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NOTE:
With proper validation
this form constitutes an ..CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONE TREP.OVERSIZE LOAD PERMIT
r
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: 9/.17/90
LOCATION OF CONSTRUCTION, move equipment
Subdivision Improvement Permit— Class III
Minor Improvement Permit Class IV
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION M= n;3 Sketch (attach construction plans if appropriate)
all Al RP l PrrA l _ rTYAAYI T.Tf-
DESCRIPTION OF CONSTRUCTION HAUL ROUTE: WASHINGTON AND FRED
WARING SOUTH TO Ave. 52 -to
BERMUDAS AND NOGALES
DIMENSION OF INSTALLATION OR REMOVAL
HAUL DATE: 9/18/90
.SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
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:
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..
Si. nature of Applicant.or Agent V /
Massev Sand and"Rock PO Box 1767 Iztdio CA 92201
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
�gN' 74 TAL 1� _90 iQ.00 14
nn file 4 A S 8 CA$H
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
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 nn.
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 10.0.0
Receipt No.
Received by Date
Recorded by
8 31
PERMIT VALIDATION
PERMIT NO. 0831
DATE APPROVED �•/18 /90
EXPIRATION DATE 9/18/90
DATE ISS.UE'D_"%9/18/90
By
v Admin�s r„i i�ve AlWhority
TELEPHONE: (619) 564-2246
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Y
NOTE:
With proper validation
this.form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
UNZ '1sEe UVZRb1Zh LUAU YI''.,KMIT
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: 9/17/90 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
all Q1 4ra 1 Pcaa 1 _ crrk+An vol -
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATIONJF"NEEDED
APPROXIMATE TIME,WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate) , .: ii
HAUL ROUTE WASHINGTON AND FRED,
WARING SOUTH TO Ave. 52 to.
BERMUDAS AND 6GAL8S*,',
HAUL DATE:` 9/18/90''
r4
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
Massev Sand and Rock PO Box 1767 Indio, CA 92201 U
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on file
Contractor's License No.
on file
City Busin00nss License No. 1 %6.1 ���. 11-g . 10.04
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
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 Depdsit-Surety Bond
if required
TOTAL: $ 10.00
Receipt No
Received by Date
Recorded by
�
° 0831
PERMIT VALIDATION
PERMIT NO. 0831
DATE APPROVED 8.118/90 r
EXPIRATION DATE 9/18/90
DATE ISSUED /9/18/90
By—
Administrative -Authority
TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this torrn caRbtitutda an CITY: OF ' LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUIrTI®N (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
GATE.
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
Subdivision Improvement Permit —Class III
Minor improvement Permit Class IV
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DE CPIPTION CONSTRU T ON �, f �% „✓' -•" "`
211501?76P eu /0'1?
DI ENSION OF INSTALLATION OR REMOVAL�ylf%J2
SIZE'OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION j_ j�
ESTIMATED CONSTRUCTION COST $ �!AJ�e `• U
(including removal of all obstruction, materials, and debris, backfilling, com• Q
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 Clty, 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 ofths wor
n
Name of Applicant1please print)
ture of Applicant or
Business Address
Telephone No.
Name of Contractor nd ob Foreman Business Address �` T eph ne No.
Contractor's License fob ' 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: 395 of estimated construction caste . N0
Minor Improvement Permit — Class IV: See attached schedule lel
Inspection Fee $
Permit Fee
Cash Deposit -Surety Bond
if required
TOTAIII ' 111
Rece}pt No..
Rialail 6y .Dote
Recorded by _ ..
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
TEEEPHQNE; W19) 564.2246
I
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