1085NOTE: /: ,
With proper validation'
this form constitutes an
encroachment permit CITY OF " LA QUINTA k .
-APPLICATION FOR PERMIT,:?
PUBLIC- WORKS CONSTRUCTION, (ENCROACHMENT) s c '' • S� '
s OF
OVERSIZE`LOAD PERMIT
,For, the construction of. -,public or .private curbs, Ariveways; pavements, sidewalks; parking lots;, sewers, water: mains;;,
and other like public works improvements in ,connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
April •26, 1991 , Subdivision Improvement Permit.—'Class'111 ,
DATE:" Minor Improvement Permit Class IV 1 ''
'LOCATION OF CONSTRUCTION - move -equipment.
'(St - reei.adciress or Description of.Gocation)
Barber Green 1016" wide plansif appropriate),;,,.
PURPOSE OF CONSTRUCTION Sketch (attach -construction
green weight all- else. legal
DESCRIPTION OF CONSTRUCTION
' Haul Route Washington at Fred Waring';
south .to Avenue 52, to Eisenhower
too 'No ales 'to Herrera
,DIM,ENSION OF.INSTALLATION OR REMOVAL
SIZE OF EXCAVATION; IF,NEEDED Haul date: 4/29/91
..{APPROXIMATE TIME.WHEN WORK WILL BEGIN '
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST, $• '^' u
(Including removal of all obstruction, materials; and debris, backfilling,'com
paction and placing permanent resurfacing and/or replacing improvements) '
r
In %consideration of. the granting of this, permit; the applicant hereby agrees to:
' _• fIndemnif defend and save the City, y, 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.
-,• :, happening5or occurring as'a proximate result of any work -,undertaken under the. permit,6ranted pursuant to this application.
Notify Authority at least twenty-four,(24) hours,, in advance of the time when work will be started.
r'
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: '
-
-Tina ,Gracey 7
Signature of Applicant or Agent
Tarmac/Massey. YO'Box 14050 'Palm Desert•,':CA.:92255
Name of. Applicant (please print) Business Address Telephone No: ..•`'',
Name of'Contractor and Job Foreman .'Business Address TelepFione No.
on -'-file on `file s
Contractor's License.No. City Business License No.
f on file t..
Applicant's ,l nsurance Company
FEES: Subdivision'Improvement Permit — Class III
r Public improvements; 3% of.estimated construction costs p _'
Private improvements: 3% of estimated construction'costs.. f 1 0`U 5
Policy Number
Minor Improvement Permit — Class IV. See attached schedule ,
E Inspection Fee r PERMIT VALIDATION
10.00.
Permit Fee PERMIT NO. •1085
Persalt
Cash Deposit Surety Bond ;g' 4 DATE APPROVED 4/26/91
if required' 4''/29/91
fes. 'EXPIRATION DATE
rTOTAt: $ 4/26/91-
DATE • ISSUED
Receipt No.
By
Received. by Date ' ` Administrative Authority
Recorded by _ TELEPHONE:. (619) 564-2246 ;
- �t � e- = .f ..r�� - y � ,.�+��.1.,- � i�.>,. .� F,,�. ���,.,,r�rr.,_ r..,�� '-�v ,•.«moi.....-,ori'..+'�. *�. i
• � �`
i
NOTE:
With proper validation
this form constitutes an
encroachment permit
0
CITY OF LA OUINTA
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
a
OVERSIZE LOAD PERMIT
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
April 26, 1991
DATE:
LOCATION OF CONSTRUCTION move equipment
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
,(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Barber Green 10'6" wide Sketch (attach construction plans if appropriate)
green weight all else legal
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
t
Haul Route: Washington at Fred Waring
south to Avenue 52, to Eisenhower
too Nogales to Herrera
Haul date: 4/29/91
APPROXIMATE TIME WHEN WORK WILL BEGIN
�f
a
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.
Tina Gracey
Signature of Applicant or Agent
Tarmac/Massey PO Box 14050 Palm Desert, CA 92255
Name of Applicant (please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address TelepHone No.
on file on file
Contracttorr'sjciense No. City Business License No.on '
Applicant's Insurance Company Policy Number
` FEES: Subdivision Improvement Permit —Class III ,
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ 10. 00
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by
Recorded by
Date
PERMIT NO.
1085
PERMIT VALIDATION
1085
DATE APPROVED 4/26/91
EXPIRATION DATE 4/29/91
DATE ISSUE 4/26/91
By ;
Administrative Authority
TELEPHONE: (619) 564-2246
P.. 0 1 A
'4 M AI S r
—26-91 1 y i'y
APR F F2 I
- +. r �..� �..� �r, •..o Vii, .,;`' �..�w.vr. ar a.r+ra�rf rr��fws�w����r��ri r,r �.► /rule. fie. a� 4•�ap.�� �1. .
NOTE:
�� r wlt%I p►tlpt>t yallelltsfttee' . . , .. �M
' thhform senattmsan
CITY OF`LA OUlNTA
envOecttrrtlrrt ttartnR
f• , APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION IENCROACHMENT)
For tna oonsmut+an of,public`ar private curbs, drivewevt, parafnantJi, sidavaiks, parking Coit, towers,
and other llka public works irnprovefrrtrrta In connsm n with MINOR IMPROVEMENTS and APP Water" W
- - ROVED SU801VfSdON$
AN
` n D>�T:- I+� ' SUbdIvhlOfl lmpr0yPermiteny Pan...+40
Minor lI' wommant Ptfln �"_�+�•�'•~ }i.;k
LOCATION PF CONMUC17ON K � IV
!Schee regrnt or C•*dagotrw Of Lotaaogl {;
PURPOSE OF CONS RUC"nON _ • ;' ` 1
Skati�+ lattltch OOmtruetien
plana ' appropry►. ;'
Q SPT ON a� 5QN RucrION�1%Lxsh i Ar,
�.
DIMENSION OF INSTALLATIO R fiEMOVAL
: � � - _ � f Via' �� `�� .' •- ' ;,, ' ..
SIZE OF EXCAVATION, IF NEEDED
L10 A��62 142
APPROXIMATE TIME WEN WORK "LL.BEGIN L
�I
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCnON COST S
(IndudinQ removal Of aq Obstruction, mamals, and de", backfilling, cam.
piston and placing permanent fensriswn and/ar rootsang improvernerrtal n er
In consideration of the granting
. t 9r"an req of L'1is partrut, the epplicent hsraby agrees to, � �.;•i;.;'., '
Ind•mnlfy, d•terd " w" the City, rte tua+orltad wf a, ofl'wan, ftrea oftir • and emolorva. hannl•e Iron+ •nd siv a* all
06WIM, Ii•brlrti•a ar WM tMJtUq been elo"M of. court #000" and ermnIt out of tiny aceaeent. Iona of drnYp tQ mormA. 4W W
no whine or amm" iq a1 a omxwmtt lerutt of any "am uAliff"h R ionow ow tetmR "A, t" Aurvam to this ousel n m r''•,' '�'
• .• Ntitlfy tlf• Admmrrelroewe Avtnwnv at bolt twvr+tp•tbvr Iie) ha+►rt wt adwilrw• Of ttul hent vRieit evork wdi be •ra+tad. .
Conray w+tn IU eea+rad• City Orei+esekva, the tarot Md tbndltlwla of the owmn ane all rmo ki"s of too City of
V Quints uw to Ow for •rrV "dm" mneme n• ommy 06 Ata rower of it vrork. {
- r Signa r of Applicant at Agent
n I t tole Lr5d—pt-AName of Aei `1
p lcrn pl Or,nti 9usinalt Addrtss T•laonoms No.
Name at Contfactof Ira JQbf oremen $uunest Addrats T No.
Contractort L,centa No C
- - � itY eualnest Lit:anta Na.
Applicant's Insuranaa Compaety poiiey Number
FEES: Subdivnion Inlortneffient Pefmrt Clan III
. ` Public improvements; 3% of sm"Ied con:trumon r:Ott3
Private Irnprovemmnts:'3%of asurnated construction Costs * �a r '
Minor Improve
nwflt P
er It — Ctatt (V: Set atuched sdwdulo
imoeetlon Fee ^ S ( PERMIT VALIDATION '
, Permit Fee
Fmilty
C+slt Doom t•Suratv.sand DATE APPROVED
If reaulretl
EXPIRATION DATE
' 'TOTAL. e ,
"'°"' DATE =UEO