1049NOTE: a,
With proper validation -
r
this form constitutes an CITY OF ;LA QUINTA
encroachment permit' ,z
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)'c
OF THB�w
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, water mains
r and other like public works* improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permlt•—'Class'III
`DATE: d K -a1 Minor Improvement Permit+.Class IV
LOCATION'OF CONSTRUCTION `
(Street address or Description of Location) �f
4� PURPOSE OF'CONSTRUCTION' Y966 Leader 15:' WIDE' GREEN Sketch (attach construction",plans if•appropriate)
4,
- + ' WEIGHT'
H it UT
t * " -DESCR,IPTION OF, CONSTRUCTION
t NOGALES &, VALLEJO. TO ET'SEN�HOWEI
T0.52°TO WASHINGTON NOX H
DIMENSION OF INSTALLATION OR REMOVAL OUT OF ' CITY✓LIMTT'
DATE; .4-5-91 L
SIZE OF. EXCAVATION;,IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN t,
APPROXIMATE TIME OF COMPLETION
m ,ESTIMATED CONSTRUCTION COST $
(Including' removal,of all`obstruction, materials, and debris, backfilling, com-
paction and
ompactionand 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 atleast twenty-four (24)•hours',in advance of .the time when work will be'started.`-
Coriiply 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,additionaf"replacement necessary` -as the result ,of this work:' "" f
n •w x Y Signature of Applicant or Agent
r TARMAC P.O:..BOX 14050 PALM-DESRT. CA- 922.55`
Name of Applicant (please print) '' E' Business Address - , Telephone No. =
' t
Name of Contractor and Job Foreman Business Address- Teleplione No.
ON FILE �.. Y ON FIL E'..
Contractor's License No' ` City"Business'License.No:',
ON FILE
Applicant's Insurance Company . - 'Policy Number
FEES: Subdivision Improvement Permit — Class II l
Public. improvements; 3% of esti,mated,construction costs
Private improvements: 3% of estimated construction costs r 1,04-9
Minor Improvement Permit —Class IV: See'attached schedule
Inspection Fee
Permit Fee
Penalty
Cash Deposit -Surety Bond
if, required
TOTAL:
Receipt No.
10.00
$ 10..00
Received by Date
Recorded by
PERMIT VALIDATION
PE RM IT.NO.- 1(ld9
DATE APPROVED 4-5-91
EXPI-R�T1.OIV-AJ,E� 4-5791
�' �" 4--5-91
DATE 11R. U =
By
Administrative Authority
TELEPH.ONE:1619) 564-2246
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40
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 lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit —Class I I I
DATE: d -5—q1 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION 966 Leader 15' WIDE GREEN Sketch (attach construction plans if appropriate)
WEIGHT I AUE- ROUTE :
DESCRIPTION OF CONSTRUCTION
NOGALES & VALLEJO TO EISENHOWEI
TO 52 TO WASHINGTON NOlTH,
DIMENSION OF INSTALLATION OR REMOVAL OUT OF CITY LIMITS
DATE 4-5-91
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
TARMAC P.O. BOX 14050 PALM DESRT CA 92255
Name of Applicant (please print) IBusiness 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 a 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
Penalty
Cash Deposit -Surety Bond
if. required
TOTAL:
Receipt No.
10.00
$ 10.00
Received by Date c
Recorded by
PERMIT NO
1049
PERMIT VALIDATION
._., *1049
DATE APPROVED 4-5-91
EXRIRATI'O`N-DATE'4-5-91
4-5-91
DATE I -_SUE -'
By
{ •Administrative Authority
TELEPHONE: (619) 564-2246
a
APR— 5-91. FR 1 1. 4 MA'S v
... .......
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NOTE.
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this form corirjit,tu
an
encreacnmerri vffynrt A
INTA
CI LA CUI
APPLICATION FOR PERMIT
PUSUC WORKS CONSMUCTION '(ENCROACHMENT)
-3,
For iris cannm=n of public or
0 private cutbi, dtiveways,'pivernerm; sidoweiks, Patking lots, Sew".
:kv
Ind ottior I".
le works irnxmmin cannei6on with MINOR !MPROVEMENTS and APPROVED SUat)IVI'
Sims
7
+
",c
DATE, Subdiv'ision Irprovarront Perm n
CIA"
Minor loipravim.m pvm� ati;i IV
LOCATION OF CONMUCTION.
or comwomat Lowbonh
PURPOSE OF CONSTRLtCnON
Sketch (Attach
ctl0rt
Plans it a
FCO %
OMRIPTI N
2
I iucr!�O
�P 1� Q�/ e 0/f/ P� a // i�
DIMENSION OF INSTALLATION OR REMOVAL -
•SIZE OF EX•CAVATION. IF NEEDIED
oil
APPROXIMATE TIME WVEN WORK iNILL SE55IN
APPROXIMATE TIME OF COMPLET109,
ESTIMATED CONSTRUCnON COST.$
(Includlrq rernovii o . . . . . . ....
d debris, "filling,•
t all obstrimWn. ftwM112, Am* =n.
PACC011 And ptacing por;konam h"UHzC* and/or
vwrwm
In C,/ ' t :•'%:i •,%
f
the grAnting 0 �thjj
P.errnit t.al IppAc;;nt'herrbV tqrftmg to:
A0 2"
MAIN, 991'em 0 am IN
Via C11V- 40'GuMnxod *"nn, Offtsnrv: fftnnwmt ' I ,
harrhiqu from and apona &W
11111" or km R"Iting hm - cls"m W court batim u4 orm"" Out GCCrdont, ton or d*i"$"
Ra0pen1A0 or eecumrp ll a peoxormate #Wimn of yfaft undmukan U tw the oun, grentod WNW to this emicirum 4
Notify rha'Adm�nrtn3sl.e Auvwrrry jR
k"t t""N-ftur 1241 he f tn6 t""a" v�haff wvft wil be rts"".
C*Mtwv Man all CJ1V Old r,�
• ftwivi"aAdconalimm A -d modn" of the a#
LA amino ii�w to NY tor owy &&Wwdw MqLftav�mn plao"My as the R"I of Is' iw", CUT
th
nt A
Siguture at Aopl(cj gorit
Name of Avolicant (please an
Gusinan Address
No. a9p
PAC or Contractor ono Jae ora rens d!
Toll
Susiness"Add
No.'
L4n1r3cTQr'1 I.,.Cento, No,
City Business Lic;nsft No.
Aopj
'cant's Insur;1,
nce conmion
rG114V Number
FEES.
•Public innarownwrr".: 3%. of amirAT2d onmuction costs
Private impromnents,
a%* emyna"o construction cc=
No
IV, Sei
810ection Fee
PERMIT VA 0 N
,''Permit Fro LIDA
Pensiry
Cash So
LIC1111", L rtnt� No,
OATE APP�OVEO
EXPIRATION DATE
TOTAL:.I
rERl) eceipt No. Inve
-A
OCII rved liv,
y
Date .....
:0
,
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' PAGES <•'
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,6193427504
4= '5-91 11'•,i'7AM f
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NOTQI f
With prPPer•1alt4.00n'
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thin form mn.tltutek an - • CITY OF LA QUINTA f
enOreaehment permit
FOR, P6RM1Y'.:
Y�-
-)'
PUhl AC WORKS GONBTRl/CTION- fENCROACMNA6NT) t •'
'pevem.nt.,
For the cant truction of public Or .Private curba, dri— Va. altlewelka, parking ioH. ..were, w.t•♦ rr•ei na `
„4 k •
•• .nd -1 Ilk.pu'<17tP woike InlPrevrr II.— In oonn•Otion with MINOR IMPROV FMENTS and APPROVQO SUBOIV ISIONB.. '
_
;
'
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. t' 5ubdivi.lon Impro men[ permit — Clam III )
. \ • 1 /'•
"
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r srt DATE.*—^' =•' • Improvement �. _ - Minor Impvemnt Permit Class IV -
. .' r
LOCATION OPCON4TRUOTION.
- -
•
- '.
IORa,n .dcro•• et' OeiPrlptlon a LawtlOnl - •, - - •
• •}'
_ PU RPOSB OF CONSTZ,",20-ION g 6 E Z,",20 -r 1 g • wTna `nav11rw� sketch (attach ccn.tryctlon atone it ePproprlote)
e
-
}� DESCRIPTION OR CONSTRUCTION
e�l' r•
N0GAL738 'G YASUU-704WO EE)i63CH7)40T4)SE
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TO"' 92`• TO779\BlS27JSf^eTON NOIQTH
'•0IM9N6lO14
ORINeTALLATION OR REMOVAL OT7T: Or CSTY LS7)QSTS i t'
• .: 1
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•- OATS 4-5.91• '
.
SIZE OPEXCAVATION, IF NEEOBO-
.l ).
APP ROXIMATB 71M9 WMSN WORK WILL BIROIN 't' • • ,
•
-
APPROXIMATE TIM@ OF COMPLETION •,, f' • ''
69TIMATEO OONBTRUCTION COST 8
l
' - •
—I of .11 b - uut in. material•. •ne dabrl.. baokfllllno, 00
(Inoiudlnp "'mo
rr • I
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paotlon one plocinp permanent resurfacing and/or replacing lmprovam t ) -
tOf
th. y Ino o+ thl. permit, the applicant
• < ,.
I
yh.—hy
• Inu.mnlfy,•defne ane m <ho OI<V �1<. authorl..d .9.in., oTrll:era• n r.•e a• .nE .rnPloys•n. h.rml.a• from..M n
'from . Llnp a Ica. . Wraoru u YO
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•aa tlo, II•bilitb• er ..0 1.. el.•m. ar end of ..v ...Idem. or ovm t0
f h.eP.nleO Or —..-Inc up. rProkl•neu r 1 et any walk uar• n.kon 1. oder the P.rmit Oren[ee Pura{rene to !1 appllaeNan.`•r ro
- -I
"' - IVotlfy the Ad,nl nl•[ra[Iw AuihellN m lee•[ tw.n: me1•r (a.)anour• In •.d ^nae of<nto [iron w{1an Werk will a '
rN•
Yr M -
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{ per•1PIY wtth . apellt.bl� �{N OWln.nw•, th. t and a eltloly u1 t e Per1e and Y spPlleaela.e end a w.tlOn. of the OPt
-. 1 •
V V Quln[P .rte <a paV for . Y .edhl.—I repl.O.m nee. ry e <na, r 1, Of [111. w0 rk'
signature of Applicant or Agent, , }
D HEim r'•A • A 2a a i' •:•-
-a 1
Nome Of AppI'denuOa0P uaa Addro.s i ."feleph One•NO. _
-
- Name of Contrao[or and Job FOr.men Bualnet• ^der.— .. • Telephone No. -� I
•
• ON P'ZL8 - rte` ON
Contractor'. Lim No. I It •City 8u•Inem Liam.. No.
r
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•
• Applicant'• bit Yrenae Company - 't ' T POIIOv N. -b.,
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PERM! Subt/lvl.{On Imoaevcment'Parmlt — Cler 111 - f "• • [ - t • ' j
•
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• Pu I. le Ica ProMm.nt1: 79l o[ e.tlm.tad penrtruotlen ease. 4 1 (� 4
PTlwa Ica St8 of e•tlm6cetl oontru Ilion oo.ts ' t -
• -
• •
Provrment.: i
Mipe, 4 nprovement Permit —Ol.w JV. Seo ettach.tl..he"WO ! i • - r / ,t
P.O..F- S ` ' ,
t . . PlRMIT' VALIOATION
P..mit Reer
r _
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ENOi
PERMIT .,
.+ rI
•
p•..I—
O.th 'O.poelt-Suroty Bond
OATH APPROVED 4—S—R1
r' • -
- 10.00`.:
•iTOTA L: ID
-
'C-5^91 • ~ S
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R.cawda by - Oae. - i
• -- •.�IP<ro<IV. Authority
• • •
I Reeard.tl bV t
I i .'AT9LOPHON11t (8119),884-=48 •• _
,
T''IS -DCC UMEN-F"'(REDU.CED" SAMP'LEABOVEY' =2
WAS SENT"..-
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NO
REMOTE }STATION, I. D.
1 i
i
DURATION
' PAGES <•'
,COMMENT: ;
1
,6193427504
4= '5-91 11'•,i'7AM f
1 02 I.
1r
. kt
,
T''IS -DCC UMEN-F"'(REDU.CED" SAMP'LEABOVEY' =2
WAS SENT"..-
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t +1 r• .
' Y i, '' • ' f J j J a y: - . - S • I. r ' . f1'; 1
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NO
REMOTE }STATION, I. D.
i
DURATION
' PAGES <•'
,COMMENT: ;
1
,6193427504
,
T''IS -DCC UMEN-F"'(REDU.CED" SAMP'LEABOVEY' =2
WAS SENT"..-
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REMOTE }STATION, I. D.
`START TIME` •`p
DURATION
' PAGES <•'
,COMMENT: ;
1
,6193427504
4= '5-91 11'•,i'7AM f
1 02 I.
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i TOTAL 001 02 1
XEROX.TELECOPI`ER 7020 ,
y I M � • * :. 5' - • . • t,, '' +,4' r r-"� •� t � t l � +�. ^ .: 'Yr ' - +
NOTE:` • e . - , t •`,�: ,� '._ y a,L�; i �',a_ �;, d,
1
- - With proper validationn
• s
<
r`� *• .f. ; this form constitutes an
^ I
-CITY "OF- LA QUINTA r:
•` �. "� + 2, encrhment permit.
A oacAPPLICATION. FOR,, PERMIT
f
•.
PUBLIC WORKSCONSTRUCTION (ENCROACHMENT)
..c
t.
l 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 J6
r
DATE: A — 5-4 Minor Improvement Permit Class IV:
xr LOCATION OF CONSTRUCTION
(Street address or Description of Location)
' PURPOSE'OF CONSTRUCTION. 966 Leader 15 WIDE � GREEN ,{ Sketch (attach construction tans if a ~
r- P ppropriatel`
-WEIGHT,"-- 1 ° ROUTE
` DESCRIPTION OF CONSTRUCTION ; f
J.
NOGALES &.' VALLEJO:.TO . EISENHOWEI
ATO. 52 _TO WASHINGTON.,NORTH'
^ " DIMENSION OF INSTALLATION OR REMOVAL OUT. OF.,CITY LIMITS.
• , ' }. DATE 4-5--91,
' ,.
_ SIZE OF EXCAVATION; IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION y'
ESTIMATED CONSTRUCTION COST $
'(Including removal of all obstruction, materials, and detiris, backfilling, com- '
paction and placing permanent resurfacing and/or replacing improvements) '
In consideration, of the granting of this permit, the applicant her by 'agrees to:; ,
.:.. res..'.. - , • y , ,
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all _
M,� �,�. I• ', i'penalties; liabilities or•loss'resulting from claims or court action -and arising out of any accident, loss ordamege to persons or property
happening or occurring as'a proximate result of'any work undertaken' under the permit granted pursuant �to'this application - -.
,�'.t `L•'� "' I, •�:' Notify-theAdmimstrative'Authority at least twenty-four (24) -hours in.advance of the time when work will be sta
Corted.' ,
-}. t
mply with all applicable City Ordinances, the terms andconditions of the permit and all applicable_ rules and regulations of the City of
t i. • i .. ; ' La Ouinta and to pay for,any additional replacement necessary as the result of this work. - -
t , i Signature of Applicant or Agent
µ `TARMAC P.O. BOXe 1'4050°.PALM DESRT CA 92255~
Name of Applicant (please print) 4 Business Address • Telephone No. -
' Name of Contractor and Job Foreman Business Address L•S, ;.Telephone No. _
ON FILE 'y ,'ON FILE • }
• `� ( Contractor's License No 'City Business License No., .
ON FILE
Applicant's Insurance Company °`Policy Number'
' t •y` FEES: ' Subdivision Improvement Permit — Class
! h ' Public improvements: 3% of estimated construction costs ' f 04 91
Private improvements: 3% of estimated construction costs' r ; ' t'• -0 ,
. y ,`. Minor Improvement Permit — Class IV: See attached schedule
," ix ^Inspection Fee $ - r - PERMIT"VALIDATIONw
;Y 10..00 - . , ,,
Permit Fee _ PERMIT NO ' f1 1 49
Penalty
y Cash Deposit -Surety Bond _ DATE APPROVED4-5-91 "•
'if required'EX=0A 4-5=91
• ! TOTAL: $ 10..00. } 4-5-91-DAReceipt No.
t
By
~'t I ministrative Authority
Received by Date tY
• f Recorded by' ' TELEPHONE: (619) 564.2246 '