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NOTE: ,
With proper validation,
this form constitutes an'
CITY OF,' LA QUINTA
encroachment permit ,
APPLICATION FOR 'PERMIT
PUBLIC WORKS` CONSTRUCTION (ENCROACHMENT)
y
ONE TEEP .OVERSIZE .1 LOAD PERMIT' w
For the . constructio.n of public, or , private curbs,' driveways; pavements, sidewalks, parking`jots, sewers, water mains
6 and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS -'
Subdivision'!mprovemerit Permit — Class II I
' •Noveinber,,14, 1990:
DATE` . , Min_ or Improvement'Permit Class IV
• t LOCATION OF�CONSTRUCT16N move equipment,
(Street address or Description of Location) ,
4,
PURPOSE OF.CONSTRUCTION `966' cat loader • 15' rhicrh• Sketch (attach construction plans if appropriate)
s ' 10' wide. leaal • *gift hh . green weiaht x -
DESC.RIPTION,OF CONSTRUCTION• '
Haul- routes, t Ave. 52 and Jefferson
r to Bermudas to Nogales to Navarro=
A, I
•.DIMENSION OF INSTALLATION OR -REMOVAL r' ti
t -. ..Haul date:' 11 / 15 / 9 0
SIZE OF EXCAVATION; IF NEEDED t
APPROXIMATE TIME WHEN WORK WILL'BEGIN
-'APPROXIMATE,TIME OF COMPLETION
ESTIMATED CONSTRUCTION- COST.$' •`
(1"ncluding removal of all obstruction, material 'and debris, backfilling, com: }
paction and placing permanent resurfacing a4or•replacing improvements)
In consideratiorr.of the granting of this permit,'the".applicant hereby agree's`.to:
Indemnity, •-defend and save the City, its'authorized agents, officers, representatives and employees, harmless from and against any and all
' penal,ties, liabilities'or -loss resulting from claims or court action and arising 'out of any accident,tioss or damage -to persons or property r
happening or occurring as a proximate result.•of any work undertaken under, the permit granted pursuant,to this 'app lication.
Notify the Administrative Authority] at least twenty-four (24) hours in advance of the time when work will I e•started.
Comply wtith,all applicable City O•to. pay rdinances, thetterms and conditions of the permit and applicable rules and regulations of the City of•. ,
La Quinta andfor any additionalreplacement necessary as'the result of this work. s s
,' •r �' 'r . ei•• j , '` � ., , - \\"+-Y/�/� • / / !i/tel/ •./ //J/./1 • • - n '.
r
Signature ofApplicant or Agent' , tiv
• MAssey. d- -Sand, anRock , PO Box 14.050 Palm' Desert;. 02255 <•.
Name of Applicant -(please print) - Business Address, Telephone No. o
Name of Contractor and Job Foreman Business'Address Telephone'No.
+� 'on file .. on file
Contractor's License No.' t City Business License No:
.. on,'file. r •fE�,w i
Applicant's Insurance Company t `' • Policy Number
FEES: Subdivision'lmprovem6nt Permit — Class I'll w l
.'.,.' =.Public improvements:3%ofestimatedconstruction`costs � ith'v
ASH ��;�T��.:�4Mg� fv.vv�
Private improve ments:'3%•of estimated construction costs
MinorImprovement Permit—* Class IV:'See attached schedule -091
Inspection Fee s $-PERMIT .VALIDATION t
Permit Fee j ' 10.00 y •' 0911 -
PERMIT NO.
Penalty F Y 11/.14/90. -
,
Cash Deposit -Surety Bond .
, '.DATE APPROVED
if required • EXPIRATION DATE, 11/15/90
TOTAL' $ 10 00 DATE'ISSj 11/ld /9(3`
UEDD-
f
Receipt No.
By
Received by 'Date Administrative Authority . y
Recorded by TELEPHONE: (619) 564-2246 ;
d
d• r
t
t
With proper validation,
this form constitutes an'
CITY OF,' LA QUINTA
encroachment permit ,
APPLICATION FOR 'PERMIT
PUBLIC WORKS` CONSTRUCTION (ENCROACHMENT)
y
ONE TEEP .OVERSIZE .1 LOAD PERMIT' w
For the . constructio.n of public, or , private curbs,' driveways; pavements, sidewalks, parking`jots, sewers, water mains
6 and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS -'
Subdivision'!mprovemerit Permit — Class II I
' •Noveinber,,14, 1990:
DATE` . , Min_ or Improvement'Permit Class IV
• t LOCATION OF�CONSTRUCT16N move equipment,
(Street address or Description of Location) ,
4,
PURPOSE OF.CONSTRUCTION `966' cat loader • 15' rhicrh• Sketch (attach construction plans if appropriate)
s ' 10' wide. leaal • *gift hh . green weiaht x -
DESC.RIPTION,OF CONSTRUCTION• '
Haul- routes, t Ave. 52 and Jefferson
r to Bermudas to Nogales to Navarro=
A, I
•.DIMENSION OF INSTALLATION OR -REMOVAL r' ti
t -. ..Haul date:' 11 / 15 / 9 0
SIZE OF EXCAVATION; IF NEEDED t
APPROXIMATE TIME WHEN WORK WILL'BEGIN
-'APPROXIMATE,TIME OF COMPLETION
ESTIMATED CONSTRUCTION- COST.$' •`
(1"ncluding removal of all obstruction, material 'and debris, backfilling, com: }
paction and placing permanent resurfacing a4or•replacing improvements)
In consideratiorr.of the granting of this permit,'the".applicant hereby agree's`.to:
Indemnity, •-defend and save the City, its'authorized agents, officers, representatives and employees, harmless from and against any and all
' penal,ties, liabilities'or -loss resulting from claims or court action and arising 'out of any accident,tioss or damage -to persons or property r
happening or occurring as a proximate result.•of any work undertaken under, the permit granted pursuant,to this 'app lication.
Notify the Administrative Authority] at least twenty-four (24) hours in advance of the time when work will I e•started.
Comply wtith,all applicable City O•to. pay rdinances, thetterms and conditions of the permit and applicable rules and regulations of the City of•. ,
La Quinta andfor any additionalreplacement necessary as'the result of this work. s s
,' •r �' 'r . ei•• j , '` � ., , - \\"+-Y/�/� • / / !i/tel/ •./ //J/./1 • • - n '.
r
Signature ofApplicant or Agent' , tiv
• MAssey. d- -Sand, anRock , PO Box 14.050 Palm' Desert;. 02255 <•.
Name of Applicant -(please print) - Business Address, Telephone No. o
Name of Contractor and Job Foreman Business'Address Telephone'No.
+� 'on file .. on file
Contractor's License No.' t City Business License No:
.. on,'file. r •fE�,w i
Applicant's Insurance Company t `' • Policy Number
FEES: Subdivision'lmprovem6nt Permit — Class I'll w l
.'.,.' =.Public improvements:3%ofestimatedconstruction`costs � ith'v
ASH ��;�T��.:�4Mg� fv.vv�
Private improve ments:'3%•of estimated construction costs
MinorImprovement Permit—* Class IV:'See attached schedule -091
Inspection Fee s $-PERMIT .VALIDATION t
Permit Fee j ' 10.00 y •' 0911 -
PERMIT NO.
Penalty F Y 11/.14/90. -
,
Cash Deposit -Surety Bond .
, '.DATE APPROVED
if required • EXPIRATION DATE, 11/15/90
TOTAL' $ 10 00 DATE'ISSj 11/ld /9(3`
UEDD-
f
Receipt No.
By
Received by 'Date Administrative Authority . y
Recorded by TELEPHONE: (619) 564-2246 ;
d
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\ i
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
DATE
November 14, 1990
Subdivision Improvement Permit — Class II I
Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION move equipment '
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 966 cat Loader 15' high Sketch (attach construction plans if appropriate)
10' *ide.,leaal *eAuhh, green weiuht
DESCRIPTION OF CONSTRUCTION 1 d ff
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
t,�
Hau route: Ave. 52 an Je erson
to Bermudas to Nogales to Navarro
Haul date: 11/15/90
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.
Signature of Applicant or Agent
MAssey Sand and Rock PO Box 14050 Palm Desert
Name of Applicant (please print)
Business Address
92255
Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on file on file
Contractor's License No. City Business License No.
on file ,
Applicant's Insurance Company v Policy Number
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
Penalty
Cash Deposit -Surety Bond
it required
10.00
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
Q$5"'!t& 'AA TOTAL i4-90 1vnvv v
Ns 0911
PERMIT VALIDATION
PERMIT NO. 0911
DATE APPROVED 11/14/90
EXPIRATION DATE 11/15/90
DATE ISSUED / 11/14/90
By
Administrative Authority ,
TELEPHONE: (619) 564-2246
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 III
DATE: '' Minor Improvement Permit Class IV
LOCATION CONS RUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DIMENSIONiOF INSTALLAT10fl OR. REMOVAL
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;
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless
fro ,m and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, foss, or.clarnage to persons or property
happening or occurring as a proximate result of any work undertaken under the perrnifo,granied pursuant to this application.
Notify the Administrative Authority 'at least twenty-four (24) hours in advanceof 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
Sketch (attach construction plans if appropriat )
l�
Name of Appl
Name of Contractor and Job Forem n Business Address Tele lion No.
Contractor's License N City Business Licens o.
Applicant's Insurance CoApany Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements; 3`ia of estimated Ggnstrwign costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
T9TA6i
beceipt No..
RoBUIVdd bV
Roonrdad by
N9
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE i
t IBM
TELEPHONE; (616) 664,2246
�ffi P16N��INt� MOP
NOTE:
With proper validationthis
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 III
DATE: '' Minor Improvement Permit Class IV
LOCATION CONS RUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DIMENSIONiOF INSTALLAT10fl OR. REMOVAL
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;
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless
fro ,m and against any and all
penalties, liabilities or loss resulting from claims or court action and arising out of any accident, foss, or.clarnage to persons or property
happening or occurring as a proximate result of any work undertaken under the perrnifo,granied pursuant to this application.
Notify the Administrative Authority 'at least twenty-four (24) hours in advanceof 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
Sketch (attach construction plans if appropriat )
l�
Name of Appl
Name of Contractor and Job Forem n Business Address Tele lion No.
Contractor's License N City Business Licens o.
Applicant's Insurance CoApany Policy Number
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs
Private improvements; 3`ia of estimated Ggnstrwign costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
T9TA6i
beceipt No..
RoBUIVdd bV
Roonrdad by
N9
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE i
t IBM
TELEPHONE; (616) 664,2246
�ffi P16N��INt� MOP
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