1063r�7
NOTE: F
With proper validation `
this form constitutes an
CITY OF LA• QUINT.A
encroachment permit. 3
APPLICATION : FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OVERSIZE LOAD PERMIT 0F�ti
..For the construction of public ,or private curbs; driveways, pavements, sidewalks, parking lots, 'sewers, water. mains.
z and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
April •16, 1991 Subdivision Improvement Permit . Class I II'
DATE: " Minor Improvement Permit Class IV '
LOCATION OF CONSTRUCTION move equipment
.(Street addressor Description of Location)
r.P-15 grinder 9'6" wide r "
.. "PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
14.'.'high, green weight all else legal
n DESCRIPTION OF CONSTRUCTION HAUL ROUTE: -Al`avarado yard between'
Monterey and Chihuahua to Eisenhower
k_ north to Washington north•to
C'DIMENSION OF INSTALLATION OR REMOVAL City limits and return same day
a a . DATE s' 4117191'
SIZE OF EXCAVATION, IF NEEDED a
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:
r
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 atleasttwenty-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 r
.L La Quinta and to pay for any -additional replacement necessary as the result of this work.
r , Tina Gracey ,
` Signature of Applicant or Agent
Tarmac'/Massey PO Box 14050 Palm Desert, CA 92260
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.,. '
ori file
Applicant's Insurance Company ' Policy Number .
l FEES: Subdivision Improvement Permit —Class I II
Public,improve.ments: 3% of estimated construction costs '
Private improvements: 3% of estimated construction costs 0.L` 'j
Minor Improvement Permit — Class IV: See attached schedule V �3
i Inspection Fee $ PERMIT VALIDATION
10:00
Permit Fee PERMIT NO. 1063
Penalty 4/16/91
Cash Deposit -Surety Bond DATE APPROVED
4/i7/81
if required EXPIRATION DATE
TOTAL: $ 4/16/91
DATE ISSUED
Receipt No.
By ��r�-�
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
Z
I
I j
NOTE:
With proper validation
this form constitutes an
encroachment' permit
J
CITY OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
OVERSIZE LOAD PERMIT
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
April 16, 1991 Subdivision Improvement Permit — Class I II
DATE: Minor Improvement Permit Class IV
- LOCATION OF CONSTRUCTION move equipment
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION P-15 grinder 9'6" wide Sketch (attach construction plans if appropriate)
14' high, green weight all else legal
DESCRIPTION OF CONSTRUCTION HAUL ROUTE: Alavarado yard between
Monterey and Chihuahua to Eisenhower
north to Washington north to
%IMENSION OF INSTALLATION OR REMOVAL City limits and return same day
DATE: 4/17/91
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.
Tina Gracey
Signature of Applicant or Agent
Tarmac/Massey PO Box 14050 Palm Desert, CA 92260
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
on file on file
Contractor'soLicense
o. City Business License No.
N•
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 $
0.00
Permit Fee
Penalty _
Cash Deposit -Surety Bond
if required _
TOTAL: $
Receipt No.
Received by Date
Recorded by
1063
PERMIT VALIDATION
PERMIT NO. 1063
DATE APPROVED 4/16/91
Bl
EXPIRATION DATE
4/16/91
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246
n _...tom' � �-- �+��_a+ — ., .��
P 0 1
TUE
:23 MMASI..
i � d� r� ,w.r �- r� .v �,�,,,,i.,-�.wwti.--o �.�we-�..r�r�..r,rr�.r•..r ��o ar �•. i�.
NOTE.
Wfd1 proper vwiidaoore• '
this form aonRtwm on CITY OF LA QUINTA
ent:roacvtnlent olrmtt '
APPLICATION FOR PERMIT
PUBLIC WORKS CONS'i UCTION (ENCROACHMENT)
For the cortmmon of public or prwate duos, drivt"Yt, pilvenwRts, ddawslke, DAWng lots, wam, wstw
and other like putilic works Improvelvw to in conniocnan widi MINOR IMPROVEMENTS and APPROVED SU861VIS10 4
_ (f/ ~/� Subdivhion ImprowCUii lit
ernt Permit •• t'
• .r�,� '?�+
DATE, Miw fmproverrwnt Parm/i t3{ss .
LOCATION OF CONSTRUCTION
IStreot twman a Dmtattraoe of i„r,�xswel
PURPOSE OF CONSTRUCnON Sketdt intact auiafsu on Own it
O R P�TJON OFC KSIfi4IJ d
FO4(.��
td �' F K if°r�'E'
bu0 r� j�l a
DIMENSION OF INSTAICATIQf N OR REMOVAL
— - - o - - — � / h (��' �" u2 �ij� cam' l� i'r�! O•Gs�
SIZE OF EXCAVATION. IF NEEDED fid' f' ~ �D �l ` ,�,1'Ff / �s
APPROXIMATE TIME KME4 WORK WILL SEGIN � r " r Ik �� �rQ � l
APPROXIMATE TIME OF COMPLETION Y
ESTIMATE) CON$TRUCTION COST S
(Including ramovol of aU abnr%j=n, enatenslt, and debris, beckfilJing, part~ ,/
paeoon and 011cing permansm fsturfaomq andlor rephtinq Impeo•mrwrttt /11/Z • le ,
In consideration of. the granting of this permit, the applicant WWI agnea to:
Indemhtfy, ester" wee "" the C►tv. its sutnonted ellam". effimrs, g mamto" end.swo en, om Fnrh alfa j ser and ri
09fti tet, 110464iq ea ion ftwfutw hpn aertm or coyn eenon ane srady out of 41ffY Immit t, I= or bine" .a IN, in M pr'Imew
h«rwing or o=-" 4111 It p oXwmtR raven of a*r wart unOW014ue Umar the Ww" ptf%TW bun wo,t to this aoplasoae,
Notify ITIS AOtmftnilt AvOoo" at leen trwmy rovr 1741 hours m odvBm* of the tmtt when wort VAII tw lito
CWWWV "'kii all rawuoble City 0fsilm. W' 1114 terPw 411d COtOtiord Of The P&mry end an eoptwwo r414""regiMrmmr Of the CIN of .
Le Cu l"M Ina to aur for sly isa*tiorw mvinotwam TISmis"v a Inti mum of the won. J a '-
7 Signs;ure of Appitcant
Name at Atimicant State orntf euaintax Address T41teonons Nn.
Name or Contractor ono Jct F 11 an Business Addrou ,ass "' No.
fa
Cane►ae�or't L.c41nse Nod___' I City 8usmes License No.
Aooltant's Insuana Conlosny Policy Numogr
FEES: Subdivaion Imorvrelttont Pvtmrt-•Clas,< 111
Public impro"morns, 3% of ermtated constivetton coral
Private imbrov.mants: 3% of asprneted construction cas" l� a
Minor JM0fQv@m0t Permit •- Clan IV; See attacnao schedule
Intnsction Fee S _ i PERMIT VALIDATION-
ptrmrt Feb - -
DATE APPROVED .._.._ _.,._�.
EXPIRATION OATS
OATIE I=E0
8v -
Admimac ov Aiathormr
Fenb1ty
C1th Deooslt•Suaty Gond
If reaurrttd
TOTAL:
Reatot No.
Received by _ - Data _ ...._.� ..
Retwood by