1129• NOTE.:
With proper validation
this form constitutes an CITY OF LA QUINTA
encroachment permit
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 6/19/91 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
HAUL
OVERSIZE.LOAD
PU1 0NTRU5°�
Sketch (attach construction Plans if appropriate)
14 -
DESCRIPTION OF CONSTRUCTION CAT D8 WITH BLADE REMOVED
AND.LOADED ROUTE: SO. ON PARK
WEST ON 50TH'TO WASHINGTON
DIMENSION OF INSTALLATION OR REMOVAL WASHINGTON; SQ 111 "
SIZE OF EXCAVATION, IF NEEDED - PROVIDE ALL REQUIRED SAFETY AND ;
SA WARNING DEVICE INCLDDING.SIGNAGE;.;
APPROXIMATE TIME WHEN WORK WILL BEGIN • 6/19/91.'FLAMES AND. FLAGGING
APPROXIMATE.TIME OF COMPLETION 6/19/91 TWO PILOT •,,,VEHICLES REQUIRED
ESTIMATED CONSTRUCTION COST $
,.(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements) n —40_04 14
In, consideration of the granting of this permit, the applicant- hereby agrees to: 10 CASH i TAL i i0.00'.
.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.
ell
Signature of Applicant or Agents ;
". DALTON TRUCKING' 13560 WHITTRAM FONTANA, CA 92335 714=823-0662'
Name'of Applicant (please print) Business Address I Telephone No.
Name of Contractor and Job Foreman Business Address t Telephone No.
ON FILE ON. FILE
Contractor's License No. City Business License No. r
ON FILE, ON FILE:
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 9'
,�.
:Minor Improvement Permit — Class -IV: See attached schedule
pspection Fee $-
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
i•f'requ fired
TOTAL: $ 10.00
Receipt No.
r Received by Date
Recorded by.
PERMIT VALIDATION
PERMIT NO.
DATEAPPROVED 6/19/91
EXPIRATION DATE 6/19/91
DATE ISSUED 6/19/91
!By .
Administrative Authority
TELEPHONE: (619) 564-2246
I
e
A2
} r
47'L. g
NOTE:
With proper validation x'
this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION. FOR PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT)
. F
r
Yv
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 IMPROVEMENTSand APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Classl_II
DATE:. 6/19/91 Minor Improvement Permit Class IV -
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PU1Rf�p OE CONSTRUCT HAUL OVERSIZE LOAD Sketch (attach construction lans if appropriate)
ON !AX 14b�� P
DESCRIPTION OF CONSTRUCTION CAT D8 WITH BLADE REMOVED
AND LOADED ROUTE: SO. ON PARK .
WEST ON 50TH TO WASHINGTON.
DIMENSION OF INSTALLATION OR REMOVAL WASHINGTON',30 111
SIZE OF EXCAVATION, IF NEEDED - PROVIDE ALL REQUIRED SAFETY AND
SA WARNING DEVICE INCLUDING SIGNAGE,
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/19/91 FLAMES AND FLAGGING
APPROXIMATE TIME OF COMPLETION 6/19/91 TWO PILOT VEHICLES REQUIRED .
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent -resurfacing and/or replacing improvements) 00§&Q-)4 o_a< - 14
In consideration of the granting of,this permit, the applicant hereby agrees to:. i CA$N 1 -0-TA1 10. 00
'
Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against anyand all
penalties, liabilities or.loss resulting from claims or court action and arising out of any accident, loss or damage to persons o� 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
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.
t,
ON FILE ON FILE
Applicant's Insurance Company Policy Number,'
FEES: Subdivision Improvement Permit - Class 111
Public improvements: 3% of estimated construction costs
' Private improvements: 3% of estimated construction costs 1 29
Minor Improvement Permit Class IV: See attached schedule .
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 /12
PERMIT NO.
Penalty
g Cash Deposit -Surety Bond - if. requ ired
TOTAL: $ 10.00
Receipt No'.
Received by
Date
DATE APPROVED 6/19/91.
EXPIRATION DATE 6/19/91
6/19/91
DATE ISSUED
Administrative Authority
Recorded by II TELEPHONE: (619) 564-2246
NOTE:
With proper validation
- this form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT EB
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
q Subdivision Improvement Permit — Class Ill
DATE: e 1 / Minor Improvement. Permit Class IV
„ LOCATION OF CONSTRUCTION -
{
1
".,,,(Street address or Description of Location) / ... • •�
f/u I e/'�SI e a� , .
w;_PURPO E OF CONSTRUCTION ✓r Sketch (attach construction plan if appropriate) >
DESCRIPTION OF CONSTRUCTION g. oil/
DIMENSION OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED
Ob
�'D �Oas�J`�,1
APPROXIMATE TIME WHEN WORK WILL BEGIN. r
APPROXIMATE TIME OF COMPLETION pD /
ESTIMATED CONSTRUCTION COST S
(Including removal of all obstruction, materials, and debris, ba kfilling, com-
paction and placing permanent resurfacing and/or repiacing_improvements).
In consideration of the granting of this permit, the applicant hereby agrees to:
F .
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 4241 hours in advance of the time when work will be started. F
A
j�• Comply with all applicable City Ordinances, the terms and conditions of the permit and all applicable rules and regulations of the City of
' f La Quinta and to pay for any additional replacement necessary as the result of t is work.
Sig/nature of Applicant c� Agent +
43 SO � t A" -=o -74 #a 64 522W,5 %l 9'23-09Z
j. Name of Applicant (please print) . V Business Address Telephone No.
ff,'4Name of Contractor and .lob Foreman Business Address Telephone No.
a}. Contractor's License No. City Business License No.
®
f` 6 tel^' / /e
` Applicant's Insurance Company Policy Number