0810•NOTE: ' ,, f, , i A'
.. -
With proper validation .' 2
;;.this form constitutes an � ; .-
I - +� .),,,CITY OFa LA -QUINTA
encroachment permit
• APPLICATION ; FOR PERMIT {
PUBLIC. WORKS CONSTRUCTION' (ENCROACHMENT) . I•,,.: w�
o 9ws
+` + ONE TRIP OVERSIZE'�LOAD PERMIT FT�
`
t'.For the construction -of public or .private curbs,,drivewa'ys, pavements, sidewalks,'pa`rking lots, sewers, water mains''
R• and other like public works improvementstin connection -with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS r
`• a .� ,` 1`. +f'. � ,� ,� .. •` '' .. -�' i • .' a .-
Subdivision Improvement Permit. Class III
DATE: 'August, 31 ' 1990 Minor Improvement Permit Class IV.
LOCATION OF CONSTRUCTION ' move; equipment
(Street address or Description of'Location) ,, , Y•'r -r I y
t � �. � by +. ♦ � r +~ .. �.
PURPOSE OF CONSTRUCTION' ,' s Sketch (attach construction plans if appropriate) rr
~DESCRIPTION OF CONSTRUCTION QA 15% 7 nArlLr "• ! , ' t .�r. •.• T , }. I '' r
.�;AA"r, ►';.,3A is►4 1,',nh 1,nrrA3 'u1pjgh4- ,'HAUL. ROUTE W6s�'.on.-AVe.'•52 to
1 r t. •'
y Bermudas,': South, to Nogales, West
, DIMENSION OF INSTALLATION OR REMOVAL `
, � t0 Navarro ,
- Haul'.date:4,,Auguet.1990
SIZE OF EXCAVATION, IF NEEDED ,r-
one, trip :only
r
APPROXIMATE TIME WHEN WORK WILL BEGIN," t '
�_ 4 , � ' •• ,
*APPROXIMATE TIME OF,.COMPLETION _
,EST.IMATED CONSTRUCTION.COST $ � , , _ ,
M (Includin' removal'of all obstruction,'mate'rials; and debris, backfillin ,.com '� ppdSi' O,b7p3 0$~-31-90 i4
g F g •, SO , ;CASH i`TOTAL i iQ:00
action and lacing permanent resurfacing and/or replacing improvements)'
P P 9
' In consideration of iW*.granting of this permit, the applicants hereby agrees to:
~, Indemnify, defend and.save the City, its authorized agents, 'Officers , representatives and employees, harmless from and against any and all .
penalties,'.IiabiIities or loss resulting 'from claims or court action and arising out of'any accident, loss•or damage'to,persons of property
t 'happening -or occurring as a proximate result of any work undertaken urider'the'permit granted pursuant to -this a'pplic'ation. '
r
Notify' the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.'-
I '
.•Com' � . :. .. .. '=� - •.< .•:, .i�,--
p y 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`: °•. �' L-,
•1 ,i. ; r.., .... �- - ,.• *•.. .v r 'rr. • .(I,,(� S';/^/J�/, -� L'.�`+.• _F4• � + .. � r ,
Signature'of Applicant or Agent .: •* '
'
`Ma and an Rcaa1� P0' Bta� Z715D Indica. C'A �" b
Name'of Applicant (please print) •. .. Business Address i+•' Telephone No.
' tor, and Job'Foreman.' j ' Business'Address : , --Telephone No.�
Name of Contrac• .''
On r F�i'1,p,f y
Contractor's License No. R •City Business License No.
on file � t
Applicant's Insurance Company` Policy Number, ;
. r`t i - 1S
w •�
FEES: Subdivision•Improvement Perrriit -'Class III'
Public'improve ments:.3% of estimated construction cosis �' j `• r �,'.. r
s
n
Private'improvemet:r3% of estimated construction costs
. _ , . ., Vis:" 0 810- • . ..
Minor Improvement Permit.— Class IV: See`attached schedule,
. Inspection Fee ;, $ �• :� ,.x.; PERMIT VALIDATION
10.00-
Permit'Fee y, '�'• t 'PERMIT N0. r 0810
Penalty' .� ,+• � . � •. �r..;rt -, . -±� + •, - r -
Cash Deposit Surety Bond, 'DATE'APPROVED •82-1 X9'0 `
if requiredi ;EXPIRATION:DATE
* `TOTAL: $ i n .An �4. • a/3Z�.90 c'
- '.. DATE ISSUED -
Receipt No.�ipj7'J1..L
Received by Date T ,Bye ' `,' ' Y Administrative Authority.
Recorded by • TELEPHONE: (61.9) 564-2246 ' `.
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
C=�
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: August 31, 1990
LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION'
DESCRIPTION OF CONSTRUCTION 99A 1 OAAor
101K11 taisig:�_ 1AVA11 hiah 1rarTa1 t,yozi,rthi-
DIMENSION OF INSTALLATION OR REMOVAL
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)
HAUL ROUTE; West on Ave. 52'to
Bermudas, South to Nogales, West
to Navarro
Haul date: August 31, 1990
one trip only -
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 00Si 10 5703 p8-31--40 14
(Including removal of all obstruction, materials, and debris, backfilling, com- i0 p$k 1 1OTAL i i0.00
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
��ojf this work. '
t " C/
Signature sof Applicant or Agent T
Massev Sand and Rock PO Box 1767 Indio, CA
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 Business License No.
on file
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
A 0810
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
PERMIT VALIDATION
PERMIT NO. 0810
DATE APPROVED 8/31/90
EXPIRATION DATE 8/31/90
DATE ISSUED 8/31/90
By
Administrative Authority
Recorded by 11 TELEPHONE: (619) 564-2246