1069I •,
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With proper validation
this form constitutes an,
encroachment permit CITY OF : LA QUINTA
APPLICATION FOR PERMIT,
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)'c�
' OF
For the construction of public or private curbs, . driveways, pavements, sidewalks; parking .lots, sewers, water mains
and other likeublic works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
P •
Subdivision Improvement. Permit— Class Ill-
DATE:..'
ll-DATE: 4-99-91 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION '
(Street addressor Description of Location)
`PURPOSE OF CONSTRUCTION 'Sketch (attach'construction plans if appropriate)'
`
ROM 52'AT JEFFERSON WEST TO
'DESCRIPTIO N OF CONSTRUCTION BG 265 PAVER 10'61' EISENHOWER SOUTH TO NOGALES TO
"'. 'WIDE GREEN WEIGHT 'ALL ELL LEGAL 'VELASCO
. :, Wit, - - •
DIMENSION OF'INSTALLATION.OR REMOVAL DATE 4-22-91 '
SIZE OF EXCAVATION, IF NEEDED„
APPROXIMATE TIME WHEN WORK WILL BEGIN'
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of a ll. 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'
4 + _-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
-+ LaQuinta and to'pay for any additional replacement necessary as the result f this work.
r�r Signature of Applicant or Agent
-TARMAC MASSEY P.O. BOX 14050 PALM'DESEHT
Name of Applicant (please print) - Business Address Telephone No.
` Name of,Contractor and Job Foreman Business Address- •'. Telephone No.
ON 'FILE'
Contractor's License No. W City Business License No. ._
A'pplicant's Insurance Company Policy Number.
if
FEES:Subdivision Improvement Permit —r Class Ill ,
Public.improvements: 3% of estimated construction costs
•r, Private improvements: 3% of estimated construction costs r Q
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit. Fee 10NO
PERMIT NO. 1069
Penalty DATE. APPROVED 4-22-91
Cash Deposit -Surety Bond
if required EXP TlnnM DA 4-22-91
i.
TOTAL: $ 10400 DATA IS�U 4-22-91
Receipt No.
By--;-
Received
y -Received by Date Administrative Authority
Recorded by r TELEPHONE: (619) 564-2246
�� � � '!�,, L� { � .+v., ti'p's Y'� 4-. *"e,`.ry`'' -t-. t t;'�" ' ec "�,S 'y.'! -. _ c,: ';,s•. ._,:. .� � - -- -•
NOTE:
With proper validation
this form constitutes an CITY OF LA W NTA
encroachment permit
APPLICATION. FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)c.
OF
For the• construction of public or private curbs, driveways, pavements, sidewalks, parking lots, sewers, watermains
and other kke public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class III
DATE: G-99-91 Minor Improvement Permit Class IV
• LOCATION.OF CONSTRUCTION
(Streevaddress or Description of Location)
PURPOSE OFCONSTRUCTION Sketch (attach construction plans if appropriate)
E 52 AT JEFFERSON WEST TO
DESCRIPTIONOF CONSTRUCTION BG 265 PAVER 10161. EISENHOWER SOUTH TO NOGALES` TO
WIDE GREEN WEIGHT ALL ELL LEGAL VELASCO
DIMENSION OF' INSTALLATION OR REMOVAL DATE A-22-91
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 th'e,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. r
0I911GLUIC U,1 F1pp1H:d11L UI MyClll
_TARMAC MASSEY P.0'. BOX 14050 PALM DESERT
Name of Applicant, (please print) Business Address Telephone No.
!Name of,Contractor and Job Foreman Business Address Telephone No. +
-ON FILE
Contractor's. License No. , City.Business License No.
._
. Applicant's Insurance.Company Policy Number
FEES Subdivision Improvement Permit — Class I I I
.Public improvements: 3% of estimated construction costs: �, Q
•:Private_ improvements: 3% of estimated construction costs O
Minor Improvement Permit — Class IV: See attached schedule'
Inspection Fee $ PERMIT VALIDATION '
Permit Feb 100 1069
PERMIT NO:
Penalty 4-22-91
'4 Cash Deposit -Surety Bond DATE APPROVED
if,required 4-22-91
XP4O
N DA
,
TOTAL: $ 10/00 4-22-91
DATE ISSUE. .
Receipt No.
B
Received by Date ;_ yt -� Administrative Authority
Recorded by TELEPHONE': (619) 564-2246
• WA
-------------
7,. r - -- -- fi -4f- - - - --
NOTE:
With proper validation -•
-this form constitutes.an t�
f,r encroachment permit r
"CITY''OF LA QUINTA,i
> rm ,APPLICATION FOR PERMIT 4 -
' PUBLIC WORKS',CONSTRUCTION; (ENCROACHMENT)
op Tl�
I For the construction of public of private curbs, -driveways, pavements, sidewalks, parking lots;'sewers, water mains;i-
and other like public works improvements in'connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
+�• Subdivision Improvement Permit —Class III
Da
ATE:—' ��-Q1 t s. y Minor Improvement Permit Class IV
LOCATION OF.CONSTRUCTION ' i
(Street address or Description'of Location) ,. r
PURPOSE OF CONSTRUCTION w Sketch (attach constructionplansif appropriate) '
MUTt 52 AT JEFFERSON WEST TO
DESCRIPTION OF CONST RUCTION BG 265 PAVER 10'6`1 ` EISENHOWER'SOUTH TO-NOGALES TO
WIDE GREEN WEIGHT ALL ELL LEGAL.`- VE LASCO
DIMENSION OF INSTALLATION OR REMOVAL DATE 4-22-91
SIZE OF EXCAVATION, IF NEEDED
t. APPROXIMATE TIME WHEN WORK WILL BEGIN'
APPROXIMATE TIME OF COMPLETION t' '
ESTIMATED CONSTRUCTION COST $'
»' (Including removal of all obstruction,'materials,,and debris, backfilling,, com-1f f
t
1paction and placing.permanent-resurfacing andlor.replacing improvements)
+
In consideration of the granting of this permit, the applicant heieby agrees to:
-; _ ••
•,
r - Indemnify,. defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and.all '
Y ..
_ s.• _
t. -
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. r • ,
-. qi-, .,-` •;
Comply with7'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 f this work. /�•-
Signature of Applicant or Agent :r
TARMAC MASSEY P.O. BOX 14050 PALM+DESERT s
! Name of Applicant (please print) Business Address Telephone No.
•
Name of Contractor a6d'Job Foreman ` •' Business Address , Telephone No. 'r '
ON•. FILE
;+ Contractor's License No. •• City Business License No. ,
GIN Fibs
Applicant's Insurance Company .• Policy Number ,
d ,FEES, Subdivision Improvement Permit. -•Class III Y t r ,
• Public improvements: 3% of estimated construction costs '
Private improvements: 3% estimated construction costs
of
r
Minor Improvement Permit — Class IV: See attached schedule
,, ` s `t
•
Inspection Fee tF k • $ r { '
PERMIT.VALIDATION + �'
• a
Permit Fee 10600
- s
� �PERMITNO. 1069
^ t
<: • .. Penalty, ` e l �.' ��
Cash Deposit -Surety Bond a + r . 1
DATE APPROVED 4-22-91
!
S
if, require
EXP..IRir DA 4-22=91 �f
},
e
i t TOTAL: $ 10000
DAT 1 / 4-22-91"
Receipt No.
'Date
By
Received by
, .t ° e ;Administrative Authority
Recorded by •
TELEPHONE: (619) 564-2246 — ''
• NOTE:
With proper validation
this form ODS an CITY OF LA QUINTA
encroachment oermlt
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs. driveways. pavemerm. sidewalks, parking lots, sewers, watK. mains.
and other like public works improrernents in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Cuss 111
DATE: ,/ Minor Improvement Permit iia' IV_
LOCATION OF CONSTRUCTION
(Strom soasa or Oav+ome of Louooh)
PURPOSE OF CONSTRUCTION Sketch i ch construction plans if appnoprgp�
DESCRIPTION OF CONS7.RUCTION ` - Ile
J
DIMENSION OF INSTALLATION O REMOVAL
SIZE OF EXCAVATION. IF NEEDED a.. s
APPROXIMATE TIME WHEN WORK MOLL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
(Including removal of all obstruction, tnawlals, and debris, backfilling, earn-
paction and placing permanent resurtaciN and/or replacing improvemafttst
In consideration of the granting of this permit. the applicant hereby agrees to:
Indarnnlfy, defend and saw the City. ns sutnonred psnp. officers. reoresomtlws and smolovsw. ham t a from and agomm amp slop MI
pnYnitim. liaOditim of (Oft resulting from claims or court action and arsing out of alis actldfM. lona or annul" to Comm cit orooww
h8opening of Occurring as a pr9eemnata recut of ally worn Yn o tolten Yoder the 00 1 t grsntad OUrauant to this atlplQdO11.
Notify tna Adminstnow Autnomy as Mint twemy-four 1241 hours in advarnce of the tuns when wOne wn•l be starno.
Compv v"tn all sl prrtatts City Ordirrnos. the terms and conditions of the 9ormn and all .00liowl' ru" aIle of i*� City of --
L Quince lino to oav for any additions rspeoame mt necetary as the ratan of �riis wort. -- : ---.
- i -17 chi
of Apquant or Agent
iVz/
Nime of Aooucant wej% orint) / Business Address Teliforlone No.
Name of Contractor lino Job Fa emsn Business Address Telechone No.
%
Contractors L.cense No. City Business License No. -
Aooticant's Insurance C4,Mn Policy Number
FEES: Subdivision Imorvwnlant Permit — Class III
Public improvenrrrts: 3% of estimated construction costs
Private improvements: 3% of estimated construction cam NO
Minor Imorovement Permit — Class IV: See sttacned schedule j� e
instsection Fee S I PERMIT VALIDATION
P.rmit Fee DSRMIT.%O. -
��� Penalty DATE APPROVED
Cash Deooslt•Surety Bond
if reouired EXPIRATION DATE
TOTAL: S - DATE ISSUED --
Racnot No. By
— — - -
Recavea by Data__.- Admineatra-a" Authority - - -
R.00raw by TELEPHONE: 1618) 584-2248