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NOTE
With .proper validation rt
this form constitutes an
encroachment permit CITY OF LA QUINTA
APPLICATION .'FOR PERMIT ;.
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
nv
" For the construction of: public or. private curbs, wclriveways, 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 II
DATE: 6/19/91 Minor Improvement Permit'Class IV
LOCATION OF CONSTRUCTION
(Street addressor Description of Location)
HAUL OVERSIZE LOAD ON
PUgpOAX SE OF CONST IUCIIIgN 8 L Sketch (attach construction plans if appropriate).*
7 LEGAL H..0 W.
DESCRIPTION OF CONSTRUCTION CAT 14G BLADE ROUTE: SO. ON PARK
WEST ON 50TH TO WASHINGTON
WASHINGTON -10 111
DIMENSION OF INSTALLATION OR REMOVAL t
SIZE --OF EXCAVATION, IF NEEDED
APPROXIMATE TIME -WHEN .WORK WILL BEGIN 6/19/91.-
.8051
/19/91 pp051gg� 1�0 2 p p6—i9-91 14
i 0 =,C A i TOTAL i 10.^00
'APPROXIMATE TIME OF COMPLETION •6/19/91
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 ;
t
penalties, liabilities ori 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 anywork 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 thiF work.
Signature of Applicant or Agent
DALTON TRUCKING 13560 WHITTRAM FONTANA, CA.92335 714-823-0662
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.
' Applicant's Insurance Company Policy Number:
FEES`: Subdivision Improvement Permit - Class II
Public improvements: 3% of estimated construction costs q i p
Private improvements:. 3% of estimated construction costs l t 2 Q a
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00
PERMIT NO.
Penalty 6/19/91
Cash Deposit -Surety Bond DATE APPROVED
if required EXPIRATION DATE, 6/19/91
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded• by
DATE ISSUED 6/19/91
By
Administrative Authority
TELEPHONE: (619) 564-2246
NOTE:
With proper validation
this form constitutes an
encroachment permit
1 CITY OF LAS 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,lI I
DATE: 6/19/91 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURfO 0 STRUCTI N HAUL OVERSIZE LOAD ON Sketch .(attach construction plans if appropriate)
/. AX LEGAL H. 10'W. L
DESCRIPTION OF CONSTRUCTION CAT 14G BLADE ROUTE: SO. ON PARK ~
WEST ON 50TH TO WASHINGTON
WASHINGTON TO 111
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/19/91 t goo0 p
800 1 �SH012 ,6OA 1i 9-9110.00 14
APPROXIMATE TIME OF COMPLETION 6/19/91
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 onloss resulting from claims or court action and arising out of any accident, loss or damage to persons 'or propeety
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. 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.
Signature of Applicant or Agent
DALTON TRUCKING. 13560 WHITTRAM FONTANA, CA -92335 •714=823-0662
Name of Applicant (please print) Business Address Telephone No.
1
-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 I
Public improvements: 3% of estimated construction costs J
Private improvements: 3% of estimated construction costs 1
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
ifxrequired„
TOTAL: $ 10.00
Receipt No.
Received by
Recorded by
Date
PERMIT VALIDATION
PERMIT NO.
el Z P
DATE APPROVED
6/19/91
EXPIRATION DATE
DATE ISSUED
6/19/91
A6/19/91
_L By—
AAq�a�
Administrative Authority
IITELEPHONE: (619),564-2246
NOTE: f .
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit 5.
APPLICATION FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
0
1.
For the construction of public or private curbs, driveways, pavements, sidewalks, parking lou, sewers, water mains
and other like public works improvements in connection with,'MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
CLQ/ Subdivision Improvement Permit — Class III
DATE: , l ` `r Minor Improvement Permit Class IV r„_,._
LOCATION OF CONSTRUCTION '
,•} (Street address or Description of Location) /
PURPOSE OF CONSTRUCT{ON du / APV Z� L d®� Sketch (attach construction plans if a pro riots
r� 1
DESCRIPTION OF CONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL
vAa- 5o opt /,q
'SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION L GUaS
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, badkfiiling, com.
paction and piicing 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 (241 hours in advance of the time when work will be started.
Comply with all applicable City Ordinances, the terns and conditions of the permit and all applicable rules and regulations of the City of
La nuinta and 'to pay for any additional replacement necessary as the result of this wgrk. „
la
I
Signature of Applicant or Agent
l%�i e ids t od d C4.327/�
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.
X0
Applicant's
Applicant's Insurance Company Policy Number
Z3D662