1077A
NOTE.:
With piciper validation
this form constitutes an
I . . I OF : '� . . CITY ,LA �i OU I NTA
encroachment permit -
encro
-APPLICAT.ION,FOR PERMIT.
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT).
OF
For. the construction of, public or'private curbs,- driveways., -pavements, sidewalks, parking lots, sewers-•= water, mains ,a.
r. and other like public works improvements in connection with.MINOR IMPROVEMENTS and APPROVED,SLIBDIV]SION.S'
Subdivision Improvement Permit = Class 111"
DATE:`
Minor Improvement Permit Class,IV
LOCATION OF CONSTRUCTION,
-`(Streei a0clress or bescription of Locatio;)
PURPOSE OF C09NSTRUCTIONn
Sketch (attach construction pla si,if appropriate)
z DESCRIPTION OF CONSTRUCTION BG 265 10' 6" WIDE GREEN WEIGHT
ALL -ELSE .LEGAL ROUTE; HEU.M NOGAUS TO, EM11M.OWER
TO 52. TO WASHINGTON NORTHIM
i
IDIMENVYbN OF -INSTALLATION OR REMOVAL WASHINGTON TO CITY LIMITS,
ti;F - 0 EXCAVATION• I F,NEtIJ'Eb
DATE: '4-25--91
APPROXIMATE TIME WHEN WORK WILL BEGIN %
APPROXIMATE TIME OF COMPLETION
--
ESTIMATED CONSTRUCTION COST$
;,.'(Including removal of all obsiructi'dri, materials, and debrisi backfilling; com
pac
ackfil ing;,co'mppc ion and placing 'permanent resurfacing, and/or repla6ing'ir�nprovemenis) -
J
I consideration of the grant i rig.bi- thi's'-per I'lit, 'the applicant hereby agrees to:
rs' repre niatives -and. employees, harmless from,and'against any and all
indemnify '-defend and save the City_ its, authorized a6ents,-,o6ice' s�
perialties, liabilities -or 16is,, resulting. from 'claims or court action airicl,arising'out of an y accident, loss or da;m�e',to persons or property
happeningoor occurring as V a pmai, e I result -of any work'Lfnderta 0en und . er the permit granted pursuant to thisapplication. _ roxi 9 . on.
ni N.btifV.the Administrative Authority at least twenty-four., (24) hciurs,ir advance of the time when work will be.,started.,
Comply with all applitible'City.-Ordinarices' the terms and conditioni'of,the permit and�all applicable rules and regulations of the City of
-.1 - -
11 L`a'.Qu'i'nta'ar!;d'to_ pay for�..�atny, acl�litionial replacement necessary a§,the re'sult9of this 'work.
%
Signature of Applicant
or Agent
P.O. BOX 1 050 - jMlk
TAW&C MASSEY 4 DESERT-'
Name of Applicant (please print) business 'Address Telephone No.
Name of Contr'actor and Job Fore man Business Address Telephone No:
%
ON FILE ON IFLE
`Contractor's License No. City. Business License.No.
ON
Applicant's I nsLirance Company Policy Number
2,
FEES Subdivision Improvement Permit Class III
':Public improvements: 3% of estimated 'construction, costs,
e, 1. Q77.,
Private improvements' 3% ofstimated construction costs
-Minor Improvement Permit = Class IV: See attached schedu lei,
Inspection Fe* e. PERMIT VALIDATION
io.o6,,
Pe'rmii Fee'
PERMIT N.O.
�Penalty- 4T_24_1;.91'-1,.,
Cash Deposit -Surety Bond DATE APPROVED
if. required.
EXPIRATION DATE 4-25-91'
•10.00 4"24
TOTAL'
DATE $U D'
Z
Receipt N,6.-,,'
By
Received by Administrative Autkori
-,Date, ty:
Recorded by -TELEPHONE: (619).564-2246
F.
,
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r,611
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NOTE-
With.proper validation
this form *constitutes* an
encroachment permit
CITY OF LA 'QUINTA
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: 4-24-91 'Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
'(Street addrei's or bescription of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
y
DESCRIPTION OF CONSTRUCTION -
BG 265 10' 6" WIDE GREEN WEIGHT
ALL ELSE LEGAL ROUTE; HERRERA NOGALES To mmmown
TO
TO 52'TO WASHINGTON NORTHLON
D11MEN§%N OF INSTALLATION OR REMOVAL WASHINGTON TO CITY LIMITS
SIZE OF EXCAVATION, IF.NEEDED
DATE:. 4-25-91
APPROXIMATE
E TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling,'comi
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of 'this permit, the applicant hereby agrees to:
I ndemnif y'. 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
TARKAC HASSEY P.O. 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 ON IFLE
Contractor's License No. City Business License No.
ON FILE
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III
Public improvements.: 3% of estimated construction s costs
-107-7
Private improvements: 3% of estimated construction costs
Minor Improvement Permit Class IV: See attached schedule
'Inspection Fee $ PERMIT VALIDATION
10.00 -II
Permit Fee
Penalty
Cash Deposit -Surety Bond
if. required
10.00.1
9TOTAL:
Receipt No.
Received by. Date
Recorded by
PERMIT NO. AUZZ
4-24-91✓
DATE APPROVED
EXPIRATION DATE 4"25-91
DATE
By
\J Administrative Authority
TELEPHONE: (619) 564-2246
'APR -24-911 IJEL, 1 2-14 6 MAS . + P-01
T
.. - NOTE:
• r i �•_ �#yftprom tlalltiitpn
r '! - • this forth oDnstr�stde
• aneroaetsrrpnr R CITY DF 'l,.A-, QUIN i'
;4 ' S' z x r APPLICATION FOR I'ERMI
PUFL:C VV<IORKS `CONSTRUCTION .IENGFtO " r
For the conte on of 'publk r°~
' ai
and other tike publ' Of private tur}�i, ovivegvrva, GeraPnIM.`sidtw W; parking lots
,.'c waits imrt►ento In connact:an wilt '
MINOR IMPROVEMENTS and APPRi�Vg �� met*'
AEDt • ivgon ImaAta .ent Permlt: LbCATIONQFCONMIne lmpfdeltPem�TON Ile .��•;��u +a:�:r,�'r'
r.r
:.
IV ,
r . • .:. titrevt aootsa or �poell pf Lodaoel ; ,�;, •',
PURPOSE OF CON51 RUC1iCN
I 5 `I Slt tdt (IltteCt! odn8wMi6h
RIPTION OF C HtlCTION , i . Nano if appraprilup +.
i _ DIMENSION OF INSrALLAT
• . ION REMOVAL.`:_
• L �� SIZE OF. EXCAVATION, IF NEFDEID
• APPROXIMA'T'ETIME yY}f
` 4..
APPROXIMATE
�# E TIME OF COMPLETION / �,� • ,
ESTIMATED CONSTRUCTION C
' tlnduding Nnioryl b! all o�tuctian, i
r Pactlp,f and platin ntatanrla, and debris, bidtfilling, gym-
+ +In g pa. n! t reeUrt8ci g and/or replacing improMar»anesl'
Conaldaauon of the psncing.Af t!►e �/ �;r•
permit, the applicant Pte • . ",
ti P - IhoemnifY. tlarered eat pvo v nbV. aQr=�i tOt . r.. s:r...
the City. fu avtnontou-M.
r D4ne+ha, IMolliti4/ q 100 ratYrld ryPrtfNCt end brlDlayy4ae. MrR11�y lrywp ••
hgppsn Or•M frprl c44m Or court aaettdn and art" Out et any tMxstaar<t, loris a 4rM1 "0-
46 �Y
•+ , oay'h°'4 a omsu me rows of w : •'.,
" +• Notafv Ina Adrniri+�nmda Au .yaM work urs uraw t►ro per" tram" pununWt 'po no. Or,plro�.nn
t ?her w Mat twentvtour 1241 hAuro M 10tranga of the hr� tWi e:eaOrs.
' Cumwv %,th oil sto'.w4 W _ on art on" be`t¢g�y. r .:
i, la Qulntq and to br ter 0rdr ; t►» tmm arm GO�dIdlYrle OP tho yaj '
civ wry
as 1>«mK switihl
addrca.w ,eorae�rrrn: R�oei� me nwh of rge.e, 4 rvl4o end of ere Lely ej . °'';r;+r4
r.
signs su of Appuwn Agent
t ' e
Nim, of Aopaaant tplaase err,
Businats Addr0.
esl l/
r 1 + 4;,` • Name of Contractor an Job urema ! :.
Business"Address
Teleph
Contratctor't L cense o — -,•'� a; �' r
v r • . City Business License No, r'r
" Aboarant's Insurance Con+aenv �'' A
+ Policy Numnsr •
FEES; Subdivision irn ormlr—CLW
fr' • m P III
• Public imoroft;'W"ta• 3% of } _ ,
tstlrrutad contraction Co.
. * • • ,'i
:Private imprpvem111Ef: 3% of on-ata�d construction cotiu
Minor ImarovaMontPermit Class IVi.Se4'r��, ? 0 _
4d wha6ute
- intoicrion fee 5IS
r4. "
:ptrmrtFee ' r' .J PERMIT VALIDATION `
,s.. Penalty
BEGIN
'Cath 040"JI.Suracy B _ y ,
. 4 rift wed:. and .` , DATE APPROVED'
• C l TOTAL:~ EXPIRATION OAT%
t s a Rtm,pt No. 'e • !'_ DATE ISSUED.' ` r.
ReaW4d tier # . By
{ t Rwby
y f ` Admrnaru trsne a..���. r 1
..„. ., _ � - - .,.. , -, �'.. , -• • sur»• -, _ _-
j
MW I
,
----------------
._ ... . i_ NOTE:'
With proper validation- ;1. `tic . #- T r.- _ ' a.- - • fx � «a 1 '"z:
this form constitutes an r ..
encroachment permit CITY OF LA OUINTA f S l
x
APPLICATION< FOR - PERMIT.f M.� r•�+ ,
- PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
i 6<. Il.. cit -'4'..r1+:..1.' a 7 •y 44.�.!i l.�'�I, �ayf�._' '-Cq -f
' »:..j ...re .>n. -'a k. r - '. � s� kq�...� .,,,i.ac T-"'"��t ;{# ;'L`�' ...t,r �"�• x:.,,,Jr,�
For -the constructionof public or private- curbs' driveways, pavements, sidewalks, parking lob,-. sewers, _waterrma ns
• and other like public.works improvements in connection with MINOR IMPROVEMENTS and -APPROVEMSUBDIVISIONS:'A , .
Subdivision Improvement Permit Clan II II
DATE: 4-74-91 Minor Improvement Permit Class4V -
LOCATION OF CONSTRUCTION
(Street addre o or DescriPtion of Location)•
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION BG 265 10' 6" WIDE GREEN WEIGHT , ^•LLQ �`..j- -
ALL.ELSE LEGAL- ROUTE; HEBBEEA NOGALES-TO;ZjSEIUlOM
TO 52 TO WASHINGTON NORTB?-OHfs_
DIMENSION OF INSTALLATION OR REMOVAL WASHINCTOH TO CITY LDEMS - r `
SIZE'OF EXCAVATION, IF NEEDED
-_DATE: 4-25-91__
T APPROXIMATE TIME WHEN WORK WILL BEGIN
v APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST - - ���. •= w ^.`~'`
(Including removal of all obstruction, materials, and debris, backfilling, com• t.'.-�, ?•' ,i`
paction.and, placing, per nattent resurfacing and/or replacing improvements)
- In consideration of the granting of thispermit, the applicant hereby agrees to:--
IndmmdN.- sr" and earn, the City, its authwhaed agents; officers, representatives and employees, henniess from and:apaiert any and V1
penalties, liabilities or Ion resulting from claims or court action and arising out of any accident, ton or damage to Parents or•prop irts,
happening or occurring es a-proaim us -result of any work undertaken under the Permit granted pursuant to this apollostlom—
Notify the Administrative Authority m least nantytour 124) hours in ad— of the Yung when work will-be-started..d. "" "' `'-"•�`
Comply, with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regWetbm:of the City of
ka Quinn and W Pav for any additional replacement necestary as the result of Mit work. '
Signature of Applicant or Agent.. , ,. t v4 ��st»k- L'�+.;,r•
' TARKAC WASSEY' P.O. BOB: 14050 PALL[ DESERT - • ` t+l ` "1A •. •'4
• _ Nameof Applicant (please print). Business Address.-- '"Werptiords Noa.,
name of k:ontraaar and jao roreman - dusmess kWaress - iekepnone'No.
-
y_ "w
OH%FILE is OR =
Contractor's License No. - r'• . - - City Business License No.x
OW FILE .
Applicant's Insurance Company Policy Number. ; . u. •.;
FEES: Subdivision Improvement Permit -Class III - •• t`'
Public -improvements: 3% of estimated construction costs 1 07.7
Private improvements: 3% of estimated construction costs I:
Mina Improvement Permit-- Class IV: See attached schedule
•
Inspection Fee • $ - - PERMIT VALIDATION"(t:r! `r •'x
Permit fee 10.00
PERMIT NO. 1g7+
Penalty
Cash Deposit -Surety Bond - DATE APPROVED" 4-24-91. . .
if re4uired,r n. _ ,.4.>. •tkM
EXPIRATION DATE`"
TOTAL: ' $ 10.00 . - 4-24-81- '
DATE U D
Receipt No Y4
\t.
Received by. "'' Date _ r;il,• Administrative Authority _ ^
Recorded by, TELEPHONE: (6191664.22463x
". 't •./.4. ;':2. "'i;