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1001E r� � 0-ri ir' �O+�Y. W As.-.ik.►� *►E_T r., �..� ...E w � �a w, w.T �.-'••� - r�.�w•...w-Mr �.yn�. rr �t tlw s+ s a � rc �.. �.s nr -.. .... r �. � w �r r� 'b c NOTE: With proper validation this form constitutes an encroachment permit Gash CITY OF LA QUINTA APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) t1'? 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 DATE: LOCATION OF CONSTRUCTION T'low EQM Subdivision Improvement Permit— Class Ill Minor Improvement Permit Class IV (Street address or Description of Location) PURPOSE OF CONSTRUCTION MOVE BARBER GRM Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION 10'V WIDE HEIM ZEAL DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN HAUL, ROUpTEg� _ 2D AS,NORTH ON BAS %xT00 WASHINGTON WASHINGTON NORTH OUT OF CITY LIMITS DATE 6-4-90 or 6-5-90 ONE DA19NLY 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 resulp�of this work. I v Signature of Applicant or Agent M ASSEY SAND AND ROCK P.O.BOX 1776 INDIO CA 92202 Name of Applicant (please print) Business Address 005182 tTifel,ephong-No-90 !4 i0 CASi� i �IOT�L i io.00 Name of Contractor and Job Foreman Business Address Telephone No. ON FILE ON FIEF Contractor's License No. City Business License No. App l`icant''s•Insu ance Company Policy Number FEES: Subdivision Improvement Permit —Class Ill Public improvements: 3% of estimated construction costs Private improvements: 3% of estimated construction costs 3a Minor Improvement Permit — Class IV: See attached schedule�� J Q Inspection Fee $ PERMIT VALIDATION Permit Fee ' 01,00 PERMIT NO. Penalty Cash Deposit -Surety Bond DATE. APPROVED ll /'; % if required D EXPIRATION DATE /n� LI s i) t ',��t_(S TOTAL: $ I DATE Receipt No. i BY .-.. Received by Date Administrative Authority Recorded by TELEPHONE: (619) 564-2246 Y I w.9a�s�. �aU-.;�..,%=-SIC 4—'�-Je�IL]+t7A`..�-x�f�c-M. asnM w tti. b rs Y �r ➢� w +Y �N- Mti'i¢�K�•s 6'� c�.6R 4'�� aE.'oa s2 a ro� Yr wr L��yr�a rcti a'k w4K. K� M •�•..w��a � M etiF rw � �9- his w - y NOTE: _ With proper validation 00'h this form constitutes an encroachment permit CITY OF LA QUINTA 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 OF CONSTRUCTION 1115M MUZ R M (Street address or Description of Location) PURPOSE OF CONSTRUCTION 1'12%11 EMP71 GRM Sketch (attach construction plans It appropriate) DESCRIPTION OF CONSTRUCTION 10'6" WIDE GH LWAI E RM BES iU�AS ATO 52DTO WASAS HINGTON DIMENSION OF INSTALLATION OR REMOVAL WASHINGTON NORTH OUT OF CITY LIMITS DATE 6-9-90 or G-5-90 SIZE OF EXCAVATION, IF NEEDED ONE DAONLY 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 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 resulVof this work. Signature of Applicant or Agent DRSSEY SAND AND ROCR P.O.BOX 1776 INDIO CA 92202 Name of Applicant (please print) Business Address 00131/92 �T�elephone�No>4?0 14 L0 C; fi i YOE i 0 150 Name of Contractor and Job Foreman Business Address Telephone No. ON FILE ON Contractor's License No. City Business License No. ary ri h� iJ Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I 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: Receipt No. $ 10, 00 to 00 Received by Date PERMIT VALIDATION PERMIT NO. r DATE APPROVED r EXPIRATION DATE O'4TE ISSUED o Administrative Authority Recorded by II TELEPHONE: (619) 564-2246 k 1 • a 1 9 .c k 1 • a 1 9 NOTE: With proper validation this form constitutes an encroachment permit -------------- --- 7— CITY OF LA QUINTA 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: A-4-90 - Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION MOVE EQUIPMENT:. (Street address or Description of Location) PURPOSE OF CONSTRUCTION MOVE BARBER GREEN Sketch.(attach construction plans if appropriate). DESCRIPTION OF CONSTRUCTION 10'6" WIDE HEIGHT LEGAL.: HAUL ROUTE CpLI �p BE RMUDAS NORTH. ON BERMUDAS '�O'" 52 TO WASHINGTON DIMENSION OF INSTACLATION:OR REMOVAL WASHINGTON NORTH. OUT. OF CITY LIMITS 1 SIZE OF EXCAVATION, IF NEEDED DATE: 6-4-90 .ox.- 6-5-90 ONE DAQNLY APPROXIMATE TIME WHEN WORK WILL BEGIN 4 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) Inconsideration 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 AIASSEY SAND AND ROCK P.O.BOX 1776 INDIO CA 92202 Name of Applicant (please print) Business Address 005182 � O -T8�h06 -U4-90 14 10 CA H i TOTAL i i0.00 Name of Contractor and Job Foreman Business Address Telephone No. - ON FILE ON, FILE Contractor's License No. City Business License No. Applicants nsurance 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 $ Permit Fee t O Penalty Cash Deposit -Surety Bond if required � X00 TOTAL: $ Receipt No. Received by Date Recorded by N2 PERMIT NO. ! DATE APPROVED IQ q_E EXPIRATION,DATE - L AT ISS U _ By PERMIT VALIDATION TELEPHONE: (619) 564-2246 Haminisirauve Huinoriiy