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10534 .NOTE: With proper validation F this form constitutes an CITY OF LA QUINTA 5,encroachment permit ,. 1� � v 'APPLICATION FOR PERMIT, 'PUBLIC WORKS CONSTRUCTION (ENCROACHMENT).'-. 0 TIiB�wS 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 /l(�( pro Subdivision Imvement Permit — Class I DATE: Minor Improvement Permit Class IV. LOCATION OF CONSTRUCTION (Street address or Description of{Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION (�tR1DEl. ALVARADO TO AAMTER EY E/8, ' Ito 111 i4 N C.R�ERI WEIG H t TO [1SEK140WER N'1,E17-'t`4- L t�l�'ifflo V b To, WA 5H f NUTOIU • D O`S Z_ DIMENSION OF INSTALLATION OR REMOVAL WA -5141 KGTDN- . KWP� TO CITY OKITS A Nb RETV, 9,N .60j' SA ruC .iZDUTF_. SIZE OF EXCAVATION, IF'NEEDED F PAUL DATt' : 4 mwl l 'APPROXIMATE TIME WHEN WORK WILL BEGIN - # RLTURMT)AT'E • �--'I{ �oct�4�I�° APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST $ u (Including removal of all obstruction, materials, and debris, backfilling; com -paction and placing permanent -resurfacing and/or replacing improvements) t. 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. t Notify the' Administrative Authority at least twenty-four (24) hours in,advince.of .the mime}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 thelCity of " La Quints and'to pay for any additional replacement•necessary•as the result of this work.' - i Signature of. Applicant:or Agent T- ARMAC: '` .' Y P.O.- 3X"N 050' PALM .DESERT ' Name of Applicant (please print) Business Address, 4 Telephone No. Name of Contractor and Job Foreman Business Address Telephone.No. 0KJ 't �FQ Lf-- - Contractor's License No. . City Business License No. pN '�tl. a DN Vt::z, ` Applicant's Insurance 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 VALIDATION - `or' Permit Fee PERMIT NO. Penalty Cash Deposit -Surety Bond if, required TOTAL: Receipt No. Received by $_Z0.06 r Date DATE APPROVED EXPIRATION DATE DATE ISSUED By %" Administrative Authority Recorded by 11 TELEPHONE: (619) 564-2246 NOTE: With proper validation this form constitutes an CITY OF LA QUINTA encroachment permit 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: If) ( Minor Improvement -Permit Class IV' LOCATION OF CONSTRUCTION .(Street address or Description of Location) PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) DESCRIPTION OF CONSTRUCTION G RiNAhE K . 11Il-Ir %At IA 11 /' PCCnl \A It I r wr DIMENSION OF INSTALLATION OR REMOVAL SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN ALVARADO TO IM NTE.R EY EE/B 1 TO FISENHOWER 1'l3 !i"0.DUtc%i�Goj V6.70 WAI�_+IINGTM 'DIJ -SZ_' WA-;,HINGTON QQ) TU IfITY LIMITS -i ANb RE i UKM ON !L-A ME IZNU T E I PAUL DATL : 4 -11 - 91 . RETURI\1HATE. 4 -II az 9 17 - APPROXIMATE TIME ZAPPROXIMATETIME OF COMPLETION s ESTIMATED CONSTRUCTION,COST $ (Including removal of all obstruction, materials, and debris, backfilling, com paction and placing permanent resurfacing and/or replacing improvements) 1 .i In consideration of the granting of this permit, the applicant hereby agrees to: i 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 propee, rty 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 whewwork 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,U,bDX 11-1650 PALM DESERT Name of Applicant (please print) Business Address Telephone No. Name of Contractor and Job Foreman. Business Address Telephone No. D til F I >_E. D K) IF I LF Contractor's License No. _ City Business License No. D l�1 FILE - Applicant's Insurance Company Policy Number.. c FEES: Subdivision Improvement Permit — Class I I I -44e Publ,ic'imprgvements:3%-of estimated construction costs Private Private improvements11. :.3% i of estimated construction costs 0 f 58 Minor Irriprovement Permit — Class IV: See attached schedule Inspection Fee $ Permit Fee 7— 0. O 0 Penalty Cash Deposit -Surety Bond DATE APPROVED if required 7-0. 0 0 TOTAL: $ Receipt No. Received by Date Recorded by PERMIT VALIDATION PERMIT NO. DATE APPROVED EXPIRATION DATE DATE,rIyS�S/UED 91 .S}yfy f� •B / " Administrative Authority TELEPHONE: (619) 564-2246 NOTE:.. r y n r With proper validation - r •! y' this form constitutes an;'i t encroachment permit-,c—r, *. `,. �t ••CITY'OF LA''QUINTP' " —APPLICATION FOR PERMIT' i " • �•R', l �-�• • - PUBLIC aWORKS CONSTRUCTION (ENCROACHMENT),`'N • '"• � � "� t ,• ♦ F r. 1 �t 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.SUB DIVISIONS ' R • ' , _ ! ' I rT ` . • - • f + � t - t 1, ` ;' • � Y3 - Subdivision Improvement Permit 'Class III �H DATE: IO =q-� ! , ; '•r+" ;� Minor Improvement Permit Class IV r, + t LOCATION OF CONSTRUCTION • • (Street address or Description of Location) •PURPOSE OF CONSTRUCTION ' t ' Sketch (attach construction, plans if appropriate) , ' DE �IIPTi of c sT gucT�qn� ► ALVARADD TO'IM.ONTI✓R.EY E/B ' r l� l4 '(a Rt Em. }TO , E15E�1HOI�ER N l B T0: DUfp1,1Ga. TO WASHINGTON 00 52. DIMENSION OF INSTALLATION OR REMOVAL '" WA5W tKGTbN 0 P,' SLA' 61TY LIMITS t ANb :tZETVIZN' OW' SAS %ZbATE . SIZE OF EXCAVATION, IF NEEDED' PAUL DATE : °4-11 :q I'• 3• APPROXIMATE TIME WHEN WORK WILL BEGIN - :RETURtiDATE' APPROXIMATE TIME OF COMPLETION 4 `' ESTIMATED CONSTRUCTION COST $ r_• - -, ."(Including removal of all obstruction, materials, -and debris, backfilling, com- paction and placing permanent resurfacing and/or replacing improvements) F 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 - ' �� r• - .penalties, liabilities o'r loss resulting fromiclaims or court. action and arising out of any accident, loss or damage to.persons or property s - - ' happening or occurringIas a proximate result of any work undertaken under -the permit granted pursuant to this application. R {„ ••f - 1 -Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work, •will be. started. *••^_._---y" _ 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. - r+ Signature of, Applicant or. Agent " TARMAC. P.0,WX-14050 PALM )NEKT t Name of Applicant (please print) . - Business Address • -,,. 4•' Telephone No. t Name of Contractor and Job Foreman Business Address Telephone No. s t 0 ►J F 'Contractor's License No. City Business License No. _ k oN FILE D ISI . V- vLE i 'Applicant's Insurance Company.., `` "' K:• ' Policy Number > •. N FEES:' Subdivision Improvement Permit.— Class III t E Public improvements: 3% of estimated construction costs !.`1 05,3 r • �' Private improvements: 3% of estimated construction costs, - r f + Minor Improvement Permit — Class IV: See attached schedule + ' Inspection Fee r $ i' k t r + « 't PERMIT VALIDATION y Permit Fee : Z O. 6C) 3> .r.. PERMIT NO. « Penalty... ; .« < 4.• _ ` Cash Deposit -Surety Bond t' # DATE APPROVED SI—%D 9 r F r if required' a+ •• �2�/ —/ Z 9 x r EXPIRATION DATE ' } r TOTAL: $ , 7-0. 0 0 = ♦• • 1-. .y-10—.91 - r J:, DATE ISSUE Receipt No. 7Q�LOl « . Received by " Date - h Administrative Authority ' s f Recorded by ��" TELEPHONE: (619_) 564-2246 WED 1 1 2 1 1+1A.S �...+ NOT1:s Witt grow valwNdom Ar thb form oorztstssbaa in CITY OF LA OUINTA anCr0l�tlrarK permit APPLICATION FOR PERMIT PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) For the Construmon of publiC or prmatm euros, driveways, pavements, sidsweika, parking Iota. seiveafv, water "miW, and other like public works irnpeavarrants in conn@CGon with MINOR IMPROVEMBIM molt APPROVED SUDDIVIS04 ' ! , w ,, f Subdivision Improvement Permit — Claps jrj ,:,.„� GATE:-- �Mittor Intltrovetrtaftt PeimR'C4�,p 11d,. LOCATION OF CONSTRUCTION•, >}� i ISrraat •01*4 0 0&mW1Pb= Of Lo�droonl PURPOSE OF CONMUCTION Sketch (atr/och ftnmue tion pwft 0 l,TION OF.COwrnu N +' BGG( �CDGCTC�; �lr�C�rCpG�`d G` DIMENSION OF INSTALLATION OR REMOVAL ��5f T d ' �''S Pr"• .C�GI�PP� SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME IWEN WORK WILL BEGIN APPROXIMATE TIME OF COMPLETION ESTIMATED CONSTRUCTION COST Sd :Indudinq ramaval of mIInnaa�bttietton, aneb:ttmis. acld debris, badef illing, ta>M 7! `� I� Picton and placing penam rm m fmnneq and/or replacing Imorc ver atrat) A/W In tonslderoaon of the granting of this perrrilt, the applicant hereby ag" to: ' r(' 5 Indemm4v, act** am Raw Ito ON, m aunronaad eeanm, offiart, eeomowtoMm arm erepldyeea, Aarmtam from and aeeetas env attut all panartt•t, Itabtlrti" at bed rlautttne from damn 0. Court /Rion era anurte out of env aeeraart. Ion or danyea 0 Im 0-ee W Maohty haooantty a oeLAmm as a oeewrttam terWt of env w044 oaeeemt&M ut4er tM eft eCMted oureudn to this eoWttat", NoVty the AdentAMM q A4jdWvty m so" fawnw4cour till noun In adver m at. the Mme whom rmx will to naraed. Cantwy vngt all ammeois tai Ordirreiwp. Vie V*"m and comimm of *4 odirner and all eooti Alla no" and MWAatrom of tR1 GN of 5 V swim and to aav far env aFdainnae "vw*mwm no =wv e• end rvwduot fnw wax. /... M .. Sig—r1mire of Applicant or AAlik �r r t P/ Name of Aooaunt (please orintt Rusiness Address Te{oser+one No, Name of Contraetorno Job Fararn$A Bus4mm Address Te of one No, A ©4 T l / /� , Contractor's L.Censo No. City 8utmess Limm No. Aaouunt's Insurance C*nVmV Policy Numoer ��• - as l �rsrr.�,r ouY�aa�� .ts FEES: Subdivision Imorowmerm Pcrmrr —clan III _ Public imprownwita: 3% of edtirnated oonsarualon costs Private imorom. rm. Wal etamated 000str.,cman coxa i� 0 Minor Imor�a_ent Ptrmtt — Ctua IY; Seo mcu�eo,�Wuim • Insaaaton Fee, S — f PERMIT VALIDATION Pormtt Fee DATE APPROVED EXPIRATION OATE DATE tSSUEfl By Admmisa:ove AW►orrty Penalty Cash Oeoostt•Surety Dona If required TOTAL- Rapala% No. Ilaettvm ey �—� Date_ �...e�.