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1143NOTE: With proper validation this form. constitutes an encroachment permit IWA CITY OF. LK,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 II I 7/9/91- DATE: Minor, Improvement Permit Class IV LOCATION OF CONSTRUCTION OVERSIZE RUNITERMIT (Street address or Description.of Location) 'PURPOSE OF CONSTRUCTION OVERSIZE LOAD Sketch (attach construction plans if appropriate) HAUL ROUTE: 3 AXLE TRUCK PULLING SCHOOL DESCRIPTION OF CONSTRUCTION *TO EAST ON FRED WARING' 'BUILDING -ON HUUSE MOVING DOLLIES WEST OUT OF CITY LIMITS 1'' ,DIMENSION OF INSTALLATION OWREMOVAL 30 W X 74 L X 16 H. SI.ZE-,OF. EXCAVATION, IF NEEDED PILOT CAR FRONT & APPROXIMATE ATE TIME WHEN WORK WILL BEGIN 7_10 1 191 .9n ATTACHED CONDITIONS., 4 AM APPROXIMATE TIME OF COMPLETION 2- ESTIMATED CONSTRUCTION COST $ MOVE AFTER 2 AOM. 'AND BEFORE (including removal of all 'obstruction, materials, and debris, backfilling, com- 4 A.M. Paction and placing permanent resurfacing and/or replacing improvements) .In consideration of the. granting of this permit, the applicant hereby agrees to: V -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 darnage'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 replacernerit necessary as the result of this work. Signature of Applicant or Agent AL ED.2INC.1I EAVY MOVING' IN2678 SO.' LILAC (7140877-0393' Name of Applicant (please print) Business Address Telephone No. BILL FOREMAN 2678 SO. LILAC RIALTO 714-077-0393 Name of Contractor and Job Foreman Business Address Telephone.No. C494960 Contractor's License No.. City Business License. No. TRAVkLERS,INS CO;. i Applicant's Insurance Company Po*lic er, 10 3080 07-09-91 14 ILV FEES: -Subdivision Improvement Permit — Class III "Public improvements: 3% of estimated construction costs Private improvements: 3%of estimated construction costs 1 43 Minor Improvement Permit — Class IV: See attached schedule Inspection Fee $ PERMIT VALIDATION 330-00 Parmit P.. Penalty Cash Deposit -Surety Bond jf,required -10.00 TOTAL: $ Receipt No. Received by Date Recorded by 'PERMIT NO. DATE APPROVED 7/9/911 7/iO/91 EXPIRATION DATE DArTE`TSSWED 7/9/91 By �a Administrative Authority TELEPHONE: (619) 56.4-2246 y.. o�.� �. e. , r .."rY �' .i.y�•. .tip - 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 DATE: 7/9/91 LOCATION OF CONSTRUCTION OVERSIZE RMInRMIT (Street address or Description of Location) PURPOSE OF CONSTRUCTION OVERSIZE LOAD Subdivision Improvement Permit — Class II I Minor Improvement Permit Class IV DESCRIPTION OF CONSTRUCTION 3 ABLE TRUCK PULLING SCHOOL BUILDING ON HWSE MOVING DOLLIES DIMENSION OF INSTALLATION OR REMOVAL 30'W B 74 L 1C 16 H SIZE OF EXCAVATION, IF NEEDED APPROXIMATE TIME WHEN WORK WILL BEGIN 7110191 Sketch (attach construction plans if appropriate) HAUL ROUTE: WEST TO EAST ON FRED WARING OUT OF CITY LIMITS APPROXIMATE TIME OF COMPLETION 2-4 AM 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: PILOT CAR FBONT r& REAR. SEE ATTACHED CONDITIONS. MOVE AFTER 2 A.M. AND BEFORE 4 A. M. Indemnify, -defend and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and all i 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 ALLIED HEAVY MOVING, INC. 2678 S0. LILAC (7148 977-9393 Name of Applicant (please print) Business Address Telephone No. BILL FOREMAN 2678 S0. LILAC RIALTO 714-877-8393 Name of Contractor and Job Foreman Business Address Telephone No. C494960 Contractor's License No. City Business License No. TRAVELERS INS CO. 660-712JO40-8 Applicant's Insurance Company Poliocfl0 elq 3080 27-09-91 14 FEES: Subdivision Improvement Permit — Class I I I 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 330.00 Penalty Cash Deposit -Surety Bond if required TOTAL: $ 10.00 Receipt No. Received by Date Recorded by 1143 PERMIT VALIDATION PERMIT NO. 7/9/91 DATE APPROVED 7/10/91 EXPIRATION DATE DA ED 7/9/91 gy G1...i Administrative Authority TELEPHONE: (619) 564-2246