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II
1' J
NOTE:
With proper validation
this form constitutes an
encroachment permit
µ
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
DATE
6/25/91
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION OVERSIZE LOAD
DESCRIPTION OF CONSTRUCTION 3 AXLE TRUCK TOWING
HOUSE, MOVING DOLLIES
DIMENSION OF INSTALLATION OR REMOVAL 30' X 70' ,X 17 H
SIZE OF EXCAVATION, IF NEEDED
Subdivision Improvement Permit — Class I I I
Minor Improvement Permit Class IV
Sketch (attach construction plans if appropriate) '
HAUL ROUTE; FRED WARING
BETWEEN•WASHINGTON AND JEFFERSON.
t
PILOT'CAR FRONT AND REAR.
SEB ATTACHED CONDITIONS.
i 0 051U Oi 2TOA Obi 25-9 i 0.00
13
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/26/91
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(Including removal of all obstruction,, materials, and debris, backfilling, com- A{MIZ. . Ipprh
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. # '
Signature of Applicant or Agent CAROL L. HAMIL, AGENT
ALLIED HEAVING MOVING INC. 2678 SO LILAC RIALTO 714-877-9393
Name of Applicant (please print) Business Address Telephone No.
BILL FOREMAN ,
Name of Contractor and Job Foreman Business Address Telephone No.
C494960
Contractor's License No. City Business'License No.
TRAVELERS YNSSCO. 660-7123040-8
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 1135
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $
Permit Fee
30.00
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $ 30.00
Receipt No.
Received by
Date
PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
6/25/91
EXPIRATION DATE
6/26/91
6/25/91
DATE ISSUED
By
Administrative Authority
Recorded by II TELEPHONE: (619) 564-2246
NOTE:.
With proper validation
this form constitutes an
encroachment permit . CITY 0 F 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
6/25/91 Subdivision Improvement Permit — Class III
DATE, Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
'
PURPOSE OF CONSTRUCTION OVERSIZE LOAD Sketch,(attach constructionplans if appropriate)
DESCRIPTION OF CONSTRUCTION. 3 AXLE TRUCK TOWING
HAUL ROUTE; FRED WAKING
HOUSE, MOVING DOLLIES
BETWEEN WASHINGTONAND JEFFERSON.
DIMENSION OF INSTALLATION OR REMOVAL 30' X 70' X 17 H PILOT CAR FRONT AND REAR.
SEE ATTACHED CONDITIONS.
SIZE OF EXCAVATION, IF NEEDED 005V'1.40 2 `-) 06-25-91 00. 1.3
is i WAL il- io.
APPROXIMATE TIME WHEN WORK WILL BEGIN 6/26/91
APPROXIMATE TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST $
(including' rem6val.of all obstruction, materials, and debris, backfilling, com-
BE
...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"propefty
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 CAROL L. HAMIL, AGENT,'
ALLIED HEAVING MOVING INC. 2678 SO LILAC' RIALTO 714=87'7_9393
Name of Applicant (please print) Business Address Telephone No.,
BILL FOREMAN
Na Me of Contractor and Job Foreman Business Address Telephone No..
'C494960
Contractor's License No. 'City ,Business License No.
TRAVELERS INSSCO. 660-712JO40-8
-Applicant's Insurance Company
Policy Number
FEES' Subdivision Improvement. Permit 7 -,,Class III
'Public improvements:, 3% of estimated constru,ction, costs
Private improvements: 3% of estimated construction costs 1135,
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee, $ PERMIT VALIDATION
Permit Fee 30.00
Dr-PRAIT NO
Penalty
Cask Deposit -Surety Bond
if required
TOTAL:: $ 30.00
Receipt No:;;
Received by Date'
Recorded by
os,� I
DATE APPROVED 6/25/91
.
EXPIRATION DATE 6/26/91
DATE ISSUED 6/25/91
IF
Administrative Authority
TELEPHONE: (619) 56.4-2246
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 .
Q Subdivision Improvement Permit — Class II
DATE: ` I Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street addressor Description of Location)
PURPOSE OF CO TRUCTIO �;, ���� Sketch (attach construction plans'if appropriate)
DESCRIPTION OF CONSTRUCTION
DIMENSION.OF INSTALLATION OR REMOVAL
SIZE OF EXCAVATION, IF NEEDED t�
APPROXIMATE TIME WHEN WORK WILLSEGIN
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.
Mn j a 14,9"
Signature of Applicant or gent
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.
Applicant's Insurance Company Policy Number
`'FEES,
4` Siii `divisign. frT provemenU'Perr�.it = Class -41 l
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs
Minor Improvement Permit - Class IV: See attached schedule
Inspection Fee $
Permit Fee
Penalty
Cash Deposit -Surety Bond
if required
TOTAL: $
Receipt No.
Received by Date
Recorded by
'PERMIT VALIDATION
PERMIT NO.
DATE APPROVED
EXPIRATION DATE
DATE ISSUED
By
Administrative Authority
TELEPHONE: (619) 564-2246'..
4 CONDITIONS FOR PERMIT 1135;
1.'• ALL MOVING•EQUIPMENT & STRUCTURE SHALL BE
EQUIPPED+WITH 'WARNING SIGNS"•
AND LIGHTED FOR NIGHT TIME.+MOVEMENT.
`.
+
I.` TWO -,PILOT CARS -.-SHALL BE FURNISHED FULLY EQUIPPED WITH FLASHERS,FOR;NIGHT
TIME.MOVEMENT".
t
3." FURNISH TRAFFIC FLAGGERS AS NEEDED.
y` `4:, STRUCTURE AND -,:ALL RELATED' MOVING. EQUIPMENT
SHALL PASS THROUGH .THE INTERSECTION''
OF FRED-WARING ANDyWASHINGTON STREET AFTER 10.00 PM'JUNE 25, 1991 AND PRIORr-
y > TO 6:00 AM,JUNE"26, 1991.
r 5.'r.MOVER SHALL NOTIFY';RIVERSIDE :COUNTY` SHERIFFS 'DEPT:- PRIOR .TO COMMENCEMENT ,
` OF MOVE THROUGH T'HE'CITY.'OF LA QUINTA.
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