1153f�s- -/• ,;if` �i�i 5�+f•�-e_ V*�`�`✓ , • i. l: C`is• +�^%ySt't.'. �.�"' '"-v�:�i"'. ;,` i" .�t'^� i'°'dN�I�i-ni';".+.iT+'^a iF..• .��--1.ro��r�!civ' 1'ti....!'••N-.'r ,f"'4,.�C{^,
41..
.. - , r �Gi ,. moi, ,, i, n - .. - Y •L -. l . . •. .- �`. ....... , � * rr•.1.-.:F.�. n
'� NOTE: • � -
With proper validation
this form constitutes an CITY OF LA QUINTA'
encroachment permit
APPLICATION FOR • PERMIT
PUBLIC WORKS CONSTRUCTION (ENCROACHMENT) ''• " ���
OF
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 III '
".., • ' .DATE: 7/16/91 Minor Improvement Permit Class IV
`°,LOCATIONbF CONSTRUCTION
(Street address or Description of Location) ,
:
, MOVE •EQUIP ,PURPOSE OF CONSTRUCTION - Sketch (attach construction plans if appropriate)
_ a
Q DESCRIPTION OF CONSTRUCTION 765 BACHER GREEN
ti 10'6°W GREEN WT ALL ELSE LEGAL. CAT PAVER•#9080' ROUTE:
WASHINGTON AT FRED WARING TO 52 TO
r�'DIMENSION OF INSTALLATION OR REMOVAL u. SEAS TO NOGAi.AS TO OBERGON.
7.� .. ,
•SIZE•OF EXCAVATION, IF NEEDED
u a
'. APPROXIMATE TIME WHEN WORK WILL BEGIN 7/17/91 -OR -7/18 91 '
'
!,'APPROXIMATE TIME -OF COMPLETION 7/17/91 OR 7/18/91
'ESTIMATED CONSTRUCTION'COST $ U
(Incl uding,removal,of all'obstruction, materials, and debris, backfilling, com ' n
.•-� paction and',placirig •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 losskresulting from claims or court action and arising -out of any accident, loss or damage to personsror 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
L La Quinta and to pay for any additional replacement necessary as the result of this work. w
. Signature of Applicant or,AgentB. -PHILLIPS
• TARMAC "CALIF P.O. B08 14050 PALM DESERT
Name of Applicant (please print) G Business Address'.' . Telephone No.'
Name of_Contractor,,and Job Foreman Business Address Telephone No. -
ON FILE _ 7 ON FILE
Contractor's License No. o City Business License No.
ON FILE '
Applicant's Insurance Company ' Policy Number
°FEES:, Subdivision •Improvement Permit —Class 111 ~
' Public improvements: 3% of estimated construction costs
153 . , Private improvements: 3% of estimated construction costs -�-1 �r
Minor Improvement Permit — Class IV: See attached schedule 1 '
Inspection Fee $ Y PERMIT VALIDATION
Permit Fee 10.00
Penalty
Cash Deposit -Surety Bond
if: required
TOTAL: $ 10.00
Receipt No.
Received by Date
Recorded by
"PERMIT NO
DATE APPROVED 7/16/91
EXPIRATION DATE 7/18/91
DSUED 7/16/91
By
Administrative Authority
TELEPHONE: (619) 564-2246
_ ya.
-NOTE:
With proper validation
this form constitutes an
encroachment permit
I
/..
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
Subdivision Improvement Permit — Class I I
DATE: 7/16/91 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIP Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 765 BACHER GREEN
10'6"W GREEN WT ALL ELSE LEGAL. CAT PAVER #9080
DIMENSION OF INSTALLATION OR REMOVAL
HAUL ROUTE:
WASHINGTON AT FRED WARING TO 52 TO
BERMUDAS TO NOGALAS TO OBERGON'
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 7/17/91 OR 7/18/91
`^ APPROXIMATE TIME OF COMPLETION 7/17/91 -.OR 7/18/91
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:
In6emnify, 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 AgentB• PHILLIPS
TARMAC CALIFP.0. BOX 14050 PALM DESERT'
Name of Applicant (please:print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE a ON FILE
Contractor's License No.� City Business License No.
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 1 5 3
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee
10.00
Penalty
Cash Deposit -Surety Bond
if,.required _
TOTAL: $ —,10.00
Receipt No.
Received by Date
a
Recorded,by
�a; .
PERMIT NO.
DATE APPROVED 7/16/91
EXPIRATION DATE 7/18/91
•7/16/91
.PATSUED
gyly Q ,"
Administrative Authority
TELEPHONE: (619) 564-2246
<«
Stu
�+•�
_ ya.
-NOTE:
With proper validation
this form constitutes an
encroachment permit
I
/..
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
Subdivision Improvement Permit — Class I I
DATE: 7/16/91 Minor Improvement Permit Class IV
LOCATION OF CONSTRUCTION
(Street address or Description of Location)
PURPOSE OF CONSTRUCTION MOVE EQUIP Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION 765 BACHER GREEN
10'6"W GREEN WT ALL ELSE LEGAL. CAT PAVER #9080
DIMENSION OF INSTALLATION OR REMOVAL
HAUL ROUTE:
WASHINGTON AT FRED WARING TO 52 TO
BERMUDAS TO NOGALAS TO OBERGON'
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN 7/17/91 OR 7/18/91
`^ APPROXIMATE TIME OF COMPLETION 7/17/91 -.OR 7/18/91
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:
In6emnify, 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 AgentB• PHILLIPS
TARMAC CALIFP.0. BOX 14050 PALM DESERT'
Name of Applicant (please:print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
ON FILE a ON FILE
Contractor's License No.� City Business License No.
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 1 5 3
Minor Improvement Permit — Class IV: See attached schedule
Inspection Fee $ PERMIT VALIDATION
Permit Fee
10.00
Penalty
Cash Deposit -Surety Bond
if,.required _
TOTAL: $ —,10.00
Receipt No.
Received by Date
a
Recorded,by
�a; .
PERMIT NO.
DATE APPROVED 7/16/91
EXPIRATION DATE 7/18/91
•7/16/91
.PATSUED
gyly Q ,"
Administrative Authority
TELEPHONE: (619) 564-2246
<«
�J Ut6 — 9 r TUE: uw .,.4 � �• ` �... wwr.:.W.rr. r� .e.�.....rr .er: r.a• o. �.
• •''".r NOTE: ""� _ _ �St"'L..-e t� .
` Whhprootrvelkistmi,
thb form oorm an
entroaoP+nwrK Oermtc
,,;�>- \•, 'rte
CITY OF LA QUINTA
.APPLICATION FOR PERMIT -
pUIBUC WORKS CONSTRUCTION (ENCROACHMENTf
' For tilt acnmucuan Of WNW of orrwts Clubs, drivewoys, pavankilms. sidewalks. Ping low. iewais. Wamer�vgllsg.
end other like Irrnlic works imyryrgrrwnta in conntman with MINOR IMPROVEMENTS and APPROVED SUaoIVISIOW
"4411
SIAWW ian Improvornant Pernlrt - CAO iii
DAtE: Mina Irnpvvfftwn Ptrrma Clul IV
LOCATION OF CONMUCTZON
15tr.rt roarer a paerspsipe a t�ssvoni ,
PURPOSE OF CONSTRUCTION . , 1 5k�+tc`f tur#I comwcclan tem H ep is
0 NOF �Q RtSCtiON ��� QLI%r�°.., �GCSfI �� �ti.,•;; .
DIMENSION OF INSTALLJITI OR REMOVAL.'
SIZE OF EXCAVATION, IF NEEOEO �loom
APPROXIMATE TIME WEN WORK VOLL BEGIN �~
APPROXIMATE. TIME OF COMPLETION
ESTIMATED CONSTRUCTION COST S
Iinduding removal of all obtvi stun, mtltanela, and debris. backfill1% pvrtrAir
pgcvon and pladng pwmrnsm romfsam and/or replacing Imorovwt,onta)
In ponttderstlon of ells gi8mting of this permit, tfis applicant henbv. eget to:
ITA-wN, mtw o arm a" rile Clty, in tutr,omod sertes: of 0n, reonwhusrvu wrd ri ftlaye", hantrrm twn or* Anna aw a" 40
penrliM, 1"1116" ar Ion nrwnbrg fMM'Mrna W CouR amen and VOW4 out of env ae,:rasnt, ICU or out*" sa pwmes ar viraoner :>
(taxwA N W oOGi yov a a orggie t " mwrt at ww v'&+ wmw• tomes the orrmrt remrq ounumin to on eovfstestn. ' ••j �• �.;r
NOON the A"(mft mrr Authgr w at tort hv"w4mr 44) hour in edom of Ihr wm "&n nor twit bo rtrnad. �., �: ,• �v
t:om01V vnet'all rrm+�Cu CNv QnA+,rnasf. the t,bRRt;6r+q'tlFlh�tl'ti0nt' 11< dN�11N++�n+�tf0 {11 rdWkikdr Wia Intl rTgWMIN+C,0) Ods tit�r;rt,'_�", ;,fit • �,:,7`� ,•,"
Tor tRn'iiKNi%
.,_.6a Orrna p+a IG gra amr eddtrk,rwt�rro,+orine nso.ti�ivbri' q} Viit.wort.-� ;.:.
` ., 5i WA of an or Agent
Name of Aoottt ant tplaetg irtrltl Butt Address 1`de No.
Nrme at COntfactat ena a F rmiln Suuneu Addaa Tata one o, f
f`
0'1f/rte _ _f �`' L 5�..,_...
Con"mor t L."nie No, City suslnu License No.
Ammant•s Inturana Comoanv Policy Numoer
FEES; Subdwuion Imcravvmem Pe"n CUO III '
Public imomm"nnes: 3% of enowted eonstruetton cosh
Privete Imorovemants: 3% of amnuted contemn em
Minor It"Wavrmenl PrYtntt _ Class IV: Seo mood sdwdula
it oeaton Per S PERMIT VALIDATION
vo
tEgMIT "0.
Penalty
Cath 0eooslr5uraty Bond OATS APPROVED
If rooutred �� EXPIRATION DATE -
TOTAL: — - -- = DATE ISSUED
By r'
Rrorraeo by Dau .. v ,_.... » A mtnattrsari Avrom. y