0986• _ �'��:x>••t�-.;>,•.,►..-.wI`�^.+.�+.�a�v^,-^,i �: ��—�..:j",r^Y �r^'�Y .-�yc-,.^ ,. x .,�6-.�I-�a r ._.,,r..•. y-.:�.� �,�—��_.err'•�!'� a
�I ^
NOTE:
With proper validation,..
this form constitutes an -
encr.permit o
"oachment CITY•, OF : LA, .QUINTA
• -' 'APPLICATION" FOR,. PERMIT
i PUBLIC WORKS CONSTRUCTION'(ENCROACHMENT),
OF q ti89�'
For the construction of public or private curbs, driveways, "pave. ment`s, sidewalks,. parking lots, sewers, water 'mains.
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS 4t+
Subdivision Improvement Permit — Class I Il x
DATE:. 1-16-91 Minor Improvement Permit Class IV
LOCATION .OF CONSTRUCTION. e '
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate):
DESCRIPTION OF CONSTRUCTION BARBER GREENE PAV-ER,10ROUTEI.W.WAS.HINGTON, SOUTH TO
101,10 1"Wideleaal :heictht legal leng.th Breen 52 AND WEST TO BERMUDAS • AND
' weight' SOUTH. TO NOGALES>,
DIMENSION OF'.INSTALLATION OR REMOVAL
DATE' 1-1741`
SIZE OF EXCAVATION, IF NEEDED y r
APPROXIMATE TIME WHEN WORK WILL°BEGIN.•
APPROXIMATE TIME OF COMPLETION s• 34�p4_ f
ESTIMATED CONSTRUCTION COST $ ?8.x;4 8 A�lg 1i 9 i
�TQjFiC 6- f 0.
(Including removal of all obstruction, materials, and debris, backfilling,-com-'
paction,and placing permanent resurfacing and/or•replacing.improvements)
In consideration of•thefgranting 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.
a Notify..the Administrative Authority at least twenty-four (24) hours in advance of the time when work1'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 /y
TARMAC MASSEY AND. ROOM' P.O. BOX 14050 :PALM DESERT >CA 924050 ,.
Name of Applicant (please print) Business Address - Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE' 4
Contractor's License No. s City. Business. License. No.
ON FILE ...'
Applicant's Insurance Company - 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 ' $ 10� 00 r !+ PERMIT VALIDATION
f.
Permit Fee .PERMIT N0. 09Rti
y
Penalty
Cash Deposit -Surety BonDATE APPROVED 1-16-91 '
Bond- • r - •
if,required0N—� 1-17-91
E�PI'RATION DATE
TOTAL: $ 1-16-91.
DATS�ISSUE-D _
By ( �.
Received by ' y Date J l./ Administrative Authority
Y �'• ., r 1. y'
Recorded by "` TELEPHONE: (619) 564-2246'
t{vt-L is • .,+,,� k �,.:y..^4. L, +a
p 1
�' �• :: - ��!Mw.�: a;rr +i r r:.,� .�...� nr .. r ah. q'a,ry.;u.-.w. _1.+..m-.�; �v-.+s .e a!�e c' �A.'(ie� .as/F�c: +t« .. r, tw e�..�•-w..w- �sw v w .! r. h w,.. wr •
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
1-16-91 Subdivision Improvement Permit — Class II I
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location) .>'
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION BARBER GREENE PAVER 10ROUTEIW WASHINGTON SOUTH TO
10110" widelegal height legal length green 52 AND WEST TO BERMUDAS AND
weicrht SOUTH TO NOGALES
DIMENSION OF INSTALLATION OR REMOVAL
DATE .1-17-131
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION ii
ESTIMATED CONSTRUCTION COST$ '8 s CA$ iz $r$ io.OV
(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.
` 4
Signature of Applicant or Agent /�'
TARMAC MASSEY AND ROCK P.O. BOX 14050 PALM DESERT CA 922'5.5 4050
Name of Applicant (please print)'
Business Address
Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE
Contractor's License No.
ON FILE
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class 111'
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
if required
TOTA L:
Receipt No.
$. 10.00
$ 10.00
Received by Date .
PERMIT VALIDATION
PERMIT NO. 0986
DATE APPROVED 1"16-91
EXPIRATION DATE/
1-17-91
DATE ISSUED' ! 1-16-91
By
Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
•i •i
OTE:
iIIiTF8 a1F Val da' tlii'
A A
rj
tis form constitutes an CiTY: OF ' LA' QUiNTA
I- — -croachment permit
APPLICATION., FOR . PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) .
i ' •• �� OA TIld4
For the construction of public or private curbs, driveways payerrtgnto, 0d@walks, parking lots, sewers, water r6gin4
and other like public works Improvements lh'conmectlon with MINOR IMPROVEMENT'S and APPROVED SUBDIVISIONS
/ Subdivision Improvement Permit — Class III
TATE: -- �— l ` Minor Improvement Permit Class IV
.00ATION OF CONSTRUCTION
Street address or Cescription of Location) I
'URPOSE OF CONSTRUCTION
)RIPTION OF CONFRUCTiON k
�o
DIMENSfON OF INSTALLATION OR`AEMOV
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)
.Sketch (attach construction plans if appropriate)
ale
257'
Sm
�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 and4canditions of the permit and all applicable rules and regulations of the City of
La Quints and to pay for any additional replacement necessary as the result of. this work.
Signat re of Applicant or Age
(Name of Applicant'(please print) Business Address /�� Telephone �
�l /� I
��
Name of Contractor a d J b Foreman
Contractor's LicenseAVo.
Business Address
Telephone No.. .
C
City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class I II
Public improvements: 3% of estimated construction costs
Private Improvements; 39'o of estimated conatructlon costa . NO
Minor improvement Permit — Class IV: See attached schedule ;• lv
Inspection Fee $ PERMIT VALIDATION
Permit Fee
Penaliy
Cash Deposit -Surety Bond
if required
TQTALI ' III
hecelpt NO."
Riadivad by bate
Recorded by
PERMIT NO.
i.a4. DATE APPROVED
EXPIRATION DATE
DATI 193AD
AdmInlstraslve Autnorlt,
'TELEPHONE; (919) 664•�Z�S '
-——————————- —— — — — —- .--—————————— --—— —— — — — — — —— ----+-------------—�
a 'NOTE:
With proper validation1
this form constitutes an
CITY OF' LA,•,QUINTA i
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
y I
Subdivision Improvement Permit — Class I I I
DATE: 1-16-91 Minor Improvement Permit Class IV.
LOCATION OF CONSTRUCTION I
(Street address or Description,of Location),
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION . BARBER'GREENE PAVER`1.fROUTE1? WASHINGTON SOUTH."TO.
10110" widelegal height legal length green. 52'AND WEST TO".BERMUDAS"AND
weight SOUTH`TO.NOGALES.
DIMENSION OF INSTALLATION OR REMOVAL
DATE 1"17-.91
SIZE OF.EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION i
r ESTIMATED CONSTRUCTION' COST $ Qg5i8CA19 12 $T(��—�b-91 10.00 4
(Including removal of all obstruction, materials, and debris, backfilling, com- ` 1 H
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 1,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 willbe started.
Comply -with,
all applicable City. Ordinances, the terms and conditionsofthe permit and all applicable rules and regulations of the City of
.: La Quinta.nd to pay for any additional replacement necessary:as the result this work. '
+s r Signature of Applicant or Agent
'TARMAC MASSEY AND ROCK. P:O',BOX- 14050. PALM DESERT - CA 92 -4050
` Name of Applicant (please print) Business Address . Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Y ON FILE „
Contfactor's License No: City Business License No.
ON FILE - :.
;Applicant's Insurance Company " K°' ° Policy Number -
J
FEES: Subdivision Improvement Permit — Class I I I
Public improvements: 3% of estimated construction costs t
` Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule + 09.8's
Inspection Fee $ - 16, 00 PERMIT VALIDATION
Permit Fee PERMIT N0. 09'R6
Penalty DATE APPROVED 1-16-91•
• Cash Deposit -Surety Bond -
if required - " ERTITE1-17-91TOTAL: $ 10.00 1-16-91
Receipt No.B-
Received by Date Administrative Authority '
t Recorded by 'TELEPHONE: (619) 564-2246
I