0841• �.-.l-+,hP�+l•-titer*+!a• ,r. '•y O+� 1 . ,, F .. +., .. _ �.�..,����...,.n..�..+–�'.—.-M.,,T-��,•-•,t...,.�a�.w�„
,.
With proper validation ; • �• i4 2•
thi11
s form: constitutes an f CITY F
" encroachment permit "+ i, O LA, QUINTAL
i 'APPLICATION -FOR PERMIT -
r'. PUBLIC WORKS`CONSTRUCTION' (ENCROACHMENT), w
+ f• ONE TRI:P' OVERSIZE YLOAD :PERMIT:
:.For the construction of%lublic or; 'private curbs; .driveways, pavements, sidewalks;xparking lots, sewers, water mains
and other'like'public works'improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS'
• wr � + +r T 1.{,'4 ,. •, `. � It, � , � ..i rx �1' r.,.. ' ay !. 1, '� •� -e,. •
r +•"Subdivision Improvement Permit =.Class III
DATE] Settember 25, '19.90 t : r ;. Minor'Improvement Permit Class1V
` L'OCATION.OF CONSTRUCTION move. eduipment
(Street address or Description of1ocation)
y. -- . ✓ es
• PURPOSE OF CONSTRUCTION N'225 cat 10! 5" ;w, length Sketch (attach construction plans if appropriate)
DESC.RIPTIONN
OF CONSTRUCTION
r : " '. ^
xtHaul Routes Ave: Fernando and.
�s
Eisenhower north -',to 'Washington
DIMENSION OF INSTALLATION OR REMOVAL north t0 1✓Itay''111 ' t
- ,
' 'SIZE OF, EXCAVATION, 1F NEEDED
t 4''APPROXIMATETIME WHEN WORK WILL BEGIN `� . Haul, dates `September. 26, : 1190
�� • APPROXIMATE.TIME OF COMPLETION '71,
`ESTIMATED CONSTRUCTION COST $ JAS
(Including removal of all obstruction, materials; and deb'ris,•backfilling, com
+ paction and''placing permanent resurfacing and7or. replacing improvements)
In consideration of the,granting`of••this permit, the applicant -hereby agrees to t
Indeinnify;ldefend.andcsave the City, its,authoriied agents, officers,"representatives,and employees, harmless.from and against any and all
penalties;'liabilities ori loss; resulting frog�laims or court action and arising'out.of any accident, loss or damage to persons or property
happen ing,"6r'o4u4ing_as a'p x' imate resultof anyy work undertaken. under the permit granted pursuant to this application.
Notify -the Administrative Authority at least twenty-four (24)"h6ursLin advance of the;,time when work will be'started.
Comply. with,all'applicable'City Ordinances, the terms'and conditions of'tfie 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.
-� t ~'r '; ` r 1• ` . 1 C . _ °
Signature of Applicant or Agent,,
•" f - u,n i ��„� �� Rar•khna- 77•.-Sf29. RBbin Place Palin Desert, 'CA
Name of_Applicant (please print) �- Business Address Telephone No. „
.•, .. Di rn ,r►i' mYttf�lt'1 hr:T • � ` • •. ,, _-af
> .Name;of Contractor and Job Foreman Business Address_ ,. Telephone No.
on file •.; on file ti
•
' Contractor's License No , s City Business'License No.
:oh, file
Applicant's Insurance Company. ` Policy Number
s
FEES: Subdivision Improvement Permit -Class-11I
005 i 82 i� 72 09•'-25-90 i 0 `
Public,improvements: 3% of estimated construction costs 10 CAS :1- TOTAL 1 10.00
Private improvements: 3% of estimated. construct ion -costs s O t
t" 'Minor Improvement Permit,— Class IV: See attached schedule' O 8 d
Inspection Fee `.-$ ' PERMIT VALIDATION
Permit Fee 1 n` n(1 "0841,
PERMIT NO.
Penalty 9/25/90 ,
Cash Deposit -Surety Bond DA
if required
TOTAL:
Receipt No.
$ 10.00
Received by Date:
Recorded by
TE APPROVED
EXPIRATION DATE 9/2,6/90
DATE ISSUED A 9/25/90
By
y Administrative Authority
TELEPHONE: (619) 564-2246
✓ ' �Aft..,
.. - '1ti-.riy�.'�!fLVR'fw-r•":� !`#'A 6.. ✓P� rW .:� — n(j .i4'.1f;P Y-4:.i:di'4Y N !i. ar �F w► W� ti 4� tM W .0 �y ire M —. •W'{► y` M M.+r r .� P 1 t yYP W V
NOTE:
With proper validation 4 Q'
this form constitutes an
CITY OF LA QUINTA
encroachment permit
•
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
ONL TRIP OVERSIZE LOAD PERMIT
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: 5eibtember 25, 1990 Minor Improvement Permit Class IV
LOCATION -OF CONSTRUCTION move equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 225 Cat 10 5" W, length Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION
Haul. Route: Ave. Fernando and
Eisenhower north to Washington
DIMENSION OF INSTALLATION OR REMOVAL north to Hwy 111
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN Haul date; September 26, 190
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
pactio.n.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 R
waal*nn c Rmr.khinip 77-5R9 Robin Place Palm Desert, CA
Name of Applicant (please print) Business Address Telephone No.
T) i rrnn i Tmilelk i ncr
Name of Contractor and Job Foreman Business Address Telephone No.
on file on file
Contractor's License No. City Business License No.
on isle .
Applicant's Insurance Company _ �� Policy Number
r FEES: Subdivision Improvement Permit —Class Ill
005 i fll"1.0 720Q 09--21 90 i 0
Public improvements: 3% of estimated construction costs i p_N .4. 1 a_
Private improvements: 3% of estimated construction costs o Q h
841
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
0841
Permit Fee 10.00 PERMIT NO.
Penalty 9/25/90
Cash .Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE 9/26/90
TOTAL: $ 10.00
DATE ISSUED 9/25/90
Receipt No.
By
Received by Date �: f Administrative Authority
Recorded by TELEPHONE: (619) 564-2246