0888_.s�,,6j,.,�..yF•�1'�-0�'�'�%�`•�lp�,'.vei..+!qa�R."^:,r^r-'��.+o-�pv^:n....s-�F'.. ..,.-.....--r.��...,.'�.�.;--,�.,��.�,.e;:,....:.r..w�••+rr.�..::..:1T,-„�,..�••"hZ,."'h=y�e'-�'!
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' NOTE:
With proper validation f 4 2
this form constitutes an -
r( CITY OF 'LA• ,QUINTA
4 encroach'ment'permit -
-APPLICATION FOR' PERMIT
•�
PUBLIC. WORKS CONSTRUCTION (ENCROACHMENT)
ONE TRIP -OVERSIZE LOAD PERMIT OF
l 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'lmprovernent Permit” — Class III
DATE: I'll~/1/90` w ` _ `. Minor Improvement Permit Class IV,
LOCATION OF CONSTRUCTION move eauinment
`(Street address or Description of Location)
PURPOSE OF'CONSTRUCTION 235 Cat 'backhoe
Sketch (attach construction plans if appropriate),
52'1.:13'h 13'ba. '9O n0(l lhg =yt,
' .DESCRIPTION.OFCONSTRUCTION•Haul -"Route`." Avenue 52 and
• s - t Jefferson,;,west,to Washington
north to Hwy. 11.1, ,west to Palm
- - - � • • ..Desert ' '< <. '
DIMENSION OF INSTALLATION OR REMOVALS
Haul date: 11/1/90 . .
l
{ SIZE OF -EXCAVATION, IF NEEDED' ONE TRIP ONLY
APPROXIMATE TIME WHEN WORK WILL BEGIN PILOT CAR REQUIRED
APPROXIMATE TIME,OF COMPLETION`�
,.
`ESTIMATEb.CONSTRUCTION COST $ '
' +(Including removal.of all obstruction; materials, and debris; backfilling, com -
-• paction' and placing permanent resurfacing and/or replacing improvements)
In consiclerabon:,of.theygranting of this permit, the applicant hereby`agrees.to:i s
: Indemfnify, 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 gout 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
_,"f l tComply with all; pplicable CityiOrdinances, the terms and conditions of the permit a`drf all;applicable rules and regulations+of the City of
La;Quinta•and to pay. for3any additional replacement'necessary; as the result of this work. `
Signature of'Applica tyor�Agentr
' Jories_'xBrother's Construction• PO Box 905 Coachella, CA 92`236.
Name of-Applicant'(please print) ",- Business Address : Teleplione No.
Name of Contractor'and Job Fo_ reman',•. Business Address +nt. e, -Telephone No. •'` e.
.406921', r 153:
Contractor's License No: r City,Business License No.•.
r t
{ 1 Aetna �- ;` h F 8059^54610 ,CCA s .�
Applicant's Insurance Company1 Policy Number:"-
!- l ,
FEES. Subdivision Improvement Permit — Class'l I If
0p5182 AS 73ii� qq-Q 90 0.
Public improvements: 3% of estimated construction'costs'l,', 40",x• C H TOAL .iG'.vv
Private improvements: 3% of estimated construction costs ��
Minor Improvement Permit -'Class IV: See attached •schedule
�• t o r, 1".]' ,' • per' �., f .•.'' �. ' • � � � .., k y- -�_ '' s,
Inspection Fee • $ - '! %PERMIT VALIDATION
,Permit Fee -
�' ln.00
` r •, ;�., PERMIT NO. f 0888
Penalty 'DATE APPROVED " 11/1/90
Cash Deposit -Surety Bond -
if required I" .EXPIRATION DATE 11/1/90
TOTAL: f $ 1 n"nn DATE,ISSUED- 11' /1 /9(1 }'
Receipt No,
By.1_.-,
Received by Date ,.- Administrative Authority
Recorded by TELEPHONE: (619) 564-2246•
1b,,.u'��''��+1t.'i'y^`'�t�5yl..'�-,`'.l.,trt�y` ' %w"'r�--�•�b"�.e�Ya' Ar. :T;.,i, ..
w'�f•:ls✓�♦N"-x v'i'•'i`"'.i" �'—•ki.O
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'
NOTE:
With proper validation
this form constitutes an
Q
O�
CITY OF LA QUINTA
encroachment permit
.
APPLICATION iFOR 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: '11/1%90 Minor Improvement Permit Class IV.'
LOCATION OF CONSTRUCTION move eauibmefit
(Street addressor Description of Location)
235 Cat backh
PURPOSE OF CONSTRUCTIONoe
;
' ? Sketch,(attact plans lans if appropriate)
5211,1.3rh. 13'ui 90.000 Ibis'
'DESCRIPTION OF CONSTRUCTION, 'Haul Route: Avenue 52 ;land,
a` Jefferson, :west 'to. 'Washingtoi I
IN north to -Hwy 111, -west to Palm '
.DIMENSION OF'INSTALLATION OR REMOVAL ` Desert °
s. Haul date: 'll/l/90
SIZE OF,EXCAVATION; IF NEEDED • ONE .TRIP 'ONLY
APPROXIMATE TIME.WHEN' WORK WILL BEGIN ..PILOT CAP.. REQUIREA '.
APPROXIMATE TIME«OF COMPLETION ,
`•'ESTIMATED CONSTRUCTION COST_ $ ;
`(Including removaI-of all obstruction, materials, and debris, backfilling, com ,
paction;and placing' permanent resurfacing and/or replacing improvements)
'3
In consideration of .the granting of this permit, the applicant .hereby -agrees to:
F;4 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 orioccurring 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. r ;
Comply•ywith'all applicable City -Ordinances, the terms and conditions of the permit andall app cable rus and regulations of the City of
La Quinta` and•`to ,pay Jor•any additional replacement necessary as the result of this work:
` � ,. ' • « ' , _ . ti`s\,i ('� � � , t
Signature of ApplicanVor�Agent,
a
Jones Brothers Canstxuction PO Box 90'.Coach6lla; CA .92236 '
Name of Applicant'(please"print) Business Address -:.Telephone No
t 's ,
Narrie`of Coritractor•ind Job Foreman n Business Address ' ' Telephone No. *,
;406921 °i 153 '
,Contractor's License No:..:,. City Business License No.
'Aetna $6F5954610 CCA `
Applicant's=,Insurance Company. Policy Number -
r , • FEES: Subdivision Improvement Permit —Class Ill."
0(f'"182 Q
793 1011 � '
,a, i• : ,Public improvements: 3% of estimated'construction.costs i C SId 1 07AL f AO.vu '
Private improvements: 3% of estimated construction costs
Mior Improvement Permit - Class IV: See attached scheduleS`�k. .
Inspection F�e`e.. •. ; � •�PERMIT •i,., r � •• ,, •
y $ 'VALIDATION
Permit Fee. 10.00 PERMIT NO. 0888
Penalty 11/1/90
Cash Deposit -Surety Bond DATE APPROVED ,
if required_11/1/90 DATE' -1.1/1/90
10:00 •• t
TOTAL: $ ' DATE ISSUED
Receipt No. ,.
Byi'r .i d
Received by Date W Administrative'Authority -
Recorded by TELEPHONE: (619) 564-2246
r .u'r_.r•iW'
NOV 01 '90 08:10 6193982012'J0NES_iBR0S. A~ P.2i2
NOTE:
With proper validation
this form constitutes an ..CITY OF LA QUlNTA
encroachment permitz# I
. .. a -APPLICATION FOR PERMIT
f9
' .PUOLIC WORKS CONSTRUCTION (ENCROACHMENT)
s�
For the, construction of -public or-pirivatre curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
and poar like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
,
���.v '� --�._r •... ..-__.._. _..:. _.__._-._.. __.. ..... .... .. .. .. ... wry
Subdivision Improvement Permit -- Class III
DATE: Mino improvement Permit Class IV ,...,...r ..�.
O
LOCATION OF CONSTRUCTION
r
(Street address or pisuiption M. Location) ���
PURPOSE* F'CQN TRUCTION Sketch` (attach construction plans if appropriate)
�r pp
DESCRIPTIO F CONSTRUCTION
'd, ate%
DIMENSION OF INSTALLATION OR REMOVAL
FE A
SIZE Q X+~AV iION'1F NEEDED
APPROXIMATE TIME WHEN'WORK WILL BEGIN
_ APPROXIMATE TIME'OF COMPLETION '
ESTIMATFD,CONSTRUCTION COST $
(including removal of all olastruction, materials; and debris, backfilling, coin
paction and placing: permanent resurfacing and/or, replacing improvements)
In considefation. of the granting of this permit, the applicant hereby agrees to:
Indemnify, defend and, isave the City,.its authorized agents, officers, representatives and, employees,, harmless from and against any and all
r' penalties, liabilities or loss resulting from claims or -court action and arising out of any accident, toss 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 .Imt 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 p licable rules and regulations'of the City of
La Quints and to pay far any additional replacement necessary as the resui of this work. ,
• Si 8914ture pfApplicant or Agent ,
Name of Applicant.(plea.ie print).. Business Address Telephone No,
Nanw. of Contor
ractand .lob Foreman Business Address Telephone No'.
trts
Contractor's License No. City Business License No. .
Applicant's.lnsurance Company t Policy Number
FEES:' 'Subdivision Improvement Permit = Clpss 111
Extended;Page„
211
Public.improvernents, A— imated constr ction costs'
•: `'
n �� '
• Private improv®mems:.3% of estinmr ud construction cosu"
Minor Improvement Permit —. Class IV: See atfached schedule
f J t f - •; . �'
Inspection Fee T w:$ ; . _^,,,;::... "� t ~
- K .: r PERMIT VALIDATION , •,'
Permit Fee.:
� •
'
- r t
'PERMIT N0. - �„
�. Penalty
" Cash peposit•Surety Bond. '
>,DATE APPROVEp -
if: rsgpiredh
' ' 1
EXPIRATION DATE
{.
•TOTAL: $, r
M .. f
;
DATE ISSUED' - ...
Receipt No...
f'
By ! . fi .,,
,
Received by •' - - Jate
Administrative Auuiariry
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iELkPH0NE. (6)9)564.2246
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