt;°asysvlcPw6, x !i�Yo-71:�at�w` d➢, •.''dra5lt.��'&Yv"
i
1i.C?Mq•. ; - W'C•+ .x.,,si=.....•r..'. ....ti..-F. r r s r.�' �. ht •r `ei^.w w� ti. e•q . M�L <
NOTE: F } 1
With proper validation ,: 2 '
this foam constitutes' an
encroachment permit * ' a • CITY �OF LA- +QUINTA
APPLICATION. FOR-'PERMIT
.; PUBLICy WORKS CONSTRUCTION �(ENCROACHMENT;,
* ` * - .a .' •• , i • •. .tY t r ' ` •;4 r a r „'w - (jn -'s• ^SV
,k s ONE TRIP OVERSIZE LOAD' PERMIT
, � .. Y • 1 _ .W 1 +j -_ ! t�'y i+• - ' y'.' �
,ik.rw' � F
' , 4 ♦ r to • ;:. ` :. r , -
Forthe construction, of public 'or private 'curbs, driveways,: pavements, sidewalks,.parking. lots, sewers, water'`mains
and otherlike public works impro-vements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
• - 'ti`. - �, 'tom ,�� 'f. Subdivision,lmprove'ment Permit—'Class,lll
DATE: R-9 �••-Afl _ r F Minor lmprovement.Permit Class
LOCATION OF CONSTRUCTION
• (Street address or Description'of Location)
PURP SE F„CONSTRUCTION •MOVE' EQUIPMENT.' ;ti
0 ' 0 s. Sketch,(attach construction plans,if appropriate)
_ • , ,�. ..; a ', ,:' •"� .,. r+Ro.. .. -
DNSTRUCTION BARBER GREENE I
.
ESCRIPTION'OF CO^ 5 „ HAUL ,'ROUTE r'. WASHINGTON -'TO'
TAMPICO �;/,B TO,CALLE'RONDO`,
t 10•'WIDE, HAUL DATE, ' 8=23 or 8-24
• , DIMENSION OF INSTAL• LATION,OR REMOVAL ONE DY`•ON.LY 1! ! n +"`
ALL ELSE LEGAL K- .
i ZE OFaEXCAVATION, IF, NEEDED r ` . ti
SI
'.'..�,
APPROXIMATE TIME WHEN�WORK'WILL BEGIN ' `y ,, �4' q �;
0SISA 0 6577 8— 3-90' 14
0
. ”"APPROXIMATE TIME'OF COMPLETION •' H 1 TOTAL. io'00,
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
{. .. T .. `' %' : ' .x.; '' cwt . ... -' '' r :'� � � : + :... -. ' "}•,.; .
Indemnify, defend and save the City, its authorized agents, officers, representatives and employees, harmless'from and against'any arid"ill • "` -
" penalties, liabilities or 'loss resulting from claims or court; action and', arising•.ouf,of'ariy 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: x '.
• • • Notify- the ,Administrative Authority at least twenty-four, (24) hours-;inadvance 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 ,{' ,SignatureCof Applicant or AgenT
` �MASSEY SAND-, AND- ROCK' , " . )'ON- FILE w ON
° '•
'Name.of Applicant'(please print) 'Business Address Telephone No.
Name of Contractor. and Job Foreman Business Address ; `' ;;`�' ;Telephone'No.
ONy FILE ON ZILE - • ,
Contractor's License No. '� , ", ,City Business License No.
ON"FILE �_. '' • r`. < ON 'PILE
Applicant's Insurance Company, r ' Policy.Number
r
FEES: Subdivision Improvement Permit — Class III r " • : e- 1•
' Public improvements: 3% of estimated construction costs t #
Private improvements: 3% of estimated construction costs '
Minor Improvement Permit — Class IV: See attached schedule N2' ,`0800
Inspection Fee $ ' PERMIT VALIDATION
Permit Fee ' !) a 10:00 0800 +
PERMIT NO` '
` Penalt
Cash'Deposit Surety Bond • . -DATE. APPROVED 8--23-90
x
if required' EXPIRATION DATE 8-25=90 '
10.00 r
TOTAL:, $ 87-23-9&
A DATE ISSUED
Receipt No..
Received by Date
Recorded by
By I
Administrative. Authority
L TELEPHONE: (619) 564-2246
wfM P�w.fjs'!i•�I.TfMM•Ilw' lw� �4 Vj ii — — — — — — — — — — i f- — — — — — — - O�Y —www .— — — —'— A
NOTE:
With proper validation
this form constitutes an
encroachment permit
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONS TRIP OVERSIZE LOAD PEP14IT
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: A-23-90
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIPMENT
DESCRIPTION OF CONSTRUCTION BARDER GR:GEEIE
DIMENSION OF INSTALLATION OR REMOVAL
ALL i;LSE: LEGAL
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)
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:
HAUL ROUTE: I,174ASHINGTO9 TO
TAMPICO E/E TO CALLE RONDO
MAUL DATE; 8-23 or 5-24
ONZ DIY ONLY 11
1o5021�AL-i3-90 14
CASIT'(0.00
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. (�
Signaturedo Applicant or Agerrt
EUAS EY SAND AND ROCK ON FILE ON FILE
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE
OIL FILE
Contractor's License No. City Business License No.
ON FILE ON FIDE
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:
1) 10.00
$ 10.00
Receipt No.
Received by Date
PERMIT NO
®1900
PERMIT VALIDATION
0800
DATE APPROVED
8-23-90
EXPIRATION DATE 6-25-90
DATE ISSUED 5-23 910
By
Administrative Authority
Recorded by 11 • TELEPHONE: (619) 564-2246
With proper validation
this form constitutes an
encroachment permit CITY: OF:LA QUINTA r.
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
DATt:_
Minor Improvement Permit Class IV
LOCATION.OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTPUCTI
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
Sketch (attach construction plans if appropriate
SIZE OF EXCAVATION, IF NEEDED
A44 9 c93
APPROXIMATE TIME WHEN WORK WILL BEGIN
C
• 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 an ' y 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.
Name of Applicant` (please print)
Signature of Applicant or Agent
Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on
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
Priygli; improvements; A of oitimated cQnstrwign cgni N�
Minor Improvement Permit Class IV: See att@;hqo Schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TQTA6; 00
lecelpt No..
Rablvad 6y to
Recorded by
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE.
'000 ISSUM _1.111111_.-_1-1-._.1-_... I—
TELEPHOE; (5 191 5q4?2940
iMM, f . y "