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1045NOTE: With proper validation this form constitutes an encroachment permit .���-'�`y"�"�J►'�+`'�t?/""�`�;.�-y+a.rr'�*�,f�Y�"w*`�.;..�:11':`"dP9iiY'�~"`4fiA�i� ,�• `�''�^�+�'r'F''� 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 DATE 4-1-91 LOCATION OF CONSTRUCTION Subdivision Improvement Permit — Class III Minor Improvement Permit Class IV (Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION bros grinder Routel, 52 at Jefferson to 916" wide 14hi green wt legal length Eisenhower south to Nogales DIMENSION OF INSTALLATION OR REMOVAL Dates 4-2-91 or 4-3-91 1 Day only 111!1ItIII 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 Tarmac p.o. box 14050 Palm 13esert da 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 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 • 10.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 1 Receipt No Received by Recorded by Date 04 PERMIT VALIDATION PERMIT NO. 1045 4-1-91 DATE APPROVED EXPI.R.AT-I. N DATE 4-3-91 r 4-1-91 DATE SSUE By Administrative Authority TELEPHONE: (619) 564-2246 i 0 U. 6P NOTE: With proper...validation 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 Ibts, sewers, water mains and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS 4-1-91 Subdivision Improvement.Permit — Class I II DATE: Minor Improvement -Permit Class IV LOCATION OF.CONSTRUCTION (Street address or Description of Location) PURPOSE OF CONSTRUCTION DESCRIPTION OF CONSTRUCTION bros grinder 9°6" wide 14hi green wt legal lencith DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION; IF NEEDED Sketch (attach:construction plans if appropriate) Routel, 52 at. Jefferson: to Eisenhower south to Nogales Date: 4-2-91 or 4-3-91 1.Day only 1111111111 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 Tarmac p_.-o'.box 14050 Palm 8esert Ga 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 II I Public improvements: 3%.of_estimated. construction, costs /. Private improvements: 3% of estimated construction costs 045 5 r Minor,lmprovement Permit — Class IV: See attached schedule Inspection Fee $ Permit Fee 10,80 Penalty Cash Deposit -Surety Bond if, requ fired 10.00 TOTAL: $ Receipt No. Received by Recorded by Date PERMIT VALIDATION PERMIT NO. 1045 4-1-91 DATE APPROVED EXPI.R•AT-LON DATE 4-3-91 4-1=91. DATE ISSUED By. -M-- �`v Administrative Authority TELEPHONE: (619) 5642246 .APFZ— 1 —9 1 MON1 1' 09 MA:S P @ 1 �. = ,,t;a[•!1N.., �.p,� }u^, :r.y:;-a° �. � �"[,' b,t;. „S`?'• ':i^aY:` ��•r.;w,r.-;;�: h..;, ..x:. .-.: f•i.� ,qa-..�.Y.. ., .-yam. w.. y.. ul;}y :,���.. /i' :.:,,, Yv ,5:jt.. .../•. .., q., ,•Zy• :, c'4/i'"v .�t",��, `,��::4{�=i ��v L2(�'�•'�.�.:-,�J.,.i c . !r• '.1' '� � w��.. :S ', r `p,::!,.,r.r .4;, :{•. ,:f l . 44� +7:.L: "'°!rd�..!.:•:4: "3. r'?{' 1 _•i •.�4 .$ ':' 'ti'` . ;r,Y ; w � af,, ��t ,� ,:..; ,.., .•. • ".. , ; , . . f. � ,:F',•: �k :° •' �+':'s , r•,"•:h.:...,... .r a!y, . ! -'�r.r �'•z1: • 'r�I',: :`.Ae/ i -:�'i':rt':.'%�'!!' " �")�"; I'• 5•. ! �� rrrrrwr.+rr�q•or......�•wrw,e� :X::..� � L:F, 'r�H. i' 'y• ''�' t v ! l{, ...,• ��i, fit•` .''1 ' .:,Z1:.•i - r•� ii :�. J:.%�:rt`. �',.7.'f'•N,f11,i�r,,,.��F1`%i 1'�,'rf,•. f�.•; ii�.^.Y' r/.' .rfr: r',':.` ..fi: w:h..+ I. .1r .Ar : .tty ;�) . ..y.. ."i`. h: a.5, i:�,`;r:i, r� y.. . !. •'�•.r� a. •;•'''6'J.•'a•. '•s; .9 , s.. ;: ��i1�^" ,,'.,f. ��'l:., '� i.. •;: ;':,5��.;.;.'�;,%'1!'•'w -..f, �^ :'ori'.^ -, f a. �r �: v .• ,:} :. {`•` ..J, � 'r{.. :•�:F `j..�,l ;i i .•!; �'' �`'y r':r;, •,y4'. ,. r.,. .f'•i!'- •j !r n:.r, .�'i�:`)', �{�y.'a.: G'r. .l. `,( •; J�' '!J'• '; t:�''r . y''��. i•>:.::.. ::'r'f•• ..(.r. .+ i;:f. ,S[< r.. . {., .'a. , •;�5;!�;%y:� 'i ::,,.r,:,�r•r ;:,;,%1;•`'cf,.:;jg pr, , r :,.,:1 :•.5.`c.?,r�?' ;,` . tl:�:,�' .a::2•. •>,\. ��,,'.ah:;;•�';'�:".T.,•..:_ ,� . {,� . � i•3!: r.f,• `•'1• l.,5 ', .5.: Vin:., ,f .. ,..? .,.5. ,ia�'.�.t` yy •.t1,e. /...t�5. iiti,iY:•t.'744• ::;,�•'.. t..t: �ry .' 1. �: L" ..5.. J rG•": :.,, 4':.. r'S% 'V;r :' r.l J., , ;•'. Wath .11 ,rr � :..(. r •� parvtllldltia,�... �. ':d:i• r.��:,`�• '.�[..�'i.':S•' a• • ��.f.� .!i,,;'ra;'!:'!�(,: :':. ,.. '.. r,i.,..rN.J.r., f•;:: ^;int:'.r ,hfL r.»� ttlti form ��}�,�,�� v '! • 't'>h.-^••wW �ii ' l', ''�. ',':'�,;'..:'!.,� �. `,f 4n •.rl, r'�.f y�1'�,{.). %a:•l�i ..:/•��', kid.. .1 % :nt►vschrrrontoeinlR' ,`. µ:CITY OF L A „QUIPITA _ION AOR PUE4lC�1iVOR4�S GOPISTI:tUCTIONAENCROACNMENTI �. _ r 1 " ; • 1'. L _ . Fer the co nstrucuon of, ublio �•private and Other Ilk p ar private curbs, drivewavf, povam.eitt, sidd tlks, parking loci, a t:uol,c ww#w iiiri aonneetlon will sawn MINOR IMPROVEMENTS and App ROVEp $�8 N fSIOkS ..'; 'OAT Subdjvhjon Imoroniiim"T Pe • LOCATION OF CONST`RUcr' N Minor Imprr9y�vm p �n aw IV _ , , z•� Istraet •'�� 'rte . .� - A .�• �'�.'., .,: aee<.as ar Oaf, �plt et LggrA� f . Y i PURPOSE OF CONSTRUMON SkWh fettadt � ►; 0 , R ?',TION 0 C N$iRUCTI / c^+m+�?on afro itlpp) ! . ' DIME slaty of IN ST LLATIQN OR REMOVAi: + SIZE OF E?LCAVATIOPV, IF NE % ,s r /L !!ur'C�c0/ , EDED , • � APPROXIMATE TIME wldEN , WORK APPROXIMATE: TIME OF COMPLETION 'ESTIMATED CQNS'{'RUCTIQN C ° ,/� ✓� - �` ' ilnduding romoyal of 811 oE�epn5r5 � n+eten And deb s pacaon and als, a debris, bac4cfilling; Ibtt9• l ,,. �' Ar d placing DermaJiant rostdf 4'Irid/or raplatang Imvrovenlm M) w In con ideratlon'of the "Iltisi of,this f H r Daletilt„the Ipolicant hercvv,agr •LOt , Indamnl}y, aataw amova thli tltv.° ra wan esti aanaltres, (iatlflltlaa Or fan orale awns, OrfigRr nR 41ny and am0lgvawl, ha t ��L/� ' harroanl it nst xv hpn ditnla Or MMR action 4110 "11"10 alit Of any aerfeant, Iola w Iem and aea.uK i a0 a 9+wllnf.tg �)M it ane wank v�Mna.sa%” lineae trta ornnn Oalnay. to oft" a NOUN Ime /1QMlnrrtrvl Av pranrad gv+lwnt ro Info 4ab1 " e IA611sY K Haat tW*ntv40;L1 124! h ptiOA' _ y' '• . Cotn01Y with all ao0lseeeNc CftV `Jro _ - our! of advasvoe of srla ttatt. wnah 4 t UIM an* to tl6V tti+ arly tM Iavrrfa end CalWlrlo,w ®! t116 pMmS arld alt •oWieaya Raw ane - - twoieiiii n t nary 1a Mo mpm OI h wovw, '- _ Ir�tvlr of -traa Clsy of ''�: c Siguture of AOpUcani or nt . Name or Ao 11 e , . ;:;:, d•% p cant Ipieb>Q tx'Intt .,` > r BfiSlnas$ Adores$ "L" : • y "o ,• .. ,..:•.� 4' • . .., ,• . ;� _�* .Y:� ;. ;,• TaioOner+allo.s. •.' -•':'� , :3'� { Name of Contractor an Job Business Addrass1,4D , Too, ,..• ;. :a. •, 1,.'. Orta No, �.' ; • r �, Contractors L,canse No: �'�' Ciry "sines, L1 RIG Ido. _ a r. _ Aaphl:ant's Ins�fanra Camoany ♦ ,. a .<''%!��':;. kr•:;�.v:;i rn;::;•{, g,,- '} ' is ":If. ,',I�:':' i,•''::i, `�lsr�'': A� I, �;. Pplicy Numbor FEES: ` psi: Subdivision Imprpr-M Permit 4 Gass 11I �- �. f, Public Im t prOVetnatrts: of @ltbtslted committori oo r rY� s Prlvine imprCvema!rii: 376 of { rsartatae Conatructton C09if a% y;?t Manor ImoraV , ;�`•A anvni f 1 rinrc .. cos; 1V; See OlUdled schedula } ? ^ NO irtsaa _ • .:.: xr: Permit Fee �'" ! PERMIT VALIQATION sF �"A Penalty / PERMIT N'O t Gut OQoout•Suret 1 Bond if roovlrad" " ;... OATEAPPROVED TOTAL;y •' _ t EXPIRATION DATE P Aa t No. "' ~ +, .�1, ISS<,IEI9 1. R (' cool %•' , . , :,� - .... ''s::.R'''..,..... �.:; r :.,,',': • ,•.,. ' .. .- ,� '„"'��. •,`'." . : is ` -" `• � 7..J".: ✓: r NOT9t 1 �Wlth, proper wlldatlon , - 'a!: ♦ ° th le form eanetltutoe'rn r t a 1 • ._ a C'a.- ree.hmene permh tt CITY OF 1-4 OUINTA t� • APPL{CATION POR"PURMIT `t a c •+�. 1' ` PUBLIC WORKS CONSTRUCTION .(MNOROACNMUNT) +a r i , _ <. t POr Sha ®n•truotlon ,'-ot .pu bile •er ,private' ourbadrlwWeYe. pavam.nv, IdeWalko, perkln O forte. .ower.,, vwtar.,nglwa - r ,wi •,' • and Odes Ilk. PubllO work.. Improwmene. In _nneM on wlth;MINOR lMp1tOVCM6NT0 and APPROVED Bt1B01V1610N6 ' 4-1-91.1 - • 6ubdly l.lon i-Prowment Permit - Olean 111 DATE: ' .t mi.- Improvement Permit Close /V 'LOCATION OF CONSTRUCTION "t ' }•, tav add --or DewrlPtlen o1 Laacatlanl - - - J / - + ^• .• '� •t•f • - , - 6ksetOh (oRAah eoev nuotro lon Plane If appPrlat.) L ' PU RP080 OF CONST 1RyUCTI ON a r 5111PRI� I8ON 01 hi BTRUCTION - ROtatas.. 52 . alt SCAT.%FOOA. t0 9 6r g=," PJio®rihower oouth, to. Nogel,&a + DIM6N610N OF INBTALLATlcisi OR RBMOVAL Dat®. 4_.2_9.1 Or 4:.,3-92 - 6176 OP EXCAVATION„IP NBEOED .L Dtsy ,oraly- . l APPROXIMATE TIM© WMEN WORK WILL BEOIN 1 aF ( •~ - • APPROXI MATE'TIME OP COMPLETION BBTIMATED CONBTRtJOTION OOBT S - - +�• '• r` - +' / -T '� 't - Ilnaludine removal of all dbatruaelPn, meserlale,'and d.brl., baokflll 1-8..­ p n0, .o _ • - ayr 1 •.iy ' _ •' ;paatlon and plitalno laermanent''ro.urfeeino and/Pr replaalno Improv.m.nb) In Poneld.r.tlpn of'ehe oavhilna'of thl. Permit, .the applfcant hor.bV o8rws t ' , Indrmnlfr, d.fend ervt mew is • mw. it. wY.horlrod .O. M.. ofneen.,rwromn•.uws. n. �ePi-ee.. norm,... from�'•nd .aolnw env �nP 11 .� panel elo. Lblll<b. Pr la- ro.utt no from claim. er eeuK o Ion end erlelno aY at. . Iden.. IOY Pr -dam t�tmrgne .n Prow r' t • _ h.Pb.nlno er emu in o . a prP.im.- ra or env work .--.k.n u : eront.d-. -' Ndtlfr tM 'Adminlaaroaly nue rtes • .�K<t -en --ft- 1241 noun-'edvene. eP etlal'ilme when work ww be .t ned. • <,' < ' r a coT PIY' wlth'.il eppllo. b:e Cl- Ordln.nae., •h. term• ..d oendnlene Of •he Perarate'•n Yle. • i f ' "i • ” Le -2-n- and tP P -v mor env .dPl.lPn.l roPl.e•mn•nr nee ` . tMe -1. or thl. Werk t .PPllublo r end r..W KIOM of the DIN M .•� - • t + r ,.Y, ` r' r 6IOna.ure of App110ant or Apent `• , - • Tt;1-ltla0 n._4a box 24050 Palm AOOmSt •C© tet" 4=.% 1 Nem. of AOpIIa (Plo.w print)' eu.in.m Addr.m ' ,- r TelePhon. No. - .) _ �Name of Oontrootor and Job Forman B.M..e. Add- - L Telephone No., ♦ rCPntresr<or•.'Uwnw No. , - - 1 - r 01-Y 6wtnw. Llo � Mo. . ♦' 00 'P ilea'- - ' ' • Applicant-. Inst.-nw Cam P.nv _ PPllav Number_ • • Faust' s.bdi.w.n Improvement PPrmlt -01s.e 11{. • t' - ' !` . H public Irnpr .nl'.: '9% of w[Imet.d wnatru P.lon oo t. • � /� - - ' ,t .Prlvaso Impr:owmentes 9% of oKimated oon'etrusttlon oo.t.' .� 1 0 4 5< 1 Ml nem Impnpva ment Permit - Clam IVs Bea attarslted ePhadule Inepeatien F.P ® t _lam , •PERMIT VA LIGATION • _ Permit Fee - 3o inn PERMIT NO. •' m+ 'Penalev ' r4-1-91 Cash DapP.IU6.1-Y Bond - GATE APPROV60 , L •,� t l•.. .. If r.Gulrod'EXP 'N DATE A-�__41 - TOrAL. '10...00 _ - - t }; GATE U RoP.lpt No. __ • RooehrsW for Data B �+�. j Adminl.trottvo Asr.I o my • , , i R.Oordad W - s �. T6LBPM0!40t-'(E10) 664.7246' . t y f J . .. ' r ( t. - : - • :, it . TH,IS DOCUMENT=-L"(REDUCED 'SA_ MPLE- ABOVE) ' t, 'IFAS SENT; _ - ; 1. COUNT V U N ,y ` t +I t .• �� t e,' ' `y 'r I ,.; 's• } kk SEND NO REMOTE -STATION .1. D., START`TIMEt,• r DURATION#PAGES = COMMENT 1 6193427504 4-- 1=91 12;18PM 1'02•" ,1 t TOTAL P T Me " NOTE:-.. r `` 4v •� r_T�1f^ With proper -validation: 45t ,a . + this form constitutes an .CITY OF• LA QUINTA:- - encroachment permit APPLICATION FOR PERMIT w •. PUBLIC WORKS CONSTRUCTION . (ENCROACHMENT) a - ^ For the constructionof. public or private ,curbs,'driveways, 'pavem'ents,-'sidewalks, parking lots, sewers, water: mains a and other like public works improvements in connection with MINOR IM ROVEMENTS and APPROVED SUBDIVISIONS Yf'* T• •t Subdivision Improvement Permit - Class.11l' 4-1-91 • r, DATE: - Minor Improvement Permit Class IV . ,LOCATION OF CONSTRUCTION. ' r y + (Street address or Description of Location) ' T 'PURPOSE OF CONSTRUCTION t Sketch (attach construction plans if appropriate)' ' •' ' ` J DESCRIPTION OF CONSTRUCTION bros grinder _ Routec.' 52 . at`Jeffers' i - to <' 9 r'6'"wide 14hi green. wt.. legal length i Eisenhower south. to. Nogales . oti • d DIMENSION OF INSTALLATION OR REMOVAL ,�` , 14 •. Date: 4-2-91 or 4'3-91 . f � SIZE OF EXCAVATION, IF NEEDED - • • � � r ' Y - T f 'APPROXIMATE TIME WHEN WORK WILL BEGIN tit APPROXIMATE TIME OF COMPLETION N ESTIMATED CONSTRUCTION COST,$ (Including removal of all obstruction , materials, and debris, backfilling, com- r s`. ., paction.and placing permanent resurfacing and/or replacing improvements), In consideration of'tlie granting of this permit, the applicant hereby agrees to:• r •. . ` t. _ y t •. 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 outof any accident, loss or damage to persons or, property.. ' ` -• - 'happening or occurring as a•proximete result of any work undertaken under the permit grantedpursuant to this application. , $Notify the AdrriinistretiJeAuthority afleast twenty-four V241 `hours inadvance of the time when work' t4ill'be started. •. � - ;, ' Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules regulations of the City ' . • -' ' '': . and of „• La Quinta and to pay foranyadditional, replacement necessary as the result of this work. ' t •• •' . - Signature of Applicant or Agent - t" , Tarmacf p.o: box 14050 Palm Desert. Ca .. . �. •'� l .� Name of Applicant (please print) 's. Business Address Telephone No.. . Name of Contractor and Job Foreman Business Address Telephone No. - r . % •onfile on -file . r. '. • `* f'•'. � •��, Contractor's License No. '�, '' - y 7 •' ' Cit Business License No. +3 • _ }.� on file • ' •.. _ Applicant's Insurance Company i, y _ ,Policy Number r f FEES:. Subdivision Improvement Permit - Class 111 „t s Public improve'ments:.3% of estimated construction costs • ' ' 1045, ' � ,�. Private improvements: 3% of estimated construction costs . - � � *. Minor Improvement Permit - Class IV: See attached schedule Ir •- Inspection Fee $ +� PERMIT VALIDATION • . ti ._ Permit Fee 10:00' i t ' r .n y- . PERMIT -NO.. 1045 + ' r Penalty _ '� 4-1-91 t .4 t a DATE APPROVED Cash Deposit -Surety Bond : .1 1- _ �a if required, + EXP N DATE 4---3-91 - , _y 10.00 -- TOTAL:,, {. s , y : - • $ • �` 4-1-91 r f DATE UE i Receipt No. #;" f. Received by Date Administrative Authority . Recorded by ` y' TELEPHONE: (619) 564-2246r -^ 41