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0920Wi'thlproper'validatiom -'this' form co'nstitues t'an M1 �_ F F LA QUINTA CITY O ' U . encroachmentpermit f - • + APPLICATION `iFOR 'PERMIT' ' !'••},') F�;,.. '• :A..i rr'j r•�. �; ', � •� � I}- ., - Cpm PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)'. .. '- ! - I •. .f.. . '�,! } )-' ,' i R - S k ' ..:E CL' of ,,,•tQ �vSv . ONE . TRIP , OVERSIZE • LOAD PERMIT '{ For' the''construction;,of public or private curbs driveways, pavements, sidewalks, 'parking lots, sewers, water mains i and other like public works improvements.in connection with MINOR. IMPROVEMENTS and APPROVED SUBDIVISIONS ` 'Subdivision Improvement Permit— Class III DATE:. ' November .16 ,` 1.990 ' Minor Improvement Permit Class IV A �LOCATION .OF:CONSTRUCTION move equipment. (Street address or Description of Location) } PURPOSE OF CONSTRUCTION 'ha ri�Pr �rra�.n x�avAr Sketch (attach construction plans if appropriate) ,.,.;,DESCRIP,,TION`OFCONSTRl1CTION.. NO'MOVE'ALLOWED BEFORE 3. • .� 7: 00 AM or` after.,5: 30 PM Monday .,- Friday t DIMENSION,OF INSTALLATION OR REMOVAL ' - - - •8:00` AM or after 5:00` PM • 'Saturdays SIZE OF EXCAVATION, IF. NEEDEDHAUL ROUTE: WASHINGTON`•AND. APPROXIMATE TIME WHEN WORK WILL BEGIN AVE. 5'2 . t0 Out of, City limits M 'APPROXIMATE TIME OFTTI COMP.LEON ° �4 ' Haul date: ONE DAY ONLY I` ?• ESTIMATED•CONSTRUCTION COST$ Y`' 11%19/90. or, 11'/20/90 .,(Including-'removal'of aII'obstruction, materials, and debris, backfilling; com , paction and placing -permanent' resurfacing and/or replacing improvements). In•con_sideration of the granting Jof this' permit, the applicant hereby •agrees to: :lhclemnify,-defend and save the City,.its authorized agents, officers, representatives and employees, harmless from and.against any'and all f "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'proxirn ie result of any work undertaken}under the permit granted pursuant to this application. a t� Notify the Administrative Authority at least twenty-four (24) hours.in advance of the time when work will be started. �Cornply with all' applicable- City Ordinances, the, terms -and conditions' of the permit and all applicable rules and regulations of the City of .' %,�La'Ouinta and to pay,for.any additional replacement necessary'as the result of this work: f-�- 1' ;, . ' • 1 ? `• Signature of Applicant or Agent ~., a cc -'v Sa d - and. 'Rock PO Box 1®050 Palm Desert 1 92255 050' ' Ne m fAy Ls:ct( I ► ,� #' B Add _�,• ' 1' h ru a o. pp anAl - pease print ,,, - . • •• usmess ress a ep one o.. , r•Name of Contractor and Job Foreman. ' +'� Business Address Telephone No. 'ori ,file' , on ' ii -le , a ' "Contractor's.License'No. ..;T City Business'License No. Applicant's Insurance Company V% _ Policy Number -a r' FEES: Subdivision Improvement Permit — Class III. 045B'' 0 2 6-90 iv 10 bii J©TFiL i.,: : i0 a 00 Public improvements: 3%° of estimated construction costs Private improvements: 3% of estimated construction costs c► • Q U Grn� e t` - . Minor Improvement Permit = Class IV: See attached schedule' } 'Inspection Fee', ' ' $ r PERMIT -.VALIDATION ' ` 10.00 X , ` Permit Fee 0920PERMIT NO. Penalty -11%16/90 ' Cash Deposit -Surety Bond DATE APPROVED' 11/20/90 if'required EXPIRATION,DATE , TOTAL: ' $ 1.0. 00 �. 111/16/90 i DATE ISSUE Receipt No. Received by Date ` AdministrativeAuthority Recorded by'' ` TELEPHONE: (61.9) 564 2246 mw:%s •cli::::- ..i+�^•;�;�L' .w,�:.tt:-,F-u:. w`r�,4� t'r+re+:ws^'r�ii��l"rx.�p.:5j.4'---._'"�-:,:3.:.H:..=�{:-i..J.'�'., :,� « �slf�...v. 4 ... •�yMlfr'�-`.... . y�Li .a +1� d...:.- rte, '+ .+f m.. �r+.# -"-"= =- �+-/.►.+1+. w-�.. +.s,11 wr. • w.Y►.�!✓r -.. w w.�,.�p^w �. Yom.+ � �. Y �►-.M-M IiY.. M� �h F� NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment per 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 dike public works improvements -in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS Subdivision Improvement Permit — Class II I DATE': -November -16, 1990 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION move equipment (Street address or Description of Location) PURPOSE OF CONSTRUCTION hi rher ni—o'n na1412r Sketch (attach construction plans if appropriate) g��� �� n i�rth+�,�l 111 tU t► .a. �� 1 crra 1 1 on � fh DESCRIPTION OF CONSTRUCTION NO MOVE ALLOWED BEFORE 7:00 AM or after 5:30 PM DIMENSION OF INSTALLATION OR REMOVAL Monday - Friday 8:00 AM or after 5:00 PM Saturdays SIZE OF EXCAVATION, IF NEEDED HAUL ROUTE: WASHINGTON AND APPROXIMATE TIME WHEN WORK WILL BEGIN AVE. 52 to Out of City limits APPROXIMATE TIME OF COMPLETION Haul date;.ONE DAY ONLY. ESTIMATED CONSTRUCTION COST $ 11/19/9.0 or 11/20/90 l (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 j penalties, liabilities or loss resulting from claims or court action and arising out of any accident, loss or damage to persons or property t . 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. L• fir+' Signature of Applicant or Agent A'v.Gv Sand and Rock PO Box 10050 Palm Desert 92255 050 Name of Applicarit (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. on file Applicant's Insurance Company Policy Number. FEES: Subdivision Improvement Permit—Class III 118 1,111 • 1b^90 iw Public improvements: 3% of estimated construction costs .J Private, improvements: 3% of estimated construction costs Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ II Permit Fee 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10 00 Receipt No. Received by Date Recorded by 1* �I 0929 PERMIT VALIDATION PERMIT NO. 0920 Y DATE APPROVED 11/16/90 - EXPIRATION DATE 11/20/90 DATE ISSUE X11/16/90 By Administrative Authority TELEPHONE: (619) 564-2246' ' '�� .-�� �—. �— �� ��� . �� �.� �� �� •i•w.�- �� ; ��: AdMIL ��� � .�� �� �� .r. �_�� • ��i Kiri iq! 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 III DATE: `' Minor Improvement Permit Class IV LOCATION O CONST UCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) RIPTIO-N OF CONSTRUCTION SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLET ON 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 occident, 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. Name of AppOcant (please print) Signature of Applicant or Agent Business Address Telephone No. Name of Contractor and Job Foreman Business Address Telephone No. Contractor's Licen a No. City Business Licens No. .Applicant's Insura+pke Company Policy Number FEES: Subdivision Improvement Per —Class III Public improvements: 3% of estimated construction'costs``': Private Improvements; 3% of estimated construction coin Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ PERMIT VALIDATION Permit Fee `. PERMIT N0. = Cash Deposit -Surety Bond . �c kF. DATE APPROVED if required 's"'• EXPIRATION DATE TVTAI.I ©ATI IN= K.� receipt No..BY Riaidl,M by bate x • AdminlNrolive Authtafit, Recorded by Il TELEPHONE; (519) 564,N49 :