1078- • ` �� �,R�f a7^� �' �7 - r '�r •• f � , I _ " w � " • � - - r . .- _ , .. .�.. r^w•�' • Ft.- t , �"`'•x'(
s y
.. ' � .t.. h ens ., , ' .• ' . � + ,. �..• + � s .. y '
NOTE:
With proper validation
tl4is form constitutes an
encroachment permit ' . CITY ,OF LA QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) =• ^,rte t�',',,��Q� cw `
For"the construction, of.pubiic.or private curbs, driveways, pavements, sidewalks, 'parking-,lots,Vsewers,-water mains
and other like.public works, improvements in connectiomwith MINOR IMPROVEMENTSanCfAPPROVED'SUBDIVISIONS r
y Subdivision Improvement Permit - Class]11 ,
DATE: 4-24'-91 I �� n �, ?.
_Minor Improvement,Permit Class IV
LOCATION OF•CONSTRUCTION
(Strek address or. Description of Location) -
�n`' PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
HUM: 52 ' AT VWON TO .
DESCRIPTION OF CONSTRUCTION
` G
CAT �1 101WOR DURAI!I< r,
h - ' `WSIGHT_,ALL HI,9B 'LBGhAL : - .. GO`.TO )QI5)�@O�iiSR SODTH • -
TO- tKIHI�fAHQA; TO 'ALQARAD0 L
n rad
DIMENSION OF.INSTALLATION ORrREMOVAL . "T• y
SIZE OF`:EXCAVATION; IF NEEDED < DAT$`4-X25-►91�^'' s yu y
iAPPROXIMATESTIME WHEN WORK WILL BEGIN 3
n,.
APPROXIMATE TIME OF COMPLETIONy
ESTIMATED CONSTRUCTION COST $'
t (includingremoval`of all obstruction, materials, and debris, backfilling,`com .,
paction ,and placing, permanent resurfacing-'and/or'replacing improvements)
16 consideration of the granting of this permit, the applicant hereby agrees to:
• ? v 'Indemnify, defend and save•,the City, its authorized agents, officers, representatives.and employees, harmless from:and against any and all r
r penalties, liabilities or, resulting from claims or court action and.arising out of any accident, loss or damage to persons or, property?
•happening or`occurring as a proximate result of any work undertaken under the permit granted pursuant to•this application. �
Notify.,the Administrative Authority at least twenty-four (24), hours in advance of the time jwhen work will be started. t ''
Comply with -all applicable_ City Ordinances, the terms and conditions -of the permit and all applicable rules and regulations' oftheCity of
La Quinta and to ,pay for any additional replacement necessary as the result of this work. i1
Signature of,Applicant"or Agent
TAR' c NUSBY 'P.O,. -BOX 14050 PALS DIS$RT ,
Name of Applicant (please print) o r9. .Business Address G Telephone No.
+
--'Name of Contractor and Job Foreman Bu'sinessAddress Telephone No. ,
'
ON •8I1l;B -
I Contractor's License No. • " » r a City Business License No.-
-kApplicant's Insurance Company . Policy Number
FEES: , Subdivision Improvement Permit — Class I I I
-.
Public improvements: 3%ofzestimated construction costs n�']' p y
Private improvements:3%of estimated,construction:costs ' �-11 1 O T
Minor Improvement Permit — Class IV: See attached schedule;
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 PERMIT NO.
QQ y 91
Ge hlDeposit-Surety Bond DATE APPROVED 4-24-
-25-91
if. required •EXPIR ON DAT
TOTAL: $ 10.00DA E ISSUE4-24-91
^
Receipt No. By
Received by Date Administrative Authority
Recorded by TELEPHONE: (619) 564-2246
I .
�y r
i
NOTE:•
With proper validation
this form constitutes an
encroachment permit
CITY OF LN QUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
For the construction. of. public o0private 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 III
DATE: 4-24-91 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
�O 1-"S: 52 AT JEFFERSON TO
DESCRIPTION OF CONSTRUCTION CAT GRINDER 10'WIDE DURANGO TO EISENBOVER SOUTH
- GREEN WEIGHT.ALL ELSE LEGAL TO CHIHUAHUA To ALVARADO
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED DATE 4-25-91
` 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.
Signature of Applicant or Agent
TARMAC MASSEY P.O. BOX 14050 PALM DESERT '
Name of Applicant (please print) Business Address Telephone No:
M_ VTT F
Name of Contractor and Job Foreman Business Address Telephone No.
ON FIS. ON FILE
Contractor's License No. City Business License No.
Applicant's Insurance Company Policy Number
'U FEES:• Subdivision Improvement Permit — Class III
• i
Public improvements: 3% of,estimated construction costs0 7 8
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee
Permit Fee
Penalty
FAh Deposit -Surety Bond
if,required
TOTAL
Receipt No
Received by
Recorded by
$
10.00
$ 10.00
Date
• PERMIT VALIDATION
PERMIT NO. 1078
DATE APPROVED 4-24-91
EXPIRATION DATE—
k,kw,;rfir3 4-24-91
DA E ISSUE
By
Administrative Authority
TELEPHONE: (619) 564-2246
P e
1 WED
�.
Y �
� �� aw .,t1► _ti �� alarm Ya1Mr w�. art• aa�F a.�F'0��®•�Y��PMr•+�� ���� rr• fir. �Yr� rM r� fit► �r
NOTE:
Whit pmw velk a*m
this form const Wim an CITY OF LA CIUINTA
Incroachnlant Permit
APPLICATION FOR PERMIT
Pusuc WORKS CONST'RUCTtON JENCROAC 4MENT)
For the eQnsG•ueupn of fsuoik or Ornate «fon, driveways, paviiinso fa, sidewalks, parking loft, wvjm, wqtW .
And other Ilke oubiie works IrnprOven*ftp in connaanon with MINOR IMPROVEMENTS and APPROVED SUg01V4StW4-
/ w 4.
c
Subdivislon Improwlmens Penrhit � CLsti IH .,�,,,�,�,�
GATE: Mirror Improvernem Pet+nit,Clart iV ,
LOCATION OF CONSTRUCTION
(Street °aorta or oo*rx Dao of i.oWMA)
PURPOSE OF CONSTRUCTION — -- Sketch lanm:h emmuctlon Waris if appso toe►
42
DES R)PT(1111:O OF NS'CRUCTION
aa 441e
DIMen
ENSION OF INSI AI LI4T NOR REMOVAL O�
(Z OF EXCAVATIO I
SIZE N, F NI:EQED
APPROXIMATE TIME WHEN W+ORX WILL BEGIN d
APPROXIMATE TIME OF COMPLETION - -
ESTIMATED CONSTRUCTION COST I
(Including romovel of atl obstruction, metonels, and debris, b4ckfilling, Corr y
WWI find placing p"manefft r9mmfacohg and/or nPlacing imorovrm mul
In consideration of the grarhnng of this permit: the sOOlieant herebV agleam to:
Intlenmfty. OafanO amt W" the City. its aumarffe6 span$, offiftn' ttgfaaatt° I" and chviavoes, harmtaal from oho wpm WW"oil
ow"410 {, Ifabflftim or lop m%oline hon tlafmc w tdury ICTton bid Int" but of I+mr Itrrdoltt, too or danwrtr to Daffgrtl M lYrgarty
ha "Tani of etfilfYeq as a or"dwe fwn of any vwmfk pnaarnum umdN Che pe "d Immou putfatant to V%k smic tm .
Nouty dta Aarfnna m " Am*WnW at lases twertty400 (24) Aautt to 40aencu of the truss TMten %QM VAO be stared.
Comply wart Int sm4ii o City OrdrrrMaq. the to... and mrotfi6tim of the panel"aft 000loebte tuna •nO MWAWftone'et this ph of
u Qutne lino to DW for any ed*tkvw m"Ortrwnt norma" as The mmm of on ware. .f
of ApptwxAj or Agent
Nijmt at Arsottcant {pieaift) f ButiMti Address /', % �la
Name of Contractor an n F an Business Address ' J TlDlephotte No
1�
Contrmor't L,C#MWIN . ON Business Ocari a No.
Aootif,rlt's insurance Comoanr Policy Numoer
rr r r 111!• i �� Ra••. - ry — _ waar•�. �
FEES: Subdivntion tmem onntar+t Permit — Cuss ill
Public imorovanartu, 3% of eaomated eonatructnon oom
Private improverments: 3% of omm od cdnstructton casts 1r 8
Minor imorovement Permit — Clan IV: Seo attained schedule 1r °
lnloactton Fact S
pirmrt Fee
penalty
Cash Oeoosit•Surety Bond
I! mQulreo
TOTAL:
Repot No. -
t4+eawad bV Date --
PERMIT VALIDATION
OSRMIT NO. , ..
OATS APPROVED
EXPIRATION DA'T'E ;
DATE ISSUED .—_,.r..,_�---••—�--•
, '' �y .�
.
� � ._ -- • �! t Ct. �',\ - ly •, x' ..�ems, 'I `'. ._, t',
,,' s
Ile
`.
`
!,
NOTE: ..
With :_
I
proper validation y
a' •'
this form constitutes an T
- • CITY OF LA•,QUINTA
' '
P
encroachment permit
1
.�
`
APPLICATION FOR PERMIT' —
PUBLIC WORKS CONSTRUCTION, (ENCROACHIMlkT)
OF
'jFor,
the 'construction. of public or privateY.m
curbs, driveways, paveents,.sidewalks,`parking lots, seweri,-water'main;
and other like publiciworks improvements in connection with MINOR IMPROVEMENTS and'APPROVED SUBDIVISIONS_
F
t,
Subdivision Improvement Permit — Class III
DATE: 4=24=91 `} Minor Improvement Permit Class_ IV
�; I'
LOCATION OF CONSTRUCTION
•
. t
(Street,atldress or Description of Location) •� .' r '• • •
• ` �,
I
.; _
4 PURPOSE OF CONSTRUCTION r Sketch (attach construction plans If appropriate) '^
i
ROUTE: `52 .AT','JEFFERSON' TO'
,DESCRIPTION OF CONSTRUCTION CAT GRINDER 10'WIDE 'DURANGO TO'EISENHOWER`SODTH'� "• -
,�`,' ,
GREEN WEIGHT ALL ELSE'LEGAL TO:CHIHUAHDA:TO ALVARADO,
` t •
OR RE
DIMENSION OF INSTALLATION MOVAL ti
)•
�.
SIZE OF EXCAVATION, IF NEEDED DATE -4=25-41
t
T
"t 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)
consideration of -the granting of this permit, the applicant hereby, agrees to:
tIn ,
Indemnify, defend and'save the City, its authorized•agents, officers, representatives and employees, harmless from and against any and'all,
'~•ti - '" , ,'�' "\
penalties, liabilities or loss resulting from claims'or court action and arising out of any accident, loss or damage to persons or property- '
- happening occurring
- x...
• -
("
or 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 workwill;be• started.
Comply with all applicable City, Ordinances,�the ieims and conditions of the permit and all applicable'rules and regulationsfof the City of
'
4La Quinta and to pay for any,additional replacement necessary as the result of this work.• 4 -
�•^.
,
Signature of Applicant or Agent
i
^t • ,
TARMAC MASSEY P.O. BO% -14050 PALM DESERT
Name of Applicant (please print) Business Address -� , • ,Telephone No.
-, .
' s-
,' •:
x +
nm ATT A .. • . , t a v.
' A
, • • � �
i,
'Name of Contractor and Job Foreman' . " Business Address x ,
4 ' , �' . Telephone No. " L
`s
` '
ON FILE ON FILE �. ;.
1
'
Contractor's License No. ! ) t City Business License No.
•�
{ i
Applicant's Insurance Company, ; a Policy Number `, r
o
FEES:' Subdivision Improvement Permit — Class I II i t ,.• t', :•
Public improvements: 3% of estimated construction costs + -,
5
r O
i 1078
t Private improvements: 3% of estimated construction costs t -8
A ' r 't
Minor Improvement Permit — Class IV: See attached schedule
3•
Inspection Fee ' $
PERMIT VALIDATION., .
!
Permit Fee 1 ^ 10.00
"
} i x
Penalty
PER NO. jg� 2
; .f 4-91'- f, ,
4— 2 1 a
Cash Deposit -Surety Bond
DATE APPROVED
—25-91,
1
if required
q _
EXPI A11ON DAT
{
. ,
'
.
TOTAL: $ 10.00
/_' 4-24-91
'
A • I
'Receipt No..
Received by Date '
' . 'Administrative Authority
r
�... V
'
Recorded by
,TELEPHONE: (619) 564.2246 ;�