1134NOTE.
With proper validation
this form constitutes an
encroachment permit
.CITY OF LA QUINTA
APPLICATION FOR 'PERM,IT.
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.11 I
DATE: 6/25/91 Minor Improvement Permit Class IV
r
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION Sketch (attach construction plans, if appropriate)
' 'W, 15 H .�
.DESCRIPTION OF CONSTRUCTION 966 LOADER 10HAUL ROUTE: WASHINGTON & ,•
GREEN WT.
FRED WARING, SOUTH BOUND
TO 52, -'TO BERMUDAS, TO MONTEREY.,
DIMENSION OF INSTALLATION OR REMOVAL
AND TO ALVARADO
DATE: 6/25/91 OR 6/26/91
SIZE OF EXCAVATION, IF NEEDED
ONE DAY ONLY
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 ofrthis 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
11:3x'
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to this application.
N'otify.. 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 applicablerules and regulations of the City.of
La Quints. and to pay for any additional replacement necessary as -the result of this work:
t Signature of Applicant or Agent TINA GRACEY,
"TARMAC CALIF PO BOX 14050 PALM DESERT, CA 92255
Name of Applicant (please print) Business Address r Telephone No. "
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE' ON FILE
Contractor's License No. City Business License No.
OM PTT.F ON FILE
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement.Permit — Class I II
-Public improvements: 3% of estimated construction costs
1134
Private improvements: 3% of estimated construction costs `
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee 10.00 11.3q ;
PERMIT NO.
Penalty 6/25/91
Cash Deposit -Surety Bond DATE APPROVED
if.,required EXPIRATION DATE 6/26/91
TOTAL: $ 10.00 6/26/91 .
DATE ISSUED
By
Administrative"Authority
TELEPHONE: (619) 564-2246
,�
• - . • -�,; -:.... ,.... ...._... _ � „e%.� - Y - ' - "\.:-n' � ... mow_ .-..L, �'-i..1;. _ ,v, �- �4 . � :,
-- __ _. _ _ _—_ _._..._ _ __.�__�_...._ _ �_ _ _ _.w _ _. _... ——--_ ..--_. _.-j_,_L...._
NOTE:
With proper validation
this form constitutes an
encroachment permit
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 work's improvements, in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
. Subdivision Improvement Permit — Class II I
DATE: 6/25/91 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
3
(Street address or Description of Location) "
PURPOSE OF CONSTRUCTION Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 966 LOADER 10'W, 15' H HAUL ROUTE: WASHINGTON &
GREEN WT. FRED WARING, SOUTH BOUND
TO 52, TO BERMUDAS, TO MONTEREY
DIMENSION OF INSTALLATION OR REMOVAL AND TO ALVARADO
F
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
DATE: 6/25/91 OR 6/26/91
Y
s
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
xk pendliies, 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 add itional,•replacement necessary as the result of this work.
1
ONE DAY ONLY
I -
P°�3��'+�.��
`
Signature of Applicant or Agent TINA GRACEY,' .
TARMAC CALIF PO BOX 14050
PALM DLSERT, 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 �.
Contractor's License No.
City Business License No.
ON FILE
ON FILE
Applicant's Insurance Company
Policy Number
' FEES: Subdivision Improvement Permit —Class III
r Public improvements: 3% of estimated construction costs 1134 /,
Private improvements: 3% of estimated construction
costs 4
Minor Improvement Permit — Class IV: See attached
schedule
Inspection Fee $
PERMIT VALIDATION
10.00,
Permit Fee
y
PERMIT NO.
Penalty
6/25/91
Bond Cash Deposit -Surety Bon
DATE APPROVED
6/26/91
if,required EXPIRATION DATE
10.00 �;� 6/26/91
•ext TOTAL: $
DATE ISSUED
Receipt No.
BY
Received by Date
Administrative Authority
Recorded by
TELEPHONE: (619) 564 2246
I -
P°�3��'+�.��
T U E
- 4 5 MAS .
.JUN -25-91 � .-...� ...........� � �---,_,,,.._...�. ..... r..• .� .... �..�.
NOTE:
YtRett a►opv wlidrtte►, '
tfib Poem Conmtttettm an CITY Of 'LA OUINTA
entyoaerernent ptrmrt '
APPLICATION FOR PERMIT
PUBLIC WORKS CONSIUCTION tENCROACHMENT) '
For the mrtruva,on of publle or prennsts cum%. driveways, psvento, to. udtwaiks, 0MIng lou, stovers, WSMV tvealeter.
And other like public Works imtxoverrw M in cannoccon yvith MINOR IMPROVEMENTS and APPROVED SUBDIVtSI&A
` Subdivision Improvement Parrrtrs Ctasa III
pAYE:_.. Miner ft►+Pertnh Chau IV ,,-
LOCATION QF CONS1'iIUCnON
rSMeirt eayrate or oUemobeo of Lam"I
PURPOSE OF CONMUCTION Sketch (atach C_o`rw vGion plane it
gt°
o jpTION Of C0=RU=ONZr-
as04 Ja� 912
go r to Arai—
.
DI ENSIGN OF INSTALLATION OR REMOVAL Ira r�✓'
40
SIZE OF EXCAVATION, IF NEEDED �O I(�j��•
APPROXIMATE TIME YMEN WORK WILL BEGIN r'v'I �✓ �� �•/
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST.i
(Indudinq removal of eq obto'tie wn, mturtala, and.debris, backfilling, darn•
paction and placing perinunarR resurtsmW end/or replacing Imorovemi rml oe
In t:onsideretion of the granting of this cermet, the applicant htrtby arm
Inderrrnrfy, 90006 Ona ewe the CItV. oil eutha+ted saerrw, 6MiVere, rwhselftPv Met ertd "love", h4rr"" from and "awM 4" arae M1
pane+tree, tistlriHiet tr tats emot,ne Mom.dermc of oaurc saran ane at*" out of arty wiziatrt, hose or Aamryn ib tw.rs. M wprs"
hetvenne or ocew+'r1a so a orwirmis npgdn Of erW wpk utimurteksin tlnoor Ohs Ps In grentets purk'wt to this s00rwnmh.
MARV the Admrnrnm a Awd:o" at lemt tmwry4our 1241 how" to W#*%as of Vie time Mien wain Mail be ItsrVd, , , • y„
Con+av'"I" all BMW -, Cdty orowrwat• ine'taniw ;�r:ss. g"+wierDni'�i m•'i !+?'n'ii iN.rwlk9we'dvia. oriai ''I„ i ,T�
. ..rw,e Oyrn4 aero m a- .i reowe'iwreA'o '4w Gti',d4,' •..�::
= , a' •'rti ,..ia• •-•••. a" for, envKkd+CkJi'+R,P i!1o�lteerVlnt :��!ylwani R'll'ene:IWAI Or n -0" 1". . ....,
S'ituM at A
Mt or Agent
Name of Wintl Ewsinttt address Telapmone
M.
Name oaf Coon�tractor jkn�fwo foreman Businau Addrtu Tale Or" No.
0
Contractor's L.unse No. City flusintss License No
Aaalicam's If-ftrancicwreany Policy Numtxr
FEES: Subdivision Imwovwffw t Permit -Clan III .
Public irnorpvanwnv: 3% of animated tonereructioa tom
Private ifl5woveMhUt 3% Of osnmated earuavrnah cam J/� j�
Minor Imorovernent Ptrnnt - Chis WV Set attarnMd st hextUlf l� l� '
tntoetuon Pta S
Permit Fee
Penalty
Cath Oettout-Surety Band
it reoulred
TOTAL; T- ,
Recerot No, ,
Rearvea by
Recorded by