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0849vim- .efw�'foQYy1.R•�a•'M.+f'1R •�^A•rRMw'K#.fY. rr M i.� -- — — — — — — — — — — — - — r — r — -- — — t — — 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 PERSTT 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: October 1 1590 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION move. eauioment (Street address or Description of Location) PURPOSE &-CONSTRUCTION 14g blade Sketch (attach construction plans if appropriate) 10'6" Saida. 1 ,' h;rrh_ ae; n n n I 1 DESCRIPTION OF CONSTRUCTION Haul Route: Ave. 52 and Jefferson to Bermudas to Navarro DIMENSION OF INSTALLATION ORREMOVAL Date: 10/1/90 SIZE OF EXCAVATIONJF 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 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. massev , band and Rc 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 file on f;1a Contractor's License No. City Business License No. . on file .Applicant's Insurance Company PolicyjNumber i0 7316 10-01-90 14 R n t-Ayu t 1 n Y /al 4 4 0 0() FEES: Subdivision Improvement Permit — Class II 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 I` Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10,00 Receipt No. Received by Date N_: 0849 PERMIT VALIDATION PERMIT NO. 0849 DATE APPROVED 10/1/90 EXPIRATION DATE 10/1/90 DATE ISSUED _/ 11/90 By C/ --h---, Administrative Authority Recorded by II TELEPHONE: (619) 564-2246 — - . 66- qqt - - - - - - r W - - - Y - Y M p 4 ti iN.' 4M� IYM 1► 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 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 DATE: October 1, 1�9wi Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION move. ecuinment (Street address or Description of Location) PURPOSE OF CONSTRUCTION 14g blade Skptrh lattnrh rnnctnirtinn nlanc if annrnnriate) 1016" widp,. I.s, high- car,- -nnn 'Iha DESCRIPTION OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN Haul Route: Ave. 52 and Jefferson to Bermudas to Navarro Date: 10/l/90 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. Massey Sand and Rc Name of Applicant (please print) Signature of Applicant or Agent Palm Ir Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. ori file Contractor's License No. on filo on file City Business License No. Applicant's Insurance Company Policy Number i4 7Zl6 io--©i- 90 14 n► yYnTAI 4 4 A f1(� 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 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. 0849 DATE APPROVED 10/1/90 10/1/90 EXPIRATION DATE �. 101/90 DATE ISSUED_q Y Administrative Authority TELEPHONE: (619) 564-2246 : c: : .: a i e. ter..• NOTE: With proper validation tfrip form oar,ecicuibo en CITY., OF LA QUINTA encroachment permit • APPLICATION .FOR, PERMIT PUBL10 woRKs 00NOTRU TION (NOROACHMEN $ ) For the, construction of public or private curbs; driveways; pavements, sldewaiks, parking lets, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit — Class 111 DATE: (- Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate% DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION �J ESTIMATED CONSTRUCTION COST $0 (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 necessaryas the result of this work. ss� sA, Signature of Ap licantor gent -/< V / a Name of Applican please print) Business Address Telephone No. Name of Contractor a Jo Foreman Business Address Teleph ne Contractor's License p,1o. 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; 3% of estimated construction coot:. No Minor Improvement Permit — Class IV: See attached schedule l� Inspection Fee Permit Fee Cash Deposit -Surety Bond if required TOTAW receipt No'. $ aii:a(Uid 6y data Recorded by PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE [ AdmInllNrative AUthaflty TELEPHONE: (619) 064,MO