0886NOTE:
With proper validation
this form constitutes an ',t- - CITY OF, LA, QUINTA ,.
encroachment-permit. - s
'�-" , • v 5
• ' • APPLICATION FOR. PERMIT•+ V.
T . •
PUBLIC. WORKS,;,CONSTRUCTION (ENCROACHMENT)
0
�' :, ,,, '�'� {;�.•i • ' ONE'#TRIP OVERSIZE.LOZD• 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
F Subdivision Improvement Permit — Class III '
-"• 1, ' 19.90 i
DATAugust 3
E: < ' '• Minor Improvement Permit Class IV
.,, move equipment
LOCATION, OF,CONSTRUCTION,' '
(Street addtess or Description of Location) 3 '
PURPOSE OF CONSTRUCTION `• Sketch (attach construction plans if appropriate)
`DESCRIPTION OF CONSTRUCTION ben ng ar .nrl6r.' '
.M�s, all, pi a Beyai " ,HAUL RF�UTE:. AVe. 52 t0 Bermudas.
.x to Nog>,es toNavarro
_ DIMENSION OF INSTALLATION OR-REMOVAL ' « c +:
Haul date:, August 31:;1.990
SIZE OF,1EXCAVATION; IF NEEDED
r} one day . only
,��� .-. _� "'. '- _ ... •.� .•� •. .. - - " � ',,fir "t-'�,*. ; `.
;'' •; APPROXIMATE TIME WHEN
i f �. t ♦ • -c' _ WOi RK;WILL BEGIN t'i 4x f.' r ^"--Y+. � -. •' • i gUSiI A
: `'w►3" '
i14
-
2 S UO 678'0
0iALi I
-APPROXIMATETIME OF'COMLETION
MP$ESTIATED CONSTRUCTION COST
(Including removal of all:, obstruction, materials, and debei`s,-backfilling,•com-
. - paction, and placing, permanent resurfacing and/or replacing improvements) '
e _ 5
r ' In consideration of the granting'of1this permit, the. applicant hereby.'agrees to:
Indemnify, defend and-save the'City, its authorized agents, officers; representatives and employees, harmless from andjagainst, anytand all
• penalties, liabilities or loss resulting from claims or court,,action and arising out,of any accident,, loss or, damage•to•persons or property
'f happening• or occurring as•a proximate result of any work•,undertaken under,the,permit granted `pursuant; to this application. •+ r
Notify the,Admiriistrative Authority'at-least twenty-four (24) hours in,advance of the time'when work will;be started.. •+ ` k
Co ply with all applicable City Ordinances, the ierms•and conditions of the permit .and all applicable rules and°regulations of,the'City,of t1 r
La Ouinfa` and'to-pay for any additional "replacement necessary as the, result of this work. * r,`so"
ySig ture of ARp�nt or'Agent �, y +y* i• w '
.—Ma'sbey Sand' and 'Rock Com>?an'� t PO. Box '1767t' Ind oi� ,QA
Name of Applicant (please print)-Business'Address «� .' Telephone No.
' ,Name of Contractor and Job;Foreman Business Address' ` ? •.« Telephone No.
•4 . �� ' Y,on°tfile ; ; •� on. filed'
`r • _ ;
Contractor's License Nora' -� , • City Business,License No.
ApJplicant's Insurance Company Policy Number
FEES: SubdivisionlmprovementPermit =Class III
,t Public improvements: 3% of estimated construction costs.'
Private improvements: 3% of estimated construction costs
- - i
0886
,.Minor Improvement Permit .+Class IV- See attached schedule
47
Inspection Fee $ '~� + • PERMIT VALIDATION
Permit Fee 10.100 PERMIT NO, D886
Penalty " , DATE APPROVED 8/.3.7:/90
Cash Deposit-Surety' Bond
if required .EXPIRATION DATE' 8/31/90'
r
TOTAL:. $ 10.00 • _
DATE ISSUED 8/31/90
Receipt No. 6'
By
Received by Date Administrative Authority
Recorded by �' TELEPHONE: (619) 564-2246
5
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1
NOTE:
With proper validation
this form constitutes an
encroachment permit
M
+F+'. x
CITY OF LA QUINTA "
APPLICATION FOR ,.PERMIT
PUBLIC WORKS- CONSTRUCTION (ENCROACHMENT)
ONE TRIP OVERSIZE LOMD 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
• _s , r
Subdivision Improvement Permit — Class I II
DATE:
August 31 � 1990 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment
ay
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION hor icr crrii.nc3Pr.
HAUL RAUTE: Ave. 52 to Bermu'dAs
DIMENSION OF INSTALLATION OR REMOVAL t0 Nogales t0 Navarro
Haul date: August 31, 1990
SIZE OF EXCAVATION, IF NEEDED one day only
APPROXIMATE TIME WHEN WORK WILL BEGIN
i�05iB�AAO i 1QTAL �3i 9410.00 14
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:
41
I'ndemnify,•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 t
La Quinta and to pay for any additional replacement necessary as the result of this work.
Signature of App'I' ci ant or Agent
Massey Sand and Rock Company PO Box 1767 Indiop CIS
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 No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I I I
F 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
T° 0886
PERMIT VALIDATION
PERMIT NO. 0886
DATE APPROVED 8/31/90
EXPIRATION DATE 8/31/90
DATE ISSUED , 8/31/90
By ,�.9 ,;4r 'A—t-1
Administrative Authority
TELEPHONE: (619) 564-2246