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1127NOTE ' With.proper validation this form constitutes an CITY OF LA QUINTA encroachment permit 'APPLICATION FOR PERMIT' PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) r" C�` 01 T08�ws For the -.construction of publicor 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 III DATE: ••6/,13/91 Minor, Irnprovement Permit.Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) BOMAG GRINDER PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) 10' W.,GREEN.WT. ALL ELSE LEGAL '.DESCRIPTION OF CONSTRUCTION ROUTE: ALVARDO & MONTEREY, TO BERMUDAS TO 52ND TO CITY - LIMITS.' -.DIMENSION OF INSTALLATION.OR REMOVAL DATE: 6/14/91 SIZE'OF EXCAVATION, IF NEEDED AP PROXIMATE. TIME WHEN WORK WILL BEGIN' 6/14/01, .APPROXIMATE TIME OF COMPLETION 6/14/91 ':ESTIMATED CONSTRUCTION COST $ (Iricluding'removal of all obstruction, materials, and debris, backfilling, com- paction om 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. Cornply 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 4 Signature of. Applicant or Agent TARMAC PA. BOX -14050 PALM DESERT, CA 92255 360-4500 Name of Applicant: (please print) Business Address Telephone No. Name'of Contractor and Job Foreman Business Address Telephone'No ON FILE ON FILE Contractor's License No. City Business License No. ON -FILE ON FILE Ap'iicant's;Insurance Company Policy Number FEES- Subdivision Improvement Permit —Class l l I, ` Public improvements: 3%0 of estimated construction costs Private improvements: 3% of estimated.construction costs '. 12.7 Minor Improvement Permit — Class IV: See attached schedule . . Inspection.Fee i $ PERMIT VALIDATION 10:00 ;. Permit Fee PERMIT NO. -Penalty 21,6/13/91 Cash Deposit -Surety Bond DATE APPROVED ifj'equired- 6/ 14/91 •• 10.00 EXPIRATION DATE TOTAL: $DATE ISS ED 6/13/91 , Receipt No. By. Received by' Date Administrative Authority Recorded by TELEPHONE (619) 564-2246 t h.. Y NOTE: With proper validation this form constitutes an encroachment permit - 0 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 III DATE- 6/13/91 Minor Improvement Permit Class IV LOCATION OF CONSTRUCTION (Street address or Description of Location) BOMAG GRINDER. PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate) 10' W GREEN WT. ALL ELSE LEGAL DESCRIPTION OF CONSTRUCTION ROUTE: ALVARDO & MONTEREY, TO BERMUDAS TO 52ND TO CITY' LIMITS. DIMENSION OF INSTALLATION OR REMOVAL DATE: 6/14/91 SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 6/14/91 APPROXIMATE TIME OF COMPLETION 6/14/91 ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction, materials, and debris, backfiiling,.com- paction and placing permanent resurfacing and/or replacing improvements) In consideration of the granting of this permit, the applicant hereby agrees to: ¢ z. Indemnify,•defend and save the City, its authorized agents, officers, representatives and employees, harmless from and agai ist�any and all „. . penalties, liabilities•or loss resultingfrom claims or court action and arising out of an accident, loss or damage to �€kYN" p ` y ` g y g persons or pro ert 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 P.O. BOX 14050 PALM DESERT, CA 92255 360-4500 Name of Applicant (please print) Business Address Telephone No. r Name of Contractor and Job Foreman Business Address Telephone'No. ON FILE ON FILE. Contractor's License No. City Business License No. ON FILE ON FILE " .Applicant's Insurance Company Policy Number FEES: Subdivision Improvement Permit — Class I I Public improvements: 3% of estimated construction costs ; Private improvements: 3% of estimated construction costs x 2 Minor Imp ovement.Permit — Class IV: See attached schedule ' Inspection Fee %. $ 10.00 PERMIT VALIDATION �1 Permit Fee NO 1127 � PERMIT Penalty ' Cash Deposit -Surety Bond if. required 10.00 TOTAL: $ Receipt No. Received by Date J by r• DATE APPROVED 6/13/91 EXPIRATION DATE 6/14/91 f.r� weti^ 6/13/91 DATE ISS ED By Administrative Authority TELEPHONE: (6)9) 564-2246 R k S 1 _ if• P 0 1 .r © 5 M A= s .. JUN — 1 3 — 9 1 T H tJ - � • �,�,-- �.. r' ( NOTE: yy►{p proper wlitfi01�1 • ': '` �, ' y' _ this farm caromw CITY OF U0. GlU1NTA • encroeatcrwnt pertnic • � AfPLICATIQN FOR PERMIT ', +• PUBLIC WORKS CONST'RUCTJON (ENCROACHMENT) ' For iris eonsuv=on of public or privets euros, drivnweVs, `save -101 , sidewe4ks, parking iota, ;Mosta, Wr MW tremae•• and other like public +troetta immrew'rtettts In connmmon with MINOR IMPROVEMENTS and APPROVED SIiBOIVt>510a+t9t Subdivlsion itri*owmant Permit s Clew III WE: � - Minot' Imwoviorneitt Permit Ctatit IV LOCATION PF CONSTRUCnON �$MM7 ea0ro� M �esr+woo+e tw laaeasoe�Y • ,' tPURPOSE I. ; s �,' , OF CCN5Y€ =ON r.� � Sketch (11mc t construction pia eppto�eirorj ��r�- DESCRIPTION QF ossa u ' DIME 510N OF INSTALLATION �) EMOVAL C140 ' SIZE OF EXCAVATION, IF NEEDED < 'APPROXIMATE TIME WHEN WORK WILL BEGIN • APPROXIMIATETIME'OFCOMPLIMON ESTIMATED CONSTRUCi`ION COSTS (IneJudinq Pamov4l of all obatrvction, matanale, and do0fif. backfilling, aorrr Pacaon and plar:ing permarprit rvettrfats sg and/or replacing improVNnionta) In f mideratlon of the Wanting of this permit. the appOcant,hereav agrees tot � ' � • . ' Ire —ov, aMa W4 ecus fAa City, r4A evtnaweotl 6"N". oN4cie t, tapwrah"tnw 4M trnvtvrese,14"T" et from ono eger�et asp asci Oil { >' o•�eltwn.•6"Itlties at too rotuetwne from HOMIA ter Lawn scum e+d aneme cwt of Wv tecatern, lose M Oonep 0p owwoe or *Nww r '.Hno�1M�'t W �rYnq to a OfOxwelle remelt at 4" worts Wrowt on viam 00 Poo if! oremwo aunrwtt 0 tIM et��nme. ."•:"�, t• . ``' NtiUty the Aommarmwe Avehonty 19 teaat .#wr 4241 haus lo awrerto Ot the time taneT a ort `.::.. ;. •:.. toAeeev Mn11.b eterwd, ; ` ' Ca*av .wttl ell.gpp,mpy Clty OeeeaMoos. t?se ientr+'i?10 tM prrnrtn w.i6 allwlMoelslo runts Na rrpewirlaoeicit tlai1CIN ,.. 'Tp • .i .j(. %.... ;".%.� ',.:. .. .. .,..,... G•.., t.0 4�uln4 AfM �e I rtl�"!�rr�men'aer+t ..n 4�I tt! ,WOt1I, '. .... ... - ::r •. �: ' . 'v'n- �4 ' .Y � �0,'. • � � � ,. .t ' .. .. ��:� :' �.r'Sd .v,r,� Vin,." Si r o Applicant at V/9. Al . Name of oputant tp+case tYtint3 - 6otlnesf Addttss teletst+orna Nv.N. t;i: a , Name of Contract a Ja fanman 84sineu Addrest Tete N C.anttaetor'I L•censo o City Business Lianu No. Aaalleant's insurance Camwy j `' Policy Number . '{ �IreIIW,.•� �.� ' r isr�l �,� mr I�� lor♦— ®+I,�RA,�M�!l,.�� - FEB, Subdivision (mbrwetitent Pern+rt ••Class ill r r } Public itnprovamK9tts; 376 of esamettd ecimmuttcon com Private lrtlpro."nu, ,% of esantsttd construction crri'a ° Minor Improvement Penna - Claw 1V: Seta otucned tcheauls lnsfxetlon Fee 5 W i PERMIT VALIDATION , `R9tnin Fee = .'O, �1 • .. �+ Oaaoslt�Surery Bond DATE APPROVED , t It eeaulrat! * EXPIRATION DA'T'E TOTAL S DAT1E ISSUED ..._ ' RMlat No. ' - BV RialvtC by «. Bate.._ Admalat+t+nva Autl+onty" Arab; t bV TEL.EPHW F- (6121 46 , ,unratal �andh mfa��4a�,1-,•� • �S,r,��Y,Y�! � ��k �r