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08527 •NOTE: With proper. val iclation'.pi - this fot:rn p constitutes an rerit permit` ' -it' . , encroachmA IqITY. OF •LA QUINTA. , APPLICATION FOR PERMiT. PUBLIC, WORKS CONSTRUCTION .(ENCROACHMENT) c -dri4 s For the, construction of public or private curbs, ways, pavements; ements' iaewalks, parking 'lots., sewers, Water i6ins' and othWlike'.public works i6provements in.connect , lonWith MINOR IMPROVEMENTS and A . PPROVED SUBDIVISIONS: s Subdivision Impr6vement Permit 4"Class I II DATE: vo—n Minor Improvement Per M"it Class IV LOCATION OF CONSTRUCTION '(Street address or*Description of Location). PURPOSE OF CONSTRUCTION l~ Ske'tch . (atia c -h construction plans if appropriate) 14 G blade cade 1016". wide j DESCRIPTION OF CONSTRUCTION e HIGHt96000 LBS 4% 15 HAUL` ROUTE DIMENSION OFINSTALLATION OR REMOVAL' EMOVAL' NEVARO AND.NOGALES TO BERMUDAS *TO 152nd, TO JEFFERSON' SIZE,O F• EXCAVATION, IF NEEDED'' APPROXIMATE TIME WHEN WORK WILL BEGIN -HAUL DATE; 10=-3=90' APPROXIMATE TIME OF COMPLETION• ESTIMATED CONSTRUCTION COST $ ONLY ONE TRIP t (Including removal of aill'o6s'trd&ion, materials, and,debrii,lbackfilling, com- ?action and placirig permanent resurfacing and/or 'replacing i.mprovements) In*consideration of the granting of this permit, the applicant hereby agrees to: lncfemnify,'deiencl and save the City, its authorized agents, off iceis,"representatives and employees; harmies's from -and against any and all penalties,' liabilities, -or loss resulting, from claims, or, court action and arising out,of any accident', los;-'or -da rage* to, persons or property -happening or occurring as -,a -proximate resuit'of-lany work undertakewunder the permit granti'd,pursuant'to,.this application' Notify the Administrative A6thority at.least twenty-four 441 hours in advance of the'tirre Iw heri' work.,will be started. Comply with all*ap6l'1cable 6itjr *Ord i 6Snces;', tKe'terms and conditions of the permit and,all applicable rul4s.and regulations of the City of * al 're�la'ementlnecessziry as the result La Quintii,and to pay,foi any addition c of this work. N. A -T, 144 Signaturo.of Applicant or Agent A C C'WV C A NMI AN -In Dnf-'v -'n n e'11"A Name Applicant (please print) J Telephone 1\16., Business Address . Name of Contra6tor and Ji5b F6reman Business Address -Telephone No. B 1? -02-90 14 C"i 734 r'AT%T ' V T T V i - TnTA 1 10.00 ,Contractor's ticense No. City'136siriiess License No. ON. FILE Applicant's In'surance Company Policy Number. FEES: Subdivision Improvem'e'nt Permit" Class I I I 3 Public improvements: % of'estimated construction costs� Privite improvements: 3% of estimated construction costs 0852 • Minor Improvement Permit — Class.1 See attached schedule • Inspection Fee $ PERMIT VALIDATION Permit Fee - 10.00 _7 PERMIT NO. r; Penalty Ciish.DeposivS6re"ty Bond DATE`APPROVED n -if requiredr\ —7— EXPIRATION DATE -7 TOTAL! 1 n—A-)—on DATE ISSUED Receipt No.' f'[S E6 Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-22 46 A j1p- - , t. �E<,.. w::4 -.Ya1. 4 � r � r. - ... _ •t _ dt`� '' •i�x +�..�.5,rr:. � _ '=*Y'��f.;�wh+.s+�✓.��+•+•.w•2.-ipr�e.^nsrr" r� .c. !► �n r.. r e. �a ►=.+ — r — r rr w r r r r. w. r r r r w: -- — — r — —..ti NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR 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 Subdivision Improvement Permit — Class II I DATE: 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 14 G blade 10'6" wide 15' HIGH 96000 LBS HAUL ROUTE DIMENSION OF INSTALLATION OR REMOVAL NEVARO AND NOGALES TO BERMUDAS TO 52nd TO JEFFERSON 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 agrees to: HAUL DATE 10-3-90 ONLY ONE TRIP 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/sof this work. Name of Applicant (please print) Signature of Applicant or Agent usiness Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. 7348,-02-90 14 nN PTT.R 4 i TnXAl i Contractor's License No. City Business License No. ON FILE 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 Penalty Cash Deposit -Surety Bond if required TOTAL: Receipt No. Received by Recorded by 10.00 Date ^ k 0 852 PERMIT VALIDATION ' PERMIT NO. - f 0852 DATE APPROVED 1D—D2 Aft EXPIRATION DATE DATE ISSUED 10—.02-90 B�� y U4dministrative Authority TELEPHONE: (619) 564-2246 NOTE: With proper validation this; form wrinitutes an encroachment permit CITY: OF: LA flUINTA APPLICATION FOR. PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) .For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water main$ and other like public works Improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit — Class III DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) I PURPOSE OF CONSTRUCTION DIMENSION OF INSTALLATION OR REMOVAL Sketch (attach construction plans if appropriate) 14,W/ u� g SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN &�� APPROXIMATE TIME OF COMPLE7110N ESTIMATED CONSTRUCTION COST $ / AA:v (Including removal of all obstruction, materials, and debris, backfilling, com-Qu./ .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 auinta and to pay for any additional replacement necessary as the result; of this work. Name of Appl Signature of Applicant or Agent (please print) Business Address Telephone No. Name of Contractor and Job Foreman Business Address T lephone No. r�l%_T Contractor's License No. , City Business License No. Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit —Class 11 Public improvements: 3% of estimated construction costs Private Improvement>i: 395 of estimated construction costs • Minor Improvement Permit — Class IV: See attached schedule Inspection Fee Permit Fee ?ri4y Cash Deposit -Surety Bond if required . TOTAW Pieceipt No.. NE41M by Data N9 PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION. DATE ©ITE ISSUE© Y - Recorded by _ _ ... 11 TELEPHONE: 0191664,2240 ��1'nlnl1ip411Y4 Ruth®Pit) -7140.2� z" t NOTE: a.. . _ ,•r = %• { With proper validation this form constitutes an' CITY OF LA 'QUINTA " encroachment permit APPLICATION',FOR PERMIT'' ' - PUBLIC WORKS CONSTRUCTION, (ENCROACHMENT) For `the construction of public or private curbs„ driveways, pavifrrients, sidewalks, parking lots; sewers, -water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS F , , Subdivision Improvement Permit — Class III ,- DATE: Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION' r (Street address or Description of Location) _ f PURPOSE OF CONSTRUCTION ' Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION -14 G blade .10'.6" taidg ., <; �. _• y t' r 15' HIGH 96000'LDSHAUL ROUTE " DIMENSION OF INSTALLATION OR REMOVAL NAVARO 'AND NOGALES` TO BERMUDAS TO • ". 52nd" TO ZEFFERSON SIZE OF EXCAVATION, IF NEEDED Arrr APPROXIMATE TIME WHEN WORK WILL BEGIN HAUL DATE 10'3-90, r APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $:.: ONLY. • ONE TRIP _ - (Including'removal of all obstruction,?materlals; and debris, backfilling,.com• }- t: • paction'and placing permanent resurfacing,end/or'replacing improvements); y In consideration of the granting of this, permit, -the applicant hereby agrees to: '"t 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, los s.or damage to persona or property happening or occurring as a proximate'resuli of any work undertaken under the permit granted pursuant to this application. e" 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 Ordinancea,,the farina and conditions of,the permit sod's)) applicable rules and regulation of the City of Le Qulnte and to pay for any additional replacement necessary as the result f thIs, workr , Signature of Applicant or Agent , Name of Applicant (please print)—business Address'` ` Telephone No. + [.. Name of Contractor and Job ForemanBusiness Address Telephone No. r' ON `b•�F,� ^ � , � ' � + w `• r .. UN iFi� MIT -9 3 TOTAL 12-90 10.00 4 ' Contractor's License No. ' '� l• City Business License No.' <- ON -FILE Applicant's Insurance Company ,Policy Number, FEES: Subdivision.lmprovement Permit —Class III Public improvements: 3% of estimated construction costs Private, improvements: 3% of estimated construction costs r w114 Minor Improvement Permit - Class IV: See attached schedule N� 085.. Inspection Fee , $ T PERMIT VALIDATION, . • Permit Fee € 10.00 PERMITNO. , $I 0. ` nR52 - a Cash DshD eposit-Surety Bond DATE APPROVED l^e C if required PI TIO DAT " TOTAL: $ a ATE ED — — Receipt No. Received by Date $ .` { inistrative'Authority Recorded by TELEPHONE; (619) 564.2246