1071'NOTE: - .. '— • °'., `�
_ k -
With.proper validation o�
this,form'constitutes an f
encroachment permit CITY OF LA 'QUINTA .
APPLICATION" FOR PERMIT
WORKS CNSTRCOCR
PUBLIC OUTIN (ENOACHMENT)
, _ c�� itis i
n
For',tlie 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
044
Subdivision Improvement Permit — Class'
III,
DATE: bsry�.:Q1 ” Minor:lmprovement Permit Class.,V
LOCATION OF CONSTRUCTION 1 mixes east Of. washington on -50th
(Street addreM. ss or Description of Location), t. , _
T` PURPOSE OF CONSTRUCTION: Y Sketch (attach construction plans if appropriate)
DESCRIPTION OF'CONSTRUCTION D8 - Dozer w/slope route washington to 50th.east
board. detached and reloaded app 1i miles.
>uip1A elw•isrht
" DIMENSION; OF INSTALLATION'OR REMOVAL 14!6"x1.4Ri91 PROV= ALL AMU" AY=r.
AWveeratl' hath puipiA wto8ht AND WARS= D$V%CBB IIiCbDDXN(;-
i.. ,• . � . - _ SI(�iAICB; FYsiiBS;, ASU=
1
lEwAG#�1G' . .
'SIZE OF'EXCAVATION, IF NEEDED r
TWO PIXOT
i ^' .�APPROXIMATE.TIME WHEN WORK WILL BEGIN r.
G . -APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COSTxw
(Including removal of all,obstruction, materials, and'debris, backfilling, com r
' paction,and'placing permanent resurfacing and/or replacing, improvements)• �Q 4� ,..fid: i w4� 23-�9i,g ^_h' 13 '
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 or loss resulting from claims or court action and arising out of any accident, loss or.,damage to persons. or propertyr '
1.6p,pening,ortoc6urring as a, proximate result of any work undertaken under the permit•granted pursuant to.this. application. '
Notify the Aaministrative Authority at least twenty-four (24) hours in advance of the time' when: work will be. starfed`°
`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.
i ' • Signature of'Applicant-or Agent
Dalton'Trucking Inc 13560 whittram 714-823-0663 `' v.
Name of Applicant (please print) • Business Address,Telephone No:
Name of Cont`ractor`and.Jo Foreman Business Address .Telephone No.
Al
Contractor's,License "' s '. 1 City Business License No. '
Applicant's'Insurance Company - _ Policy Number
i 'n m r vement Permit — Class I I I '
FEES: Subdivis o I o
p L. -
' ,t
c _ n h f -
Public -imp rovements:-3%,of estimated construction costs, _
r ,✓
*• Private improvements: 3% of
'Minor
construction costs
"Minor Improvement Permit -Class IV: See attached schedule
Inspection Fee ' $ * PERMIT VALIDATION
1071
Permit Fee PERMIT NO.
Penalty 4-23•-91
' Cash Deposit -Surety Bond DATE APPROVED
if required 4_ 2491'_111 {
EXPIRAT N'DATE
10
TOTAL: r �� ,� 3-91_-
$ DATE ISSUE45'
•Receipt No. yn �.; f.
i ,.
Received by r Date B ` Administrative Authority .
1
Recorded by� TELEPHONE: (619) 564-2246
: Y r ,. V f •
! `NOT -E'
With proper validation
this form constitutes an
encroachment permit
CITY OF" to QUINTA
APPLICATION FOR 'PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
I
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 SU.BDIVISIONS
I Subdivision Improvement Permit —Class III
11 -DATE: 4=23-91. Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION 1j miles east of Washington on 50th
(Street address or Description of Location)
E• PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
,f. .
l,. t
1. DESCRIPTION OF CONSTRUCTION D8 Dozer w/slope route washirigto'n to ,50th east
board detached and reloaded app 1j miles
purple wwi>aht
DIMENSION OF INSTALLATION OR REMOVAL 106"x1416661 PROVIDE ALL REQUIRED SAFETY
610Ioyerall lensth purple wieght AND WARNING DEVICES INCLUDING
SIGNAGE,- PLANES, AND FLAGONG
SIZE OF EXCAVATION, IF NEEDED
T90 PICOT VHICLES REQUIRED . .
APPROXIMATE -TIME WHEN WORK WILL BEGIN
',APPROXIMATE TIME OF COMPLETION
ESTIMATED CONST RUCTION•COST $
(Including removal of all obstruction, materials, and debris,•backfill ing; com
paction and placing permanent resurfacing and/or replacing 'improvements) QO��k� ...�0., i r.4, ,04;23-9f�� �A f3
„ ...'. y 7 • rva. a a • . ..
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 theyAdministrative 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.O ~ r
Dalton Truckiiig-'Inc 13560 whit.tram 714-823-0663
Name of 'Applicant (please 'print) . Business Address . Telephone No.
Name of Contractor and Job Foreman Business Address - Telephone No.
or's License No: City Business, License No.
Applicant's Insurance Company Policy Number
.FEES: Subdivision Improvement Permit — Class I I I ;
` Public improvements: 36/o-of.estimated construction costs.
` Private improvements: 3% of estimated construction costs 0 £ /
Minor.lmprovement Permit — Class IV: See attached scheduler ,
Inspection Fee . $ PERMIT VALIDATION
Permit Fee PERMIT NO.
Penalty°`..R.' 4-23-91
Cash Deposit -Surety Bond DATE APPROVED'
i#,required EXPIRATION DATE - on
24-91
TOTAL:
Receipt No.
Received by Date
Recorded by
DATE ISSUPO,
By
`TELEPHONE: (619) 564
�1
Administrative Authority
'NOTE:
With proper validation ,
this form constitutes an
encroachment permit` `• + CITY OF LA QUINTA,' ti to
APPLICATION FOR - PERMIT
PUBLIC .WORKS CONSTRUCTION, (ENCROACHMENT)
n
• For the ,construction of 'public or pvate 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 Ill
DATE: X23-9� Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION' ' f 11z 1`411 aS -RA ST &47 WA-, IN ISM o`N .SUS
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION '' a Sketch (attach construction pans if appropriate)
' O =2 {/�GNSTRUCI72 JDE RIPTION OF ��
-
/IG p A
DIMENSION OF INSTALLATION O REMOVAL.... 147��' 7 14 7 1
' 1,,,� Bth�P./1C.L. Ls✓NC•,'T'Fi: uR-PC_E I,1I£.yHT . .
' SIZE OF EXCAVATION, IF NEEDED A '
APPR XIMATE TIME WHEN WORK WILL BEGIN S k
- APPROXIMATE TIME OF COMPLETION '2 3 -
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, -and debris, 5adkfilling, mm• 3
paction and placing permanent resurfacing and/oro replacing improvements).. • '
In consideration of the granting",of.this permit, the applicant hereby agrees to:
ti
Indemnify, defend and save the City, its authorized -agents, officers, representatives and employees, harmless from and against any and all
c penalties, liabilities.or loss resulting -from claims or court -action and arising out of any accident, loss or damage to persons or,properfy
happening or, occurring as a proximate result of any work undertaken under the permit grained pursuant to this application.
Notify the Administrative Authority at least twenty-four (24) hourstin advance of the time when work will be started,"
4 Comply with all a* ficabfe City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of.the City of
La Ouinta and to pay for,any additional replacement nece»ary as the result of this work.
r � -
r Signature of Applicant or A t
t LIZ1�1' J-auclCI�1�f ZN�. 4� 1 3Sra0 c,.)�l� itrv` �l�-:? _ a,o
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
"Contractor's License No. City Business License No.
10
Applicant's Insurance Company . } Policy Number
-
FEES: 'Subdivision Improvement Permit — Class I II^• , '
Public improvements: 3% of estimated construction costs { s
'Private improvements: 3% of estimated construction costs' O
Minor Improvement Permit = Class.CV; See attached schedule
Inspection Fee $ PERMIT VALIDATION '
Permit Fee
PERMIT NO_
Penalty DATE APPROVED J '
-Cash Deposit -Surety Bond . • , A
if required EXPIRATION DATE
TOTAL: sY $ DATE ISSUED' '
Receipt No. • t�,
By F ;'
I Received by .Date„ Administrative Authority.
_ t,
Recorded by ` . "TELEPHONE: (619) 5642246
t. j
iR ,
NOTE:
With proper validation
this form constitutes an CITY OF LA aUINTA
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 111
DATE: 4-91-91 Minor'Improvement Permit Class IV
LOCATION OF CONSTRUCTION ii
miles east of washington on 50th
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION
DESCRIPTION OF CONSTRUCTION D8 Dozer w/'sloi)e
board detached and reloaded
gurgle weight
DIMENSION OF INSTALLATION OR REMOVAL 14 t 6"x14' 01
41!Joyerall length purple wieght
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
Sketch (attach construction plans if appropriate)
route washington to 50th east
app 1j miles .
PROVIDE ALL REQUIRED SAFETY
AND WARNING.DEVICES INCLUDING
SIGNAGE,. -FLAMES, AND FLAGGING
TWO PILOT VEHICLES REQUIRED
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)Q051 0
nrL-&---h9 —
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
Dalton Trucking Inc 13560 whittram 714-823-0663
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor nd Jo Foreman Business Address Telephone No.
� p ----
Contractor's License No. City Business License No.
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
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ Z�2
Receipt No.
Received by Date
Recorded by
1071
PERMIT VALIDATION
1071
PERMIT NO
DATE APPROVED 4-23-91
EXPIRATION DATE 4 24-91
�- — 23-91
DATE ISSUKI_ T
By
TELEPHONE: (619)
Administrative Authority