1023With proper validation
"this form constitutes an {
'! encroachment permit APP CITY, OF ILAQUINTA
" • '_`
LICATION'' FOR PERMIT '
PUBLIC WORKS' CONSTRUCTION (ENCROACHMENT)
,
} For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
-4- +l— like ublic workov
s im rements in connection with MINOR IMPROVEMENTS d APPROVED SU
p p .r an • - BDIVISIONS
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3-6-91
DATE: `r Minor Improvement Permit Class IV
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PU 0 CU TRU X966 •leader" . _ Sketch (attach construction plans if a
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' ',DESCRIPTION.OF'CONSTRUCTION a^' `' ' HAUL ROUTE.
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With proper validation
"this form constitutes an {
'! encroachment permit APP CITY, OF ILAQUINTA
" • '_`
LICATION'' FOR PERMIT '
PUBLIC WORKS' CONSTRUCTION (ENCROACHMENT)
,
} For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
-4- +l— like ublic workov
s im rements in connection with MINOR IMPROVEMENTS d APPROVED SU
p p .r an • - BDIVISIONS
Subdivision Improvement Permit — Class III
}'
3-6-91
DATE: `r Minor Improvement Permit Class IV
• "LOCATION. OF CONSTRUCTION
(Street'address or Description of Location)
\ION 4
PU 0 CU TRU X966 •leader" . _ Sketch (attach construction plans if a
4 P PPropriate)
g I wide green weight- t- .f
' ',DESCRIPTION.OF'CONSTRUCTION a^' `' ' HAUL ROUTE.
TO'
' _ Y �• EISENHOWER TO' 52 AM, out of,
DIMENSION OF, INSTALLATION OR REMOVAL'S Cit. admits'
:date 1,3-61-` 91.E
SIZE OF'EXCAVATION, IF NEEDED'
' 'APPROXIMATE TIME WHEN WORK'WILL BEGIN`" ''a ''
+ 'APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $.t`� t �.� k
.(Including,,removal,of".all obstruction; mate`rials;'and debris,ybackfilling, coni;
�:,
y• f, a, • r x v e =A R r f
paction and; placing. permanent resurfacing and/or •replacing'improvements)
An consideration; of the,gra ting of this permit, e • ' • 7 , '
applicant hereby agres to-
^she t e
'defend'a"d-savelhe
City,* authorized agents, officers,•repres'enteives and employees, harmless from and against any and all
_Indemnify,
penalties, liabilities or loss resulting•from claims or `court action,,and.arising,out of any accident, loss o,da'mage to persons or property.
happening -or occurring, as a proximate result of any' work'undertaken'under'the permit granted pursuant!to.this application:
,. .,. r �. x ..
Notify the Administrative Authority at: least twenty four (24)` hours- in advance of the time when"work will be. started
Comply with all. applicable, ity',Ordinarices, the terms and conditions of,the permit and all applicable rules and. reg.•ulati5oans of the City_of'
La Quinta and to pay for any additional replacement necessary�as the result of this
Signature of Applicant or.Agent >
- TARMAD SAND_f ° AND •.ROCK P...O e: 14050 Pa1m,' Desert: -
-BOX ,
Name of Applicant (please print) 4 i ' :, Business Address ' •'• -Telephone No.
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Name of Contractor and Job Foreman Business Address Telephone No.,
fi .ori file
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Contractor's:Lrcenso No;'vr} r i= : ,r • k, a City;Business License No. -
on file S i•
ry'r:
Applicant 'sInsurance Company%' ,' Policy -Number
`P-rmit
FEES: Subdivision.Imprveme9 Class Ill
' o — ,. _}
4Public,irtiprovements-,3%`of estimated construction costs- _ T •,,, _ - ;
102 -3 -
Private improvements: 3% of estimated construction costs r
Minor Improvement Permit — Class IV: See attached schedule.
�'. 'Inspection Fee $ PERMIT VALIDATION'
Permit Fee 10.00
:4; Penalty
Cash Deposit -Surety Bond
if required
' `TOTAL: $ 10..00 .,
Receipt No.
Received bV Date A
Recorded by
PERMIT NO. '`1023
DATFAP` 0\'tE- 3-6-91
PI RATION DAT\6-—�—
'E ISSUED Z J—
By
TELEPHONE: (619) 564-2246 •
Authority
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NOTE:
With proper validation
this form constitutes an
ii 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. 3 6-91 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
4 966 leader ( p ppropriate)
PU SSE OFhCQf� TRUG�ION Sketch attach construction tans if a
ig lu Wide green weight
DESCRIPTION OF CONSTRUCTION HAUL ROUTE
NOGALES AND VALLEJO TO
EISENHOWER TO 52 92d out of
DIMENSION OF INSTALLATION OR REMOVAL City limits'
date 3-6-91
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 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
TARMAD SAND AND ROCK P.O. BOX 14050 Palm Desert
Name of Applicant (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 I I I
Public improvements: 3% of estimated construction costs O
Private improvements: 3% of estimated construction costs
23
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ ( PERMIT VALIDATION
Permit Fee 10.00 1023
Penalty
Cash Deposit -Surety Bond
if.required
TOTAL: $
10.00
Receipt No.
Received by Date
Recorded by
I:', -, -...._ A
PERMIT NO.
DATF,AFP OG,D3-6-91
IRATION DATE/-e"-'-4—�
`D ISSOED ZL6AI
By
TELEPHONE: (619) 564-2246
Adr i'rristrative Authority
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NOTE: s, t p - '2: -
'
,With proper validation
a
this form constitutes an
CITY OF LA QUINTA
encroachment permit
APPLICATION PERMIT
`�
y,FOR'
•PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)'
•ice,
y
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•'�
-• For the construction of public. or private curbs, driveways, pavements, sidewalks,parking lots, sewers, watec'mains
-
'' and other like."public work s'improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS...
.
Subdivision Improvement Permit = Class II I
• + ,
DATE: 3-6-91 'Minor Improvement Permit Class IV
`LOCATIONOF CONSTRUCTION. ' ' t 4A
+ ,
%t (Street address or Description of Location) •„ t `- : + '''- _i' r '
1 •+PU QSE.0F C N�TRU ION966, leader- ` • - Sketch attach construction plans if appropriate)
(
nigW. 0 -,
. wi�e .green weight -
DESCRIPTION OF CONSTRUCTION y ` HAUL ROUTE
NOGALES AND. VALLEJO TO
EISENHOWER TO,, 52 and out-'of
I DIMENSION OF INSTALLATION OR REMOVAL city 'limits
w.
date. 3-6-91 •
SIZE OF EXCAVATION, 1F NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
'.. ,,`
• i' .APPROXIMATE TIME OF COMPLETION'
'
�• "
a 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:
t
,
Indemnify, defend and savetheCity, its authorizedagents; 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 propertyF- .
_
• -' „' �,':r f
�, w 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 124) hours in advance of the time when work will be started..
•
t,' r' ' ' �-
1 Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the,City of
4. •. -
La Quinta and to pay for�any additional, replacement necessary as the result of this work. - -k*, - i•
!
5 `
• r
4 *ter - t•- Signature of Applicant or Agent
�. --
-TARMAC SAND AND ROCK` PO. BOX 14050 TPalm,SDesert r
e' Name of Applicant (please print),`..• . ` Business Address 'Telephone No.
tir
Name of Contractor and Job Foreman ", " ; ` Business Address Telephone No.
K y
fila on file
nn Y'
Contractor's License No. 4 ,. City Business License No.
3'
on file r-
••
} � Applicant's Insurance Company _ - �- � Policy Number .'
FEES: Subdivision Improvement'Permit — Class I I I
Public improvements: 3% of estimated construction costs t rl
3;
10231
+Private improvements: 3% of estimated construction costs L t
t
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ -
PERMIT VALIDATIONI� �` r
.
' 1'0
.!
t
Permit Fee .,0'0
PERMIT NO. 1023
Penalty '' is
3-6 91
r, Cash Deposit-Surety Bond _ .
DAT�APPRO
'A•y
if required <, _ y'
IRATION DA —7— 40 t
��~
NOTAL. $ 10:00
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—,/; y•
IS ED'
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Receipt No.
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M-
Received by' Date
Adm " trative Authority
Recorded by .E 4
TELEPHONE: (619),,564-2246 v
WED 1 4
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Non
With Propff V111406M.
CITY Of LA QUINTA
ff r49M
APPLICATION FOR PERMIT
PUBLIC WORKS CONMUCTION JENCROACHMENT)
For the conitrjcton of PUWIC of PrIV615 CUrbl. dflYt""Y', Pavements, sidwalka, parking lots, WA", w1aw ftlgiswl�.
and other like Millie work= irnwo"tnents In connectlan wide MINOR IMPROVEMENTS and APPROVED SUBDIVIS10"
Sulkliw4ion IMMV2ftwnt Perm w Ctux III
RATE;
Minor IrnPvvtftwM Pmit 044 IV
LOCATION OF CONMUCnON
PURPOSE OF CONMUCr(ON Sketch (Smaj ewst—l•on ours if xpwvp*m�
)O� a of e7
Dq9R)PT 4STAWCI
Irl Z7 I.,)
7Q
olmos,w- OF INSTALLATION O.R REMOVAL
SIZE OF EXCAVATION, IF NEEOEO
eet
APPROXIMATE TIME WHEN WORK YALL BEGIN
APPROXIMATE TIME OF COMPLET'ION
ESTIMATED CONSTRUCTION COSTS
0Q'
(Including Miltil*41 Of III obflrmian. MWINIS, and debris, backfilliml, corn.
paction And placing perynamerit ietwft" And/or replacing im0rOv*ffwM)
In wsideravlon of the gaming of ltti permit, the soolitzint hartfw Sqrftl to:
lads—tv, detsov mfd Im the City. re 44ithomzad para. Wars, reomwmtrm end aTmiovess. nem"itu from end agwttt 9" Ind 211
CON411", l4bilities of ion m1millfIq bwn 0411101 Of curt w1aft and 11"W4 M Of 9" 6-Urd0"T. last Or dMlop to pateorte of Orem Or
400"tM Of OQCWrM 46 A DAMersift fMtt 01 iftV *oft Ur4wnk#h Unmw the oentrtt q?%"tqd pursuant To via sww1va".
Natft the AdmintintwA Auvrorvw 4K tsta twor"y4our 1241 hours in sovao" of the tim@ "qft worst will be
cdffluly wish oil A0044swow 0034ant"11114 M11111 Ind cvawiwft at" wm" OW sit sookwo riles r19uwwft of the Cltv of
L& Quints end to my for Inv awniamw MwAuff" M40"wv as me to"% a
rig "or%.
5grweurA Appeant or Agonj
Name of Acoucant)dleliw onrill S%Ainsu Address No.
Name of Cant77app jab Foreman BusirBusinessAddAddressTalwane N*.
o
Contractor's L,Caf%p N
Citv Business Licanm No.
Acolicint's Insurance Ciasmy
Policy Number
FEES: Subdivision &orov*m"tPerMrt—CtAtI III
Of ed
I WNW.tCta0. txSsti
Hyatt iM0rowM*rtz: 3% of tzrnated coninfu=0f, COM
Minor imorovement Permit — amass 11.1, Soo assumed ichudula
Insoectlan Fee
Permit Fee
Penalty
C41h 000mit-Sumv Bond
it redulf4d
TOTAL-
St"Jot No.
R00tyed by L;4u
PERMIT VALIDATION,
zC
-q M I T .1. 0.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By