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0887` row 3+I+:• ;f =6vx: s"`t.� 'x 1.f. +.s_-• � •�•ivF+rwc�l0e;�iehy ►..w w`t rir- w.. _ , w. ....+a .y r. { �''a:'� -� :NOTE: 3t �• �. ' �+ �.• i With proper validation �' 2 r ' this form constitutes an �• II ' •I. 'CITY OF,. LA QUINTA encroachment permit APPLICATION' FOR PERMIT. - 1' PUBLIC; WORKS CONSTRUCTION (ENCROACHMENT) "n"" ONE TRIP OVERSIZE LOAD ;PERMIT " '`For the . construction of public or -private ' curl's; 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 II, t1t% DATE: August 31 � 1390 �. :Minor�lmprovement Permit Class IV ` LOCATION OF CONSTRUCTION move eQi i=eht +, (Street address o� D'escription of Location) PURPOSE,OF CONSTRUCTION Sketch (attach construction'plans'if appropriate) ; DESCRIPTION OF CONSTRUCTION q6A 1 nAder . • 1 n F'�� uti �c+ _-{�l tt F °. ,h i rth v..rrbi ryin - l c,rra l ., � HAUL, ROUTE : NOGASES TO ' BERMUDAS to-Avenue'52 out`Of City Limits DIMENSION OF -INSTALLATION OR REMOVAL �`. Haul. Date:.... August' 31,, 1990 ar ' SLZE'OF,^EXCAVATION, IF NEEDED Y M September. ;4, 1990' -'ONE DAY MOVE ONLY .APPROXIMATE TIME,WHEN WORK WILL BEGIN , ! APPROXIMATE TIME OF COMPLETION` k t s 14 :ESTIMATED'CONSTRUCTION COST $ - ' ' . �$45�- ppqq�� Q0- ►i-9. r }, y /- S 7TOTAL i ',. i(i.00 (Including 'removal of all, obstruction,' materials,.and debris; backfilling, com . �' '' • rr paction andlplacing permanent resurfacing and/or replacing improvements) '.In"consid'eration of"the granting of this 'permit, the applicant hereby agrees,to: - , i. r ,Indemnify; clefericl and'sav`e the City, its authorized agents, officers, representatives and employees,` harmless from and against any and all r penalties,' liabilities+or loss resultin from claims or -court action and -arising out of -an accident, loss oi.dama e',to �. _ 9 9 Y , . g _ Persons or.:Property_ happening eor" occu +ring as`a proximate result of'any.work' undertaken'under,the permit,granted pursuant 'to this application. _ Notify the Administrative Authorrity'at, least ftwenty-four'(24)-hours -in advance of the time when work will be started.. . ) Comply with all applicable City Ordinances, -the teams and conditions of the permit and all applicable rules and regulations of the City of � :• La Quinta'and to pay, for any additionalreplacement-necessary as the result of this work: Signature o fAppli ant'or Agent v � Massey ``Sand,,and FRock J PO' Box 1767 Tndio' ."CA �` 4 Name of=Applicant (please print)" Business Address • • Y ; ,.. Telephone No. r.,F•-?i.>,(S .'- - r vt � l� ., _ •. a .YL• Name of Contractor and Job Foreman { Business Address, � Telephone'No: on`'`file on:file Coniractor:s. License`'No. 5 ^ ti _ City Business License No. j +t.Appl canf's`Insurance Company Policy Number + ' FEES: Subdivision Improvement Permit - Class I l l "Public improvements:'3%. of estimated construction costs a ' Private improvements: 3% of estimated construction costs (, 5 e ' 2N20881, P -Minor .Improvement Permit' Class IV: See'attached schedule f ' Inspection Fee; '. $ ' _ PERMIT VALIDATION ,Permit Fee 0887 PERMIT.'NO. Penalty " Cash Deposit Surety Bond DATE APPROVED '`R X31 /9n ..> if required EXPIRATION DATE 9 /A/90 'TOTAL: $ 1 n nn DATE ISSUED 8/31/90 ,. Receipt No. _�(�`L�% ' f By Received by Date v i .y r Administrative Authority Recorded by TELEPHONE: (619) 564-2246 }' k®� ) +Kt'w.e+.c+�c �r�• �w�`�+••'�w�e-�M�"r"mtirR s. �r r�r --------------- y---w--rr -------------- NOTE: ---r rrrrsw— NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ONL TRIP OVERSIZE LOAD PE J,,IT 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 I II DATE: August 31, 1990 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION move eaui"ment (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION QAA loader 1n1A° toiAom 1QIAn hirrh wgbirrht- 1orx41 DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED Sketch (attach construction plans if appropriate) HAUL ROUTE: NOGASES TO BERMUDAS to Avenue 52 out of City Limits Haul Date: August 31, 1990 or September 4, 1990 APPROXIMATE TIME WHEN WORK WILL BEGIN ONE DAY MOVE ONLY APPROXIMATE TIME OF COMPLETION a ESTIMATED CONSTRUCTION COST $ i.� CASH 11,10NAT -i1-94 10.00 14 (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. A Signature of pplicant or A ent Massev Sand and Rock PO Box 1767 Indio" CA 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 III Public improvements: 3% of estimated construction costs if Private improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ Permit Fee 10. CD Penalty Cash Deposit -Surety Bond if required TOTAL: $ X(! . DC Receipt No. Received by Date Recorded by 0987 PERMIT VALIDATION PERMIT NO. 0"8 DATE APPROVED $J31/9A EXPIRATION DATE 9/4/90 DATE ISSUED 8/31/90 Bytom'- `" Administrative Authority TELEPHONE: (619) 564-2246