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0848.w.....r.w.r+-�•r+eac,:. i'�.-s�a•.o.-aa-xwcws... r.. w..�. •.,.. �. r.:.++. — r' — — — — — r-vr — — — .. — • ....i+. ' J NOTE: With proper validation this., form,,constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONE TRIP OVERSIZE 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 l I • DATE: 9' 28-90 Minor Improvement Permit Class IV ;LOCATION OF CONSTRUCTION (Street address or Description.of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) .DESCRIPTION OF CONSTRUCTION • Oat 1.4U Blade Haul Route: 52 and Jefferson to 1U'.6° wide 15 hign yIb,UUU lbs Bermudas to Nogales•to Navarro DIMENSION OF INSTALLATION OR REMOVAL Haul bate: .9-28-90 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 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 agrees1to: Indemnify, -defend and save the City, its authorized agents, off icers,.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 14ac�Pv Sanri a c3 ork P.O„ Box 1767 India., Ca 92201. Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business.Address Telephone No. nn file on file Contractor's License No. City Business License No. on `file (�f)S1R? 1fT 7781 09-2$-40 14 Applicant's Insurance Company PolicyNumbPPSH 'I JUlI AL 1 1v.v0 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 0 Penalty Cash Deposit -Surety Bond if required TOTAL:. $ Receipt No. Received by Date Recorded by IBJ 0848 PERMIT VALIDATION PERMIT NO. DATE APPROVED — �'� — 9 0 EXPIRATION DATE 2— 2— 9 6 al 0 DATE ISSUED 19-2 8_ 9 0 Administrative Authority TELEPHONE: (619) 564-2246 ,ti�j=i+''r, �•! - � 'Sf i•[�.'�: ti: .a yt"'7Y .,i "vv+Y., ar � <�"� -w'a• n- F:+.'- w •:* s J h. •e,�x aa- t -.,ll 'h � Ni . r i•r r ys..d , ��-�;; i,,_rr• '�"etr'lr'E:R:n +•�.3=,',�,`�,,•,=•i�'"`s}y'h+�i5,�`'Stix.•.��t.:f+�`'s�.1r-L:•7l':.n':�'�.,,"-.•.a•airta..+0.•-��.v'""� '�"r.�ti.�•+;r• • .,;bi4'IFF��s.4+'1}."•'�'-?+K�.M_ Mr •!;+ (.. Y. "�, M r �.+.•M:.r s. w'.•W M4 �.^A. .b � M. +fi .c. M P s r+ M W l+n� ,r w'Y �. • � �+w.� �-•M � Y � �"y'�°•+► NOTE: .. {y v With proper validation 4 2 this form constitutes an`� CITY OFi LA QUINTA encroachment permit '. - • •• ,. , t' • APPLICATION' FOR PERMIT ' r PUBLIC• WORKS CONSTRUCTION- (ENCROACHMENT). ONE' TRIP' - OVERSIZE PERP4IToFTt�9 tar ` + 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 AL _ Subdivision Improvement Permit — Class III . DATE: 9-28"90 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) ` PURPOSE OF.CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OAF CONSTRUCTION, Cat.. 14U j31ade •• Haul -Route: •'S2 and `.7efferson to lU 6" viae 15 nign yb; uuu lns Beimiudas to Nogales to' Navarro DIMENSION OF. INSTALLATION �OR.REMOVAL Haul'Date: 9-28-90 SIZE OF. EXCAVATION, IF NEEDED. , -.APPROXIMATE TIME -WHEN WORK WILL BEGIN + + n APPROXIMATE TIME OF,COMPLET16N -ESTIMATED CONSTRUCTION COST $ ' (Including removal of all obstruction,materials, and debris, backfilling; com{ action•and lacin ` +r `F p p�g 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 of damage'to persons or, property happening or occurring as a''proximate •result of any,work undertaken under the permit -granted pursuant to thris•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.. t ' Signature of Applicant or Agent tBaGsrw Sand 'and Rock . P.O. Box 1767 Indio. Ca 92201 Name.of Applicant (please print)' Business Address ' Telephone No. r ' •Name of.Contractor'and Job',Foreman + Business Address : " Telephone No."' on file ; on:'fi1e Co'ntractor's License No. "` 'City Business'License No % ` ' - on file � ' . ., .�,� -• � - ' in 71)9 11 09 -'.'its-.' 14 Applicant's Insurance Company Policy4urn eraSR "1; Tl)1'AI_ i IU.tJQ• ,FEES: _ Subdivision •lmpro`vement 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 + N2 + o Inspection Fee $ • f PERMIT. VALIDATION ` Permit Fee rQ) 4). • 53 PERMIT NO.' , Penalty ' Cash Deposit -Surety Bond DATE APPROVED ' if requiredEXPIRATION DATE ' 3 „• Z 9-�%`6''' TOTAL: $ • DATE ISSUED' r p Recei t No. 'g Received by Date • Administrative Authority Recorded by TELEPHONE: (619) 564-2246 , :...:_.:. �r_.,� �� - '.moi .�� .�. �� . • �� .� �� • �.� _ �� .� �.� �� r. �� , �� .� NOTE: With proper validation this form constitutes an encroachmCITY OF _LA QUINTA ent perlttit a APPLICATION. FdA: 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 �y Subdivision Improvement Permit — Class Ill DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION �✓E b7QLwex_fFJT �Setch_ ttach construction plans if appropriate) DS�CRIPTI9N O,F YCONSTRUCTION , DIMENSION OF INSTALLATION OR REMOVAL T1 opE�so; rn Jea( s 7/0 SIZE OF EXCAVATION, IF NEEDED NO. 5j a S ' '0 - A�_ APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION S I ATED CONSTRUCTION ETM C N TRUCTION 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 o: 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 end 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. Name of Applicant (please print) nature of Applicant or Agent Business Address Telephone No. Name of Contractor nd Job Foreman Business Address T lephone. No. ek Contractor's Lice se No. City Business License No. ok 1 Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I) ' Public improvements: 3% of estimated, construction costs Private improvements; 3`Ye of estimated conatructign costs . No Minor Improvement Permlt — Class IV: See attached schedule.1V Inspection Fee $ PERMIT VALIDATION o Permit Fee Q PERMIT NO. Cash Deposit -Surety Bond DATE APPROVED if required EXPIRATION DATE 5� 7 9 q O TVTA6a I. : heceipt NO.. Riadlyail by .Data �Y YAdminittratIvs AUtho ItV Recorded by TELEPHQNE; (619) 564,2246