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NOTE:
With proper validation
this form constitutes an
encroachment permit CITY. OF LA' QUINTA
APPLICATION FOR PERMIT'
a PUBLIC -WORKS CONSTRUCTION .(ENCROACHMENT)
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: February 1 1991 Minor Improvement Permit Class IV,
.LOCATION OF CONSTRUCTION move ` ecluilDment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
s '
DESCRIPTION OF CONSTRUCTION nrl mr HAUL ROUTE:' 52 at Jefferson to
Eisenhower, and south to Nogales.
DIMENSION OF. INSTALLATION OR REMOVAL Hall date: 2/4/91
no moving before lam of after
SIZE OF EXCAVATION, IF NEEDED 5:30 pm Monday -Friday
APPROXIMATE TIME WHEN WORK WILL BEGIN no moving before S am of after
5 pm Saturday
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 tc pay for any additional replacement necessary as the result of'this.work..
ell
Signature of Applicant or Agentj
Tarmac/Massey Sand and Rock PO -Box 14050 Palm Desert, CA 255-.4060
Name of Applicant (please print) Business Address Telephone No. .
Name of Contractor and Job Foreman Business Address Telephone No.
on f lP '. on- file
Contractor's License No. City Business License No.
on file
Applicant's Insurance'Company Policy Number
FEES: Subdivision Improvement Permit — Class II I ggQQ gg 33 pp� t i0
4?di82CRSH911TOT�LOi-91 S0.(�t3
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 '
TOTAL:
10.00-
$ 10.00
Receipt No.
Received by Date
PERMIT VALIDATION •
PERMIT NO. 0997
DATE APPROVED 2/1/91
EXPIRATION DATE 2/4/91
2/1/91
DATE ISSUED
By�u�
U Administrative Authority
Recorded by 1 11 , TELEPHONE: (619) 564-224.6
...t �t„.`fi"'”`h"t{•...ii.:-�4:m:'E.a-.z�4te''b""e�#+.<'i�?• �1 a
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NOTE:
With proper validation
'this form constitutes an '
CITY.- OF LA QUINTA
encroachment permit'.
APPLICATION FOR PERMIT
- PUBLIC WORKSCONSTRUCTION (ENCROACHMENT)
OVERSIZE LOAD PERMIT c� 0F�w
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 lmprovement.Permit — Class III•
DATE`: February 1,-1991 Minor Improvement Permit Class' IV
•,_ "
LOCATION OF CONSTRUCTION -- move equipment s
(Street address or Description'of Location) '.
PURPOSE OF CONSTRUCTION' t Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION hAlTh Pracxri near HAUL ROUTE: 52. at Jefferson to i
Eisenhower;. and south to Nogales
DIMENSION OF INSTALLATION OR REMOVAL Hail date: 2/4/91 t '
„ no -moving'before lam of after
SIZE OF EXCAVATION, IF NEEDED 5:30 pm Monday.- Friday
APPROXIMATE TIME.WHEN WORK WILL BEGIN no,moving before • 8; am.. of ( after
5` Pm Saturday
t APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obsfruction,' 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,sofficers, 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, logs 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. ,
Cornply 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 '
Tarmac/Mass,ey Sand" and Rock' PO Box 14050 Palm Desert, CA� 255-4050
Name of. -Applicant (please print) Business Address Telephone No.
Y'
Name of Contractor and Job Foreman Business Address Telephone No..'
An 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 f
• •' .. • 0 .xf�2.-•95. - t�
Public improvements: 3% of estimated construction costs .( C QL , �pF (• '.
Private improvements: 3%•of estimated construction costs Q
Minor Improvement Permit`—'Class IV: See attached schedule
Inspection Fee.' $ PERMIT VALIDATION
.10.00-0997
Permit Fee PERMIT NO.
-Penalty DATE APPROVED 2/•1/91
Cash Deposit -Surety Bond ~ ' 2/4/91
if required EXPIRATION DATE
TOTAL':.- $ '10:00 2/1/91
DATE ISSUED,
Receipt No.t.
�
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
,.
TOTE:
lith ofoof uahldiiEli3if I I `' ; ;.i' ;•.: I ' ` ,
its form constitutes an
icroachment permit CITY: OF LA, QUINTA
APPLICATION„ FOR , PERMIT
PUBLIC -WORKS CONSTRUCTION (BNCROACHMMT)
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
i
Subdivision Improvement Permit Class III
)ATE: Minor Improvement Permit Class IV
.00ATION OF CONSTRUCTION
Street address or Description of Location) I
'URPOSE OF CONSTRUCTION
DESCRIPTION OF PONSTRUIONaa
If lz_
.'Sketch (attach construction plans if appropriate)
3t ENSION OF INSTAL ATION OR REMOVAL r
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 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
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 1241 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 Quints and to pay for any additional replacement necessary as the result of. th s work.
gnature of Applicant or Agent
S t�Cl G 771/ 1ya /�! tiUPScP/` C
Name of Applicant ( lease print) Business Address Telepho e'No.
//3,4
Name of Contractor and ob oreman. Business Address Telephone No,
Contractor's License N City Business License No.
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit —Class 111 " is
Public improvements: 3% of estimated construction costs-.,:
Private improvements; 3% of estimated conetructlon coits
No
Minor improvement Permit — Class IV: See attached schedule •s" 1V
inspection Fee $ I PERMIT VALIDATION
Permit Fee .
Ponillty <<`+
Cash Deposit -Surety Bond
if required i
TOTAL►
Nceipt No..
Ai:'cAl��d by bat•
Recorded by
PERMIT NO.
OATS APPROVED
{
L';,• EXPIRATION DATE
Adlr►Inlstrative�Alu l
TELEPHONE; (1519) 604,2240
FEB— 1-91 FRI 15:57 MAS .� P.01
' �.. ,..r w.r �•w r� , rr.� �• ..-r �� r.� •••••� .�. �r!•�� �r , rwr w•,� r. ww„ � �. w �•. �MwKr V�i'�i
VOTES
Niih pfaodf
;his form constitutes on '
:ncroachmont permit CITY: OF `LA 'QUINTA
APPLICATION, FOR, PERMIT
PUBLIC" WORKS CONSTRUCTION r(ENCROACIAWNT)
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lot., towers, water mains
and other like public works Improvements In'connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
t,
� Subdivision Improvement Permit— Class Ill
DATE+-- ., .7,� i° ' c' Minor Improvement • P t Permit Class !V
LOCATION OF CONSTRUCTION
(Street address or Dascriptlon of Locat(onl
PURPOSE OF CONSTRUCTIONSk` etch (attach construction plans if appropriate)
DESCRIPTION QF ONST RUC -,g 4OZ14-TION
G + r r
0 ENS10N OF INSTAL ATION OR REMOVAI.
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN'
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ 0
(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 anti save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all
panaltias, 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 feast twenty-four 1241 hours In advance of the time when work will be started.
Comply with all applicable City Ordinances, the terms endatonditions of the permit and all appocabie rules and regulations or the City or
La Quints end to pay for any additional replacement necsuery as the result of t s work.
/ K ` '$nature of Applicant or A ant
S l..✓t� � i7 e� � cz �l./�tjP
Name of Applicant ( lease print) Business Address /�Telephorta No.�/
Name of Contractor and ob oreman Business Address
Telephone No,
Contractors License NC
�ity Business License No.
Applicant's Insurance Com'rany Policy Number
FEES: Subdivlslo6'Impr6vement permit
Extended Page
•,1
4'
r
„ Publlc khprw®ments: 39G of estimated constructlontcosts
's
Prwata.lrriprsvomentt; 3% of ostimoted conitrlactlon goats
.
,
. .
.' :,Minor Improvement Perrnit,— Clots IV; Sea attached 1 ' ' • ',' ' '3
� j ,
Schedule
, .l
lnspoctlon, Fe® fi . .-yS _., � � � � � .
•, ': • � Y � �,� � .. ., F ,
.
PERMIT VAa.i4TI0N' ,
Perm,it Fee
PEAml, NO. , :_ �•
1;',.
C.eh Deposii-Sursty Bond •''
�µ' ,''GATE APPROVED'
if requlred f r ;� , ' ,.
1 . F
;I t- _
�EXPIRAT16N
bATE,
TOTAL!
, f
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