1067xx u y , *^
M J i �'� a,�s i. .s •.+. ~• , -, - ' J - .... rr ... ..' A,.--v..4i•vy.w.-.
NOTE:
With proper validation . 4
form constitutes an
encroachment permit CITY OF . LA QUINTA .
APPLICATION.. FOR PERMIT'
',:PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)'
SOF
-For the construction ofpublic or private curbs;, driveways, pavements, sidewalks, parking lots, sewers,` water. ;mains `
and other like,public:works'improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIV.iSIONS
Subdivision•Improvement Permit — Class III
4-17-91
DATE: Minor Improvement Permit Class IV
LOCATION OFCONSTRUCTION
(Street -addressor Description'of Location) "
PU'RPO.SE, OF CONSTRUCTION. , ` Sketch (attach construction plans if appropriate);
"• DESC.RIPTION OF_CONSTR.UCTfON' D-4 with r,1nnA t;�A;-.1 Route Alvarado -at Monterey to
1'lft wide legal elsewhere le Eisenhower' to 52nd- out of -
..� City limits
DIMENSION OF. INSTALLATION OR REMOVAL ?
SIZE OF EXCAVATION, IF NEEDED
i V ',ABPROXIMATE TIME WHEN'WORK;WILL BEGIN wF
r APPROXIMATE TIME.OF COMPLETION '* }
n. x ESTIMATED CONSTRUCTION COST $'
(Including removal of all obstruction; materials; and debris, backfilling, Com r,
•'paction and placing permanent, resurfacing and/or replacing improvements)
InWconsideration of the -granting of. this permit, the applicant hereby agrees to:.
;.. ,
L -,• ` Indemnify,.defendand save the City, its•authorized agents: officers .representatives -and employees, harmless'from and against�anyand 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. ofan'y; work` -undertaken under'the permit granted pursuant to.this application.." "
''Notify the Administrative Authority `at -least twenty-four (24) -hours iri'advance. of the time when work will be started.
"„ .•
Comply -with all applicable City Ordinances,'theiterms and conditions of the permit and -all ,applicable. rules and regulations of.the City of
„. La Quinia and .to pay for. any 'additional ._replace"ment necessary as the result of his work.' ,
.� Signature of Applicant or AgentI
;Tarmac Massey �p. o. box 1400" a:
Name of Applicant (please print) ` ;` Business Address Telephone'No.
'; Name of Contractor and Job. Foreman :`Business'Address .Telephone No.
3 ' on *file on, file
i Contractor's License No.. f' " City Business License No. .
oil f ile
'Appl'icant's Insurance Company ;`.:, Policy Number
'. FEES: Subdivision Improvement• Permit Class
z Public improvements: 3% of estimated construction, costs
`
1: Private improvements: 3% of estimated 'construction costs
Minor Improvement Permit — Class IV: See attached schedule.' .•
Inspection Fee $ PERMIT VALIDATION
10:00'
Permit Fee PERMIT NO. 106.7
* 4-
Penalty
1791 DATE APPROVED.
Cash Deposit Surety Bond . ;
'.i.f.required ;.EXPIRATIWDATE 4- 17-91
r TOTAL: $//
.DATE I U.E V 4— 17=91
Receipt No..
By
Received by Date Administrative Authority.
Recorded by. TELEPHONE: (619) 564-2246
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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
4-17-91 Subdivision Improvement Permit — Class III
DATE: Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
D-4 with sloe oard Route .Alvarado at Monterey to
DESCRIPTION OF CONSTRUCTION pb
-
11fC wide legal elsewhere le Eisenhower to 52nd out of
City limits
DIMENSION OF INSTALLATION OR REMOVAL
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 work.
Signature of Applicant or Agent
Tarmac Massey p.o. box 14050
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: $
Receipt No.
Received by Date
Recorded by
1067
PERMIT VALIDATION
PERMIT NO., 1067
17-91
DATE APPROVED
4— 17-91
EXPIRATION DATE
nATE MR1 I 4- 17-91
By
Administrative Authority
TELEPHONE: (619) 564-2246
• . "`..t t '• .+ f NOTE y, � �. •.� .. • � t: �• � ; � f'
With proper validation �' . e C h. • - r gt
.• this form constitutes an
encroachment permitCITY OF -LA. QUINTA
' �. .. s• APPLICATION, FOR PERMIT,
PUBLIC WORKS CONSTRUCTION"
+ • 3 t' for the construction of.. public or4'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
—
n
+.
1 4-17-91 !' Subdivision Improvement Permit = Class 111 4t
DATE: +• a Minor Improvement Permit Class IV:.`
LOCATION OF'CONSTRUCTION'
(Streetaddress or Description of Location) t a a' )
`.PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) '
DESCRIPTION OF CONSTRUCTION, D-4 with RIdpa hnard �� Route Alvarado at Monterey to.
11ft wide legal elsewhere lei Eisenhower. to 52nd out -8f
-city limits (.
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED Y•
APPROXIMATE TIME WHEN WORK WILL BEGIN T t
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $ i'• ,
S (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: �f ,•.
e ;.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 personsror_ property•` ,
'happening or occurring as a proximate result of any work_'undertaken under the permit granted pursuant to.this application.. -
.� r'Notify the Administretive�Authority af•leasf 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,
-v r La Quinta and to pay for any additional replacement necessary as the. result of this work. ;, • ,
Signature of Applicant or Agent
Tarmac.4dassey'p.o. 'box- 14050 `
Name of Applicant (please print) Business Address t Telephone. No.
'Name of Contractor and Job Foreman t Business Address Telephone No. �I
,. k Lon file r'
on file
c
Contractor's License No, City Business License No.
on file s .
d " - Applicant's Insurance Company - , ' • j,, Policy Number
�' i ; .�. '-� ,E�. �,• FEES: Subdivision Improvement Permit -Class III
,Public improvements: 3%of estimated construction costs t• ,
G '
Private improvements: 3% of estimated construction costs t 0.6:7 � .. a
-Minor Improvement Permit -'Class IV: See attached schedule
' r Inspection Fee. , $ ti PERMIT VALIDATION
Permit Fee.. -
r 10.00 - r t r 1067 t'
". 2' +' ' PERMIT NO.
_ Penaky` r 4— 17-91
Cash Deposit -Surety Bond: DATE APPROVED; 't `
` d ' .'4217-91
if require
EXPIRATION.DATE,
_
TOTAL:I $
DATEI UE 4'— — ~
Receipt No. a F
Received byDate v y ; " B41-
k Administrative Authority.
:.' .Recorded by °' `" ,�TELEPHONE:(619)564-2246••:
NOTE:
V: .f With proper vsiKbtww
this form constitutes an
encroachment permitCITY OF LA QUINTA
APPLICATION FOR PERMIT
. - PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the constrtictioll of, public or private curbs. driveways, pavements. sidewaiks, parking lots' visstes w4jew-
' and other tike public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISION$
Class 111 �� '� •; �.., ,
Subdivision Improvement Permit - :.;;.i..:: �•
DATE: Misr Impionmw it Permit Clue IV
-LOCATION OF CONSTRUCTION
{Strut mom" of 6avlouon of L0000n►
PURPOSE OF CONSTRUCTION Sketch lattach construction fa d s'pprpprim
' DESCR 10 OF NSTRU��'
OIMENSI NOF INSTALLATION OR REMOVAL G _
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME NMEN WORK WILL BEGIN ;
APPROXIMATE TIME OF COMPLETION ` r
_^ '"ESTIMATED CONSTRUCTION COSTS
Y (Including removal of all obstruction, tniwids, and debris, bar+tfilling, aohn '
- paction and placing permanent resurfacsnq and/or replacing improvulwnts)
In consideration of the granting of this permit, the applicant hereby agrees to: *'
-- Inatmmty, astento arta nave the City. rte auaionaod poem, offillm. rebreeemestrres and emotoven, Mmness from inn perst env and Ml
1 • - - tionsill". liabllitin or Ian rewitint9 tram Cnaumt or Court salon and armm9 out of anv aCirownt, loll or damp" to OenarM or property-
lietrpemn9 Or 00MM t9 et a pnokenato nwtt of aM work Mid taken un =r tde oerrntt granted ouraiiant to this applttlttoli. -
..,_T--`'':. �•^- - Nancy Me Admmotrwwn Ailowniv a Matt twenty-four 1211 hours to edvertta of the
two when wok will be etsrild.
all aooliable City Ordinance tM tem" and mndttions of the p men and a1 mookume rule and rerAnten" of cited of ,..
-- ,_.., '' >• Ls Quints ono to ore for any ow tio, nwsceme , na=awv its we mutt of,Mh wonc.z ` T'" •: -� _ -}^"'
Signal of Apptiant or A
Name or Aooucant lolesse crin Ausiness Address
A
;Te
le/p/clary No.
~ Name or ContracToraina Job Foreman f Business Address Telephone No.
I j
n City Business License No.
.
Contractors L.unse ./ -
Y Apoucarivs Insurance Conwany Policy Numoer -
FEES: Subdivition Imoroyameett Permit - Ctatt ill
Public improvements: 3% of estimated construction costs
i Private improvements: 3% of estimated construction cont
O
Minor imorovement Permit - Class IV: See attacned schedule - a
insoection Fee 5 I PERMIT VALIDATION
Permit Fee
-----
--Cash Oeoosnt•Surety Bond DATE APPROVED
' r
ifreouired • - _ _ -
_ - -_�sEXPIRATION DATE
TOTAL:
DATE ISSUED
T a _�pealpt No.-
j
y
Received by Data B
. - Adminou Live Authority
_ _ Recorded - - - - TELEPHONE: 16191664-2246